application of RUSH(rapid ultrasound in shock and hypotension)protocol on patients presenting in emergency with Shock

Background: Emergency ultrasound examinations should be done for a clearly defined emergency condition. RUSH (Rapid ultrasound in shock and hypotension) protocol in an emergency setting can play a vital role. The present study was conducted with the aim of applying RUSH protocol on patients with shock in the emergency department. Materials and methods: The present cross-sectional clinical observational study was conducted in the Emergency department. Only 57 samples were selected by non-random sampling method in this study. We performed an early bedside sonographic examination for participants based on RUSH protocol. Patients received all needed standard therapeutic and diagnostic interventions without delay and were followed to document their final diagnosis. The data analysis was done with help of SPSS 18. Results: Our study had overall sensitivity of 93% and specificity of 96% with kappa index of 0.85 which shows good agreement (85%) of our RUSH protocol with the final diagnosis. In addition, distributive shock showed the highest degree of agreement with the final diagnosis (kappa index=1) followed by hypovolemic (kappa index=0.91), cardiogenic (kappa index=0.83) and obstructive (kappa index=0.71). While, mixed variety of shock had the lowest agreement (kappa=0.70) with the final diagnosis. Conclusion: The RUSH protocol is significantly effective in making a rapid diagnosis of shock etiology, especially in ruling out obstructive, cardiogenic, and hypovolemic types. Moreover, the protocol can be helpful in minimizing morbidity and mortality among shock patients in the emergency department.