Repository of Research and Investigative Information

Repository of Research and Investigative Information

Baqiyatallah University of Medical Sciences

Accuracy of early rapid ultrasound in shock (RUSH) examination performed by emergency physician for diagnosis of shock etiology in critically ill patients

(2015) Accuracy of early rapid ultrasound in shock (RUSH) examination performed by emergency physician for diagnosis of shock etiology in critically ill patients. J Emerg Trauma Shock. pp. 5-10. ISSN 0974-2700 (Print) 0974-2700

[img] Text
Accuracy of early rapid ultrasound in shock (RUSH) examination performed by emergency physician for diagnosis of shock etiology in critically ill patients..pdf

Download (92kB)

Official URL: http://www.ncbi.nlm.nih.gov/pubmed/25709245

Abstract

BACKGROUND: Rapid Ultrasound in Shock (RUSH) is a recently reported emergency ultrasound protocol designed to help clinicians better recognize distinctive shock etiologies in a short time. We tried to evaluate the accuracy of early RUSH protocol performed by emergency physicians to predict the shock type in critically ill patients. MATERIALS AND METHODS: Our prospective study was approved by the ethics committee of trauma research center, Baqiyatallah University of Medical Science, Iran. We enrolled 52 patients with shock state in the emergency department from April 2013 to October 2013. We performed early bed-side 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. Agreement (Kappa index) of initial impression provided by RUSH with final diagnosis, and also sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RUSH for diagnosis of each shock type were calculated. RESULTS: Fifty-two patients were enrolled in our study. Kappa index was 0.7 (P value = 0.000), reflecting acceptable general agreement between initial impression and final diagnosis. For hypovolemic and obstructive shocks, the protocol had sensitivity of 100 but had lower PPV. For shocks with distributive or mixed etiology, RUSH showed PPV of 100 but had low sensitivity. For cardiogenic shocks, all reliability indices were above 90. CONCLUSION: We highlight the role of RUSH examination in the hands of an emergency physician in making a rapid diagnosis of shock etiology, especially in ruling out obstructive, cardiogenic, and hypovolemic types.

Item Type: Article
Keywords: Accuracy predictive value rapid ultrasound in shock shock ultrasound
Divisions:
Page Range: pp. 5-10
Journal or Publication Title: J Emerg Trauma Shock
Journal Index: Pubmed
Volume: 8
Number: 1
Identification Number: https://doi.org/10.4103/0974-2700.145406
ISSN: 0974-2700 (Print) 0974-2700
Depositing User: مهندس مهدی شریفی
URI: http://eprints.bmsu.ac.ir/id/eprint/1769

Actions (login required)

View Item View Item