Ultrasonographic Effectiveness in Hypotensive Patients

Objective: This study aimed to investigate the efficacy of sonography in reducing morbidity and mortality among patients with shock, particularly in the emergency department (ED). By employing the “Rapid Ultrasound for Shock and Hypotension” (RUSH) protocol with ED patients, the aim was to assess its contribution to patient outcomes. Materials and Methods: This prospective, cross-sectional study spanned 2 years and was conducted in a university-based emergency department. Overall, 100 adult patients with blood pressure ≤90/60 mmHg and shock index >1 were enrolled. The RUSH protocol was followed for each patient. Results: The study comprised 35 females and 65 males, with a mean age of 57.12 ± 17.1 years. The RUSH assessment indicated that 50 patients had fluid volume indices below 1.5 cm, predominantly presenting with hypovolemic shock (55%). Extended Focused Assessment with Sonography in Trauma (E-FAST) examination revealed free abdominal fluid in 18% of the patients. Cardiogenic shock, including arrhythmia and heart failure, was diagnosed in 9 patients each. Nine patients experienced obstructive shock. Initial RUSH protocol diagnoses included hypovolemic shock ( n = 55), distributional shock ( n = 19), cardiogenic shock ( n = 8), obstructive shock ( n = 6), and complex shock ( n = 12). Conclusion: The RUSH protocol has emerged as an early, systematic, and practical method for assessing patients with hypotension and shock in the ED. It may also offer the potential to enhance patient management and outcomes.