RUSH checks the pump (LV, RV, pericardium), the tank (IVC, lungs, peritoneum, pleura) and the pipes (aorta, leg veins) to classify shock in minutes. eFAST looks for free fluid and pneumothorax in trauma.
At the bedside
Timed steps- 1
Heart
PumpEffusion/tamponade, LV function, RV size.
- 2
Volume
TankIVC, lung B-lines, pleural fluid, peritoneal free fluid (Morison's pouch, splenorenal, pelvis).
- 3
Vessels
PipesAbdominal aorta (> 3 cm = aneurysm; flap = dissection), femoral and popliteal veins for DVT.
- 4
eFAST
TraumaRUQ, LUQ, pelvis, subxiphoid pericardium, both anterior chests for pneumothorax. Repeat if the patient changes.
- 5
By pattern
ActHypovolaemic, distributive, cardiogenic or obstructive shock (see module 3).
RUSH patterns
| Hypovolaemic | Cardiogenic | Obstructive | Distributive | |
|---|---|---|---|---|
| Pump | Hyperdynamic, small | Poor contractility, dilated | Effusion/tamponade, dilated RV | Hyperdynamic (early) |
| Tank | Flat IVC, free fluid | Plethoric IVC, B-lines, effusions | Plethoric IVC, absent sliding (tension) | Normal or small IVC, possible fluid (peritonitis/empyema) |
| Pipes | AAA, dissection | Normal | DVT | Normal |
References
- 1
- 2
RUSH sequence
Step 1 of ~5
Pump: effusion, LV, RV
Based on Perera P, Mailhot T, Riley D, Mandavia D. Educational use; follow local protocol.
Evidence
- RUSH (2010): structured approach to shock; subsequent studies show good agreement with final diagnosis.
- eFAST (2004): ultrasound was more sensitive than supine chest X-ray for traumatic pneumothorax.
🇮🇳 India notes
- Road traffic injuries are a leading cause of trauma in India; eFAST is a core skill in emergency departments and ICUs (see module 5).
References
- 1
- 2
Test yourself
Module quiz · score 70% to complete the module
Educational reference for trained clinicians. Check doses against your hospital protocol and the patient in front of you.