Accuracy of Early Rapid Ultrasound in Shock (Rush) Examination Performed by Emergency Physician for Diagnosis of Shock Etiology in Critically Ill Patients

Accuracy of Early Rapid Ultrasound in Shock (Rush) Examination Performed by Emergency Physician for Diagnosis of Shock Etiology in Critically Ill Patients Publisher

Ghane MR¹ ; Gharib M² ; Ebrahimi A³ ; Saeedi M⁴ ; Akbarikamrani M⁵ ; Rezaee M⁶ ; Rasouli H⁶

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1. Department of Emergency Medicine, Baqiyatallah University of Medical Science, Tehran, Iran
2. Department of Radiology, Iran University of Medical Science, Tehran, Iran
3. Department of Surgery, Baqiyatallah University of Medical Science, Tehran, Iran
4. Department of Emergency Medicine, Tehran University of Medical Science, Tehran, Iran
5. Department of Ophthalmology, Tehran University of Medical Science, Tehran, Iran
6. Researcher, Trauma Research Center, Baqiyatallah University of Medical Science, Tehran, Iran

Source: Journal of Emergencies# Trauma and Shock Published:2015

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.

Style	Citing Format
MLA	Ghane MR, et al.. "Accuracy of Early Rapid Ultrasound in Shock (Rush) Examination Performed by Emergency Physician for Diagnosis of Shock Etiology in Critically Ill Patients." Journal of Emergencies# Trauma and Shock, vol. 8, no. 1, 2015, pp. 5-10.
APA	Ghane MR, Gharib M, Ebrahimi A, Saeedi M, Akbarikamrani M, Rezaee M, Rasouli H (2015). Accuracy of Early Rapid Ultrasound in Shock (Rush) Examination Performed by Emergency Physician for Diagnosis of Shock Etiology in Critically Ill Patients. Journal of Emergencies# Trauma and Shock, 8(1), 5-10.
Chicago	Ghane MR, Gharib M, Ebrahimi A, Saeedi M, Akbarikamrani M, Rezaee M, Rasouli H. "Accuracy of Early Rapid Ultrasound in Shock (Rush) Examination Performed by Emergency Physician for Diagnosis of Shock Etiology in Critically Ill Patients." Journal of Emergencies# Trauma and Shock 8, no. 1 (2015): 5-10.
Harvard	Ghane MR et al. (2015) 'Accuracy of Early Rapid Ultrasound in Shock (Rush) Examination Performed by Emergency Physician for Diagnosis of Shock Etiology in Critically Ill Patients', Journal of Emergencies# Trauma and Shock, 8(1), pp. 5-10.
Vancouver	Ghane MR, Gharib M, Ebrahimi A, Saeedi M, Akbarikamrani M, Rezaee M, et al.. Accuracy of Early Rapid Ultrasound in Shock (Rush) Examination Performed by Emergency Physician for Diagnosis of Shock Etiology in Critically Ill Patients. Journal of Emergencies# Trauma and Shock. 2015;8(1):5-10.
BibTex	@article{ author = {Ghane MR and Gharib M and Ebrahimi A and Saeedi M and Akbarikamrani M and Rezaee M and Rasouli H}, title = {Accuracy of Early Rapid Ultrasound in Shock (Rush) Examination Performed by Emergency Physician for Diagnosis of Shock Etiology in Critically Ill Patients}, journal = {Journal of Emergencies# Trauma and Shock}, volume = {8}, number = {1}, pages = {5-10}, year = {2015} }
RIS	TY - JOUR AU - Ghane MR AU - Gharib M AU - Ebrahimi A AU - Saeedi M AU - Akbarikamrani M AU - Rezaee M AU - Rasouli H TI - Accuracy of Early Rapid Ultrasound in Shock (Rush) Examination Performed by Emergency Physician for Diagnosis of Shock Etiology in Critically Ill Patients JO - Journal of Emergencies# Trauma and Shock VL - 8 IS - 1 SP - 5 EP - 10 PY - 2015 ER -

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