RUSH - Rapid Ultrasound for Shock and Hypotension

HIMAP: Heart, IVC, Morrison's, Aorta, Pneumothorax

IVC: youtube

- Better to use M-mode

IVC	cm	Insp collapse	CVP
Fluid load likely to help	<1.5cm	Complete	<5
FL unlikely to increase CO	<2.5cm	No Collapse	>20

* give fluid if there is >50% IVC collapse with respiration,

or even if collapse is clearly visible without a specific measurement

No IVC collapse = does not mean fluid overload

- it means if you give fluids, cardiac output will not increase

eg. sepsis = negative inotropy = IVC will not collapse

- give inotropic support like calcium or dobutamine/dopamine, cardiac output increases, check IVC again, now it will collapse, then you can give fluids

IVC/Aorta Ratio

- correlates better with BSA, age, sex: more patient specific assessment of volume

IVC/Ao = 1.2 normal

IVC/Ao <1 volume depleted

IVC/Ao >1.5 overload/poor cardiac output

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Source: emcrit.org