The RUSH exam—Rapid Ultrasound in Shock and Hypotension—serves as a critical diagnostic tool for managing undifferentiated shock in emergency medicine. Utilizing the HIMAP mnemonic, providers systematically evaluate the heart, IVC, Morrison’s pouch, aorta, and pulmonary status to identify life-threatening pathologies like pericardial effusion, pulmonary embolism, or internal hemorrhage. Bedside ultrasound offers a high-yield, rapid assessment that significantly lowers the "number needed to scan" to save lives. While the heart remains the most critical view for identifying obstructive or cardiogenic shock, the IVC provides essential context regarding central venous pressure and volume status. Integrating these sonographic findings with clinical history and physical exams allows for precise, life-saving interventions in peri-arrest patients, far exceeding the diagnostic speed of traditional imaging modalities.
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