hi my name is Tom Cook I'm going to demonstrate the rush exam for you today Rush is an acronym that stands for Rapid ultrasound and shock and hypotension and today we're going to be using clar's new transducer it's the pal HD3 pal is an acronym which stands for a phased array linear in other words this is a combination probe that can give you both phased array and linear array ultrasound scanning we're also going to be using the auto pre-select AI software in other words this transducer actually understands what part of the body I'm examining and reconfigures the setup so I get a great image every time I examine the patient to start off we'll go ahead and examine the parisal long AIS view you can see that on this Auto preset AI software the image is already in the cardiac preset the transducer actually figures out that you're looking at the heart and sets it up that way you don't have to go in and do it yourself before the exam and you can see we got a beautiful image here in the peristal long AIS view I can also of course flip and get a beautiful view here parisal short axis as well then I'm going to move over to the appical view so this is the appical four chamber view of course you can see the Apex at the top of the screen and the base of the heart the Atria at the bottom from here we're going to go ahead and move over to the epigastrium to go ahead and get a look at our inferior vinaa you can see that it has flipped the image into a abdominal preset so now we're looking in the epigram specifically at the inferior venic Caven we can see that it looks normal we'll move over to the right upper quadrant so we want to look at two things we want to look at morson's pouch look for the accumulation of fluid we also want to make sure that we look above the diaphragm to see if we can pick any pick up any evidence of plural fluid from here we'll move to the left upper quadrant once again looking at the potential space between the spleen and the kidney for evidence of free fluid but we'll also go above the diaphragm looking for evidence of plural fluid in the left hemithorax from here we'll go ahead and move down the abdomen looking at the aorta for any evidence of aortic pathology finally we'll go ahead and move move up to the lungs look for evidence of pneumothorax or more likely pulmonary edema and once again the AI technology understands this and changes the preset into a linear array from phased array of course you can see you got normal sliding we'll go ahead and put this in M mode so we can look for Sandy Beach sign and then we'll move over to the left hemithorax once again looking for Sandy Beach sign and then we can come back into B mode looking for evidence of plural sliding so that's the extended Rush exam it's incredibly useful in patients who are unstable those patients in with undifferentiated shock you really have a long difference you can walk into the room and within a few minutes establish whether or not a patient has a number of different lethal pathologies it's something that every Emergency Physician and critical care physician should be able to do
