The Study of Rapid Ultrasound in Shock in Patients of Undifferentiated Hypotension Presenting to Emergency Department
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Date
2022-12
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Publisher
GCS Medical College, Hospital and Research Center
Abstract
Background: Patients with hypotension or shock usually have high mortality rates, and use of traditional physical examination techniques only may be misleading for rapid diagnosis and treating the same. RUSH (Rapid Ultrasound for Shock and Hypotension) protocol is used in patients with undifferentiated shock to improve accurate diagnosis of shock. Methods: A prospective observational study was done from April to June 2022 at emergency department in 100 patients who presented with hypotension. This included patients who had systolic blood pressure (SBP) of <90 mmHg, along with tachypnoea and tachycardia. Patients RUSH examination was performed. The patients were followed up to document their final diagnosis. Results: In our study, the mean age of patients with hypotension was 58.8±8.7 years with male preponderance of 53%. The hypovolemic shock (40%) was found to be the most common subtype of shock. 86% of patients were correctly diagnosed with RUSH study. The sensitivity, specificity, PPV and NPV of RUSH in shock patients was 36.69%, 25.7%, 26.5%, 87.25% respectively and disease prevalence 31.5% and accuracy 68.75%.Cohens Kappa index was 0.5 showed a moderate agreement of the RUSH protocol in diagnosis of causes of shock with the final diagnosis. Conclusion: This study advocates the use of RUSH protocol in patients presenting with undifferentiated hypotension in the emergency department. It narrows the possible differentials of shock and guides the emergency physician to an early initial therapy, thereby improving the final outcome of patient.
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Keywords
Emergency department, Hypotension, Rapid Ultrasound for Shock and Hypotension, Shock
Citation
Ginoya Sonal K, Parmar Ami, Parikh Samira. The Study of Rapid Ultrasound in Shock in Patients of Undifferentiated Hypotension Presenting to Emergency Department. GCSMC Journal of Medical Sciences. 2022 Dec; 11(2): 40-45