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 Elevate head of bed or place patient in reverse Trendelenburg to maximize venous distension of lower extremities.

 Do not assume an anechoic lumen is a patent lumen. An acute clot may be anechoic.

 Baker’s cyst or lymph nodes may be mistaken for clot.

Table 4.5 RUSH exam protocol.

RUSH exam	Hypovolemic shock	Cardiogenic shock	Obstructive shock	Distributive shock
Pump	Hyperconstractile heart Small heart size	Hypoconstractile heart Dilated heart size	Pericardial effusion RV strain Hyperconstractile heart	Hyperconstractile heart (early sepsis) Hypoconstractile heart (late sepsis)
Tank	Flat IVC Flat IJV Peritoneal fluid Pleural fluid	Distended IVC Distended IJV Lung rockets Pleural effusions, ascites	Distended IVC Distended IJV Absent lung sliding (PTX)	Normal/small IVC Normal/small IJV Pleural fluid (empyema) Peritoneal fluid (peritonitis)
Pipes	AAA Aortic dissection	Normal	DVT	Normal