PROCEDURAL COLUMNRapid Ultrasound for Shock and Hypotension A Clinical Update for the Advanced Practice Provider: Part 2Gonzalez, Juan M. DNP, APRN, AGACNP-BC, ENP-C, FNP-BC, CEN; Ortega, Johis PhD, APRN, ACNP-BC, FNP-BC, ENP-BC, FAAN, FAANP; Crenshaw, Nichole DNP, APRN, ACNP-BC, ANP-BC, FAANP; de Tantillo, Lila PhD, MS, APRN, FNP-BCEditor(s): Wilbeck, Jennifer DNP, RN, FNP-BC, ACNP-BC, ENP-C, FAANP, FAAN, Column Editor Author Information University of Miami School of Nursing and Health Studies, Coral Gables, Florida (Drs Gonzalez, Ortega, and Crenshaw) Keigwin School of Nursing, Jacksonville University, Jacksonville, FL (Dr de Tantillo). Corresponding Author: Juan M. Gonzalez, DNP, APRN, AGACNP-BC, ENP-C, FNP-BC, CEN, University of Miami School of Nursing and Health Studies, Coral Gables, FL 33146 ([email protected]). Disclosure: The authors report no conflicts of interest. Advanced Emergency Nursing Journal: October/December 2020 - Volume 42 - Issue 4 - p 284-292 doi: 10.1097/TME.0000000000000322 Buy Take the CE Test Metrics Abstract The Rapid Ultrasound for Shock and Hypotension (RUSH) examination is used for patients with hypotension without clear cause or undifferentiated hypotension. In the emergency department setting, clinicians may perform the RUSH examination to supplement the physical assessment and differentiate the diagnosis of hypovolemic, obstructive, cardiogenic, and distributive forms of shock. The key elements of the RUSH examination are the pump, tank, and pipes, meaning potentially causes of the hypotension are examined within the heart, vascular volume and integrity, and the vessels themselves. Clinicians follow a systemic protocol to seeking evidence of specific conditions including heart failure exacerbation, cardiac tamponade, pleural effusion, pneumothorax, abdominal aortic aneurysm, and deep vein thrombosis. Because ultrasonography is a user-dependent skill, the advanced practice nurse in the emergency department should be educated regarding the RUSH protocol and prepared to implement the examination. © 2020 Wolters Kluwer Health, Inc. All rights reserved.