DVT

The final part of the Rush protocol is the assessment of the big vessels; looking at the abdominal aorta for aneurysm or dissection, and at the femoral and popliteal veins for deep vein thrombosis (DVT), using the curvilinear probe. 

The assessment of the pipes looks to answer the following questions? 

• Is there an aortic aneurysm or dissection?
• Is there a DVT in a large vein?

How to perform:

Abdominal Aorta Aneurysm (AAA)

A detailed review of how to perform a AAA assessment is available in the RCEM Learning Session Abdominal Aorta Aneurysm assessment.

The recommended scanning style for the RUSH protocol is to sweep down from the xiphoid to the bifurcation of the aorta.

DVT

An addition to the original RUSH protocol is a limited two-point compression scan to look for DVT at:

• Common femoral vein in the inguinal canal
• Popliteal vein in the popliteal region

Learning bite

The presence of echogenic material in the vein, or the lack of collapsibility of the vein on applying pressure is indicative of DVT.