Crashing undifferentiated shock: which POCUS findings change management now?

In crashing undifferentiated shock, immediate POCUS priorities are identifying obstructive, cardiogenic, hypovolemic, or distributive physiology that changes resuscitation in real time. The RUSH framework (“pump, tank, pipes”) rapidly evaluates pericardial tamponade, RV strain/PE physiology, severe LV dysfunction, hypovolemia/fluid responsiveness, pneumothorax, hemorrhage, and AAA. Findings that immediately alter management include tamponade with chamber collapse, tension pneumothorax with absent lung sliding, markedly depressed LV function, RV dilation/strain, plethoric or collapsible IVC, pulmonary edema/B-lines, and intra-abdominal free fluid or ruptured AAA. Shock index >0.7–0.8 also supports significant instability or occult shock.^{1 2 4}