Emergency management

In the emergency management of a leaking or ruptured AAA, the admitting doctor acts firstly as a coordinator, alerting the relevant teams of the emergency. These include, in order:

• blood bank - ten units of blood need cross matching
• theatres - including the anaesthetists
• senior members of the admitting team
• vascular surgeons - if not included in the admitting team
• the nursing staff in the admitting facility

On arrival in hospital priorities are as follows:

• very rapid assessment
• establishing venous access - large venflons, each arm
• blood for cross match
• start resuscitation - haemaccel, normal saline etc., but note that this is one of the few situations where transfer to theatre and surgery should occur despite inadequate resuscitation