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
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