Initial management involves:
- Oxygen 15L/min
- Establish good IV access (large bore cannulae in antecubital fossa)
- Blood tests – FBC, Clotting screen, U&Es, Glucose, Group & Save + Cross match 6-8units of blood
- Insert urinary catheter
- Contact and involve consultant vascular surgeon as soon as the diagnosis of ruptured AAA is suspected.
The decision to perform imaging (such as CT angio) should be taken by the consultant vascular surgeon. If the patient is stable then imaging may be performed to confirm diagnosis and establish best treatment options (open repair or stent graft). If the patient is unstable, then needs to be transferred to operating theatre ASAP. Survival is dependent upon speed of diagnosis and treatment.
Around 50% of patients with ruptured AAA die at home. Of those arriving in hospital around 70% are suitable for intervention (others are turned down for surgery due to significant co-morbid disease).
Those undergoing surgery, have significant risk of developing multiorgan failure, and overall survival following repair is around 50%.
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