Abdominal Aortic Aneurysm

Abdominal Aortic Aneurysm AAA Triple A

If any patient admitted with a known aneurysm develops symptoms such as abdominal or back pain, a senior member of the surgical team MUST be informed immediately.

All patients with known AAA should have large bore access obtained as a precaution and G&H sent to the lab so that blood will be available on urgent request.

In-acute emergency:

1. Get senior help at once

2. Establish large bore peripheral IV access

3. Take blood for FBC, U&E, Creatinine, LFT, COAG, and GXM 10 units. Some emergency cases may need request of O negative blood at once

4. Give O

5. Pass urinary catheter for monitoring of hourly output, see section 9.5

6. Inform theater and anaesthetist

7. Arrange for ICU bed

8. Prophylactic IV antibiotics (Co-Amoxiclav)- it is easy to forget these in the emergency aneurysm but they are probably more important than in elective cases.

AAA mimics testicular/ back/ abdominal/ lower limbs/ ureteric pain. $>$ 40 years old are unlikely to get ureteric colic = AAA until proven otherwise