EM Cases · Abdominal aortic aneurysm
Ruptured AAA — the hypotensive older man resus station
ACEM Fellowship resus station testing clinical diagnosis of ruptured AAA, permissive hypotension, massive haemorrhage protocol and direct pathway to theatre/EVAR without CT delay.
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Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
An elderly male smoker with sudden back pain and hypotension who looks like renal colic until the candidate recognises ruptured AAA.
Stem
All values, findings and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
Format. Clinical-management (resus) station, 11 minutes. You are the EM consultant.
Candidate instructions. Assess and manage. Examiner plays nurse and vascular registrar on the phone.[3]
References3ShowHide
- [1]Isselbacher EM, Preventza O, Hamilton Black J, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease. Journal of Thoracic and Cardiovascular Surgery, 2023.PMID 37389507
- [2]Powell JT, Sweeting MJ, Thompson MM, et al. Endovascular or open repair strategy for ruptured abdominal aortic aneurysm: 30-day outcomes from the IMPROVE randomised trial. BMJ, 2014.PMID 24418950
- [3]Wanhainen A, Verzini F, Van Herzeele I, et al. ESVS 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms. European Journal of Vascular and Endovascular Surgery, 2019.PMID 30528142