Medical Gems

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Systems01 Cardiovascular Cs Vs4 Syndromes Diseases

Ruptured AAA

Last modified: 05 July 2021, 1:58:56 PM AEST
Gems / Priorities1 / 2
  • true anaesthetic and surgical emergency with 50% mortality
  • don't delay surgery with insertion of lines
  • prepare vasoC, vasoD, inotropes, B-blockers
  • resuscitate towards normalising BE
Anaesthetic considerations2 / 2
  • Pre-op
    • resuscitation in OT
    • aim SBP 89-90
    • XM 10 units PRBC
    • large bore IV access = 2 x 14G / large bore CVC / Swan sheath
    • arterial line
    • patient prepped and draped before induction
  • Intra-op
    • modified RSI with high dose opioid / etomidate / ketamine
    • surgery start as soon as intubation confirmed
    • both drips running full on induction
    • dedicated assistant for fluids and blood
    • regular ABG
    • early FFP + cryo + platelets
    • maintain normal temperature
    • monitor UO
  • Post-op
    • ventilate in ICU
    • treat renal failure, blood loss, hypothermia, coagulopathy