Continuing Professional Development: Abdominal Aortic Aneurysm (AAA)

Friday, December 2, 2011

OverviewAn abdominal aortic aneurysm (AAA) is a localized dilatation of the abdominal aorta resulting from degenerative cardiovascular disease. Such aneurysmal arteries pose few problems for many patients and are simply monitored and managed conservatively within the community. However, the ruptured abdominal aortic aneurysm is a time-critical medical emergency requiring timely surgical intervention in order to offer any chance of survival. Even when recognized early, 90% of patients will suffer an out-of-hospital cardiac arrest prior to arriving at the emergency department, and of those who reach theatre, only 40% will survive. This article aims to increase the paramedic practitioner's knowledge and understanding of AAA through a holistic discussion of the prehospital recognition and early management. Particular emphasis will be placed on fluid replacement therapy and analgesia, with specific reference to the issues associated with aggressive fluid resuscitation and the potential benefits elicited through the use of opiate analgesia and subsequent pharmacologically induced hypotension. This article further aims to set the prehospital management into the wider context, thus providing paramedic practitioner's with an insight into how prehospital interventions affect the patients' ultimate outcome and post-operative quality of life.Learning OutcomesAfter completing this module you will be able to:• Have an understanding of the pathophysiology, risk factors and diagnosis of abdominal aortic aneurysm (AAA)• Understand the cardinal signs and symptoms indicative of the ruptured AAA• Gain further insight into the potential benefits of opiate analgesia• Gain an appreciation of appropriate fluid replacement therapy and potential complications• Gain an insight into surgical repair methodologies and post-operative prognosis.

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