Abdominal Aortic Aneurysm
Summary: <br> Kidney Stones are a Diagnosis of Exclusion!!!<br> <br> <br> <br> History<br> <br> <br> <br> * Risk factors* Age >60* Tobacco use* Classic presentations* Stable with sudden flank/back/abdominal pain or syncope* Unstable with pallor, hypotension, and ill appearance<br> <br> <br> <br> Exam<br> <br> <br> <br> * Pulsatile abdominal mass* Unstable vitals<br> <br> <br> <br> Testing Plan<br> <br> <br> <br> * Labs* TYPE AND SCREEN* CBC* Electrolytes* Coagulation studies* Lactic acid* Imaging* Bedside ultrasound (optimal)* Aorta protocol* Look for aorta >3cm* RUSH protocol* Mnemonic: HI-MAP* Heart* IVC* Morrisons Pouch (RUQ)* Aorta* Pulmonary* CT scan with IV contrast (less optimal)<br> <br> <br> <br> Treatment Plan<br> <br> <br> <br> * 2 Large bore IVs (16G)* Massive transfusion protocol* PRBCs* Platelets* Fresh Frozen Plasma* Blood pressure management* Goal Systolic ~100* Goal MAP ~60-65<br> <br> <br> <br> Clerkship Pearls<br> <br> <br> <br> * Put AAA in your differential during your presentation for all older patients with back/flank pain* Attempt to perform a bedside ultrasound of the aorta OR find recent CT of the abdomen with normal sized aorta<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * Abdominal Aortic Aneurysm Review <a href="https://emedicine.medscape.com/article/1979501-treatment">(Medscape)</a><br> <br> <br> <br> <br>
