[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-505936-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-505936-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","ruptured-abdominal-aortic-aneurysm-aaa-assessment-consultation-referral-guide-june-2023","Ruptured Abdominal Aortic Aneurysm (AAA) Assessment, Consultation & Referral Guide - June 2023","","Ruptured Abdominal Aortic Aneurysm (AAA) is treated as a vascular surgical emergency requiring rapid assessment and immediate coordination. The guide supports emergency department clinicians with time-bound steps for initial diagnosis, including clinical presentation evaluation with POCUS or rapid radiologic assessment, and clear imaging and transfer instructions. It details prompt vascular surgeon consultation via CritiCall Ontario, required discussion topics, and immediate management actions such as permissive hypotension, blood product use, analgesia, and measures to optimize outcomes. It also outlines rapid transfer planning and receiving-hospital intervention time goals.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/ruptured-abdominal-aortic-aneurysm-aaa-assessment-consultation-referral-guide-june-2023/505936/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/ruptured-abdominal-aortic-aneurysm-aaa-assessment-consultation-referral-guide-june-2023/505936.png","ImageObject",300,407,{"name":42,"@type":43},"kopisore","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-07","2026-10-04",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",11,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is the time goal from first medical contact to CritiCall activation for suspected ruptured AAA?","Question",{"text":63,"@type":64},"The guide sets a time goal of 30 minutes or less from first medical contact to CritiCall activation for patients with moderate to high suspicion of ruptured AAA.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"When should clinicians initiate vascular surgeon consultation and who should be contacted?",{"text":68,"@type":64},"Consultation with a vascular surgeon should be initiated within 30 minutes of first medical contact. If vascular services are not available on-site, clinicians should phone CritiCall Ontario to facilitate consultations and transfers to a vascular program.",{"name":70,"@type":61,"acceptedAnswer":71},"What are the key immediate clinical management steps for suspected or diagnosed ruptured AAA?",{"text":72,"@type":64},"Immediate steps include two large-bore IV lines, permissive hypotension to maintain mental status with a target systolic blood pressure of 70–90 mmHg, preference for blood products to treat hypotension (with cross-match if it won’t delay transfer), medication for pain, and Foley catheter placement consideration if it won’t delay transfer; patient warming and avoidance of elective intubation may help outcomes.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},505936,1791504098,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":30,"preview_page_count":4},962090880963,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Ruptured Abdominal  \nAortic Aneurysm (AAA) Assessment, Consultation & Referral Guide  \nThis guide is intended as a support tool to assist the emergency department clinician with initial diagnosis, immediate clinical management and vascular surgeon consultation and/or transfer to a vascular program for  \n*Time goal:  \n≤30 minutes  \nfrom first medical contact to CritiCall activation  \npatients with moderate to high suspicion for ruptured AAA and should be applied using clinical judgement.  \nRuptured AAA is a vascular surgical emergency.  \nConsultation with a vascular surgeon should be initiated within 30 minutes of first medical contact with a patient with suspected ruptured AAA.  \nIf vascular services are not available on-site, phone CritiCall Ontario to facilitate all ruptured AAA consultations with avascular surgeon and transfers to a vascular program.  \nThis information is for guidance only and is not a requirement.  \n*Time goals are not standards for medicolegal purposes. Times will vary based on patient presentation and other circumstances.  \nConsult, transfer and repatriation of the patient is supported by the Ontario Life or Limb Policy.5  \nFinal decision to transfer remains at the discretion of the referring and receiving physicians.  \nReferences  \n1. Mell MW, Starnes BW, Kraiss, LW, et al. Western Vascular Society Guidelines for Transfer of Patients with Ruptured AAA. J Vasc Surg, 2017;65:603-8.  \n2. Chaikof EL, Dalman RL, Eskandari RK, et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J Vasc Surg, 2018;67:2-77.  \n3. Hinchliffe RJ, Ribbons T, Ulug P, et al. Transfer of patients with ruptured abdominal aortic aneurysm from general hospitals to specialist vascular centres: results of a Delphi consensus study. Emerg MedJ, 2013;30:483–486.  \n4. Spahn DR, Bouillon D, Cerny, V, et al. Management of bleeding and coagulopathy following major trauma: an updated European guideline. Crit Care, 2013;17(2):R76 .  \n5. Ontario Life or Limb Policy:  \n[http://www.health.gov.on.ca/en/pro/programs/criticalcare/docs/provincial_life_or_limb_policy.pdf](http://www.health.gov.on.ca/en/pro/programs/criticalcare/docs/provincial_life_or_limb_policy.pdf)  \n\n| CLINICAL PRESENTATION (Clinical assessment time goal: ≤10 minutes*) |\n| --- |\n|  Abdominal pain or back pain AND hypotension1-3-proceed to point-of-care ultrasound (POCUS) or rapid radiologic assessment.\u003Cbr> Known AAA AND abdominal pain or back pain, hypotension or impending cardiovascular collapse1-3-proceed to rapid radiologic assessment IF it will not delay referral to a vascular surgeon.\u003Cbr>If ruptured AAA is considered as part of differential diagnosis based on clinical presentation, a rapid radiological assessment or POCUS must be completed to confirm or rule out presence of AAA.1-3 If no CT/CTA on-site or CT/CTA is not immediately available, proceed with request for vascular consult if clinical presentation and ultrasound findings suggest presence of ruptured AAA. |\n\n| RAPID RADIOLOGIC ASSESSMENT (Rapid radiologic assessment time goal: ≤20 minutes*) |\n| --- |\n| After-hours: Do not delay consult with vascular surgeon for on-call technologists and radiologists. Do not transfer patient to other hospital for purpose of CT/CTA. Proceed to consult based on clinical presentation and POCUS.\u003Cbr> Emergent abdominal and pelvic CT/CTA at 1mm cuts. CTA is preferred. Creatinine not necessary prior to CTA.\u003Cbr> Imaging should be automatically transferred to the Emergency Neuro Image Transfer System (ENITS) . If unable to transfer to ENITS, a digital copy of imaging must be transferred with the patient.1-3 |\n\n~~ PHONE CRITICALL ONTARIO ~~~~ ~~  \n1-800-668-4357   \n| CONSULT WITH VASCULAR SURGEON |\n| --- |\n| For all patients with suspected or diagnosed ruptured AAA, immediate consultation with a vascular surgeon should be facilitated by phoning CritiCall Ontario.1,2\u003Cbr>Discussion with vascular surgeon to include:\u003Cbr> CTA imaging avail","cbCaigQd67NQiPFo","https://ap.wps.com/l/cbCaigQd67NQiPFo","pdf",203170,"English","# Ruptured AAA Assessment & Referral Timing\n## Clinical presentation and initial assessment\n## Rapid radiologic assessment\n## Phone CritiCall Ontario for vascular consultation\n## Immediate clinical management\n## Rapid transfer and receiving hospital","[{\"question\":\"What is the time goal from first medical contact to CritiCall activation for suspected ruptured AAA?\",\"answer\":\"The guide sets a time goal of 30 minutes or less from first medical contact to CritiCall activation for patients with moderate to high suspicion of ruptured AAA.\"},{\"question\":\"When should clinicians initiate vascular surgeon consultation and who should be contacted?\",\"answer\":\"Consultation with a vascular surgeon should be initiated within 30 minutes of first medical contact. If vascular services are not available on-site, clinicians should phone CritiCall Ontario to facilitate consultations and transfers to a vascular program.\"},{\"question\":\"What are the key immediate clinical management steps for suspected or diagnosed ruptured AAA?\",\"answer\":\"Immediate steps include two large-bore IV lines, permissive hypotension to maintain mental status with a target systolic blood pressure of 70–90 mmHg, preference for blood products to treat hypotension (with cross-match if it won’t delay transfer), medication for pain, and Foley catheter placement consideration if it won’t delay transfer; patient warming and avoidance of elective intubation may help outcomes.\"}]","Ruptured Abdominal Aortic Aneurysm (AAA) Assessment, Consultation & Referral Guide - June 2023 | PDF",1791156009]