The emergency physician's role in the care of a patient with an acute rupture of an AAA lies largely in making the diagnosis and assisting with rapid transfer to the operating room.
Any suspected ruptured aneurysm requires immediate operative repair. One-half of patients with a ruptured aneurysm who reach the operating room die. 9 Imaging modalities should be restricted to patients who are considered unlikely to have a ruptured aorta. Standard resuscitative maneuvers (two large-bore intravenous catheters, a cardiac monitor, and supplemental oxygen) are required. The patient suspected of having an AAA may require resuscitation for blood loss. However, overly vigorous fluid resuscitation may be harmful (see Chap...27), and the appropriate amount of intravenous fluids to be given is controversial.
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