Ruptured AAA Primary Bypass


An incident has occurred in the Queen Elizabeth Hospital Kings Lynn (QEHKL), where a patient with a known abdominal aortic aneurysm (AAA), which subsequently ruptured, was taken to their Emergency Department (ED), rather than direct to Norfolk and Norwich (designated) vascular centre. Survivability with a rupture can only be aided through prompt treatment at a vascular centre.

While we are working with the QEHKL to review the specific details, we would like to remind people of the protocol around primary divert to a vascular centre within the Norfolk System.

The following patients should be taken direct to the Norfolk and Norwich ED, pre-alerting the ruptured AAA and asking for the vascular on call consultant to be contacted:

  • A patient with a known AAA, who develops sudden onset of back and/or abdominal pain.
  • They are hypotensive and/or in a collapsed state.
  • **For patients without a known AAA, but with a presentation and symptoms suggestive meeting the above two points, can be discussed with the vascular consultant on call**.

The following exceptions or considerations apply, where they should be taken to the nearest ED:

  • Patients who are over 85.
  • The patient has an advanced directive.
  • A valid Do Not Attempt CPR (DNACPR) form is presented.
  • An immediate threat to life for the patient related to airway or breathing problems.

The vascular centres within EEAST are:

  • Addenbrooke’s Hospital
  • Bedford Hospital
  • Colchester Hospital
  • John Radcliffe Hospital
  • Kings college
  • Lister Hospital
  • Luton and Dunstable Hospital
  • Milton Keynes Hospital
  • Norfolk and Norwich University Hospital
  • Peterborough Hospital
  • Queen’s Hospital
  • Royal London Hospital
  • St George’s Hospital
  • St Mary’s Hospital
  • Watford General Hospital

Published 7th October 2019

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