For clinical reference only — does not replace local trust guidelines or clinical judgement.
Vascular Surgery · Referral

AAA (Abdominal Aortic Aneurysm)

What to ask

  • Acute abdominal / back / flank pain
  • Syncope / collapse
  • Known AAA, last surveillance scan size
  • Cardiovascular history, anticoagulation

What to examine

  • Obs — BP both arms
  • Pulsatile expansile mass above umbilicus
  • Femoral, popliteal, foot pulses
  • Look for tenderness, peritonism

Essential investigations

  • Bedside USS / FAST if available
  • CT angiogram aorta if stable
  • Bloods: FBC, U&E, clotting, group & cross-match 6 units
  • ECG

Immediate management

01Resuscitate — permissive hypotension
Aim SBP 80–100 mmHg until repaired. Two large-bore IV cannulae. Activate major haemorrhage.
02Analgesia + antiemetic
Titrate IV morphine.
03Get to CT or theatre
Don't sit on a stable AAA — talk to vascular early.

What the registrar will ask

  • 01Is the patient haemodynamically stable?
  • 02Known AAA size?
  • 03Group & cross-match in lab?
  • 04CT done / available?
  • 05Anticoagulated?

Referral checklist

Ready-to-refer score: 0% — gather the remaining items before calling.