Archive for Abdominal Aortic Aneurysm
In emergency medical situations a patient assessment is one of the most important steps emergency personnel utilizes at the scene. This assessment will assist the Advanced Cardiac Life Support emergency workers in answering all of the vital questions. Who, what, how, and address all life threatening situations not only with the patient but in the surrounding area as well. Who the patient is; is the patient a pediatric or an adult? This makes a big difference in your approach to treatment. What happened; what is the emergency and how did it happen or the mechanism of injury.
Knowing where the injury is and how it happened will also weigh in on the mode of transportation as in by air or ambulance, is it going to be a rapid transport situation. If it is going to be a rapid transport situation then all of the life threatening wounds should be addressed and the rest can be done on the way to the receiving facility. Knowing the what and how will also be able to help you decide the type of receiving facility to transport to. Some facilities offer higher levels of care than others depending on severity of injury.
The patient assessment always begins with a scene size up. You should always make sure the scene is safe. Look for downed power lines, irate individuals with weapons, gas leaks, etc… Once the scene is safe and you are allowed to enter you will want to then make sure you observe body substance isolation or (BSI). Before you enter a scene it is a good idea to have BSI. You want as much protection as you can get from the fluids and other substances from the patient and your scene. Once you have observed BSI you will want to find out the number of patients. Knowing this will help you to find out if you are going to need to triage patients as well as know if you are going to need additional resources which is the next step in the patient assessment.
Once you have determined whether or not you will need additional resources and they are contacted if needed, you will then need to determine the mechanism of injury. Knowing the mechanism of injury will assist you in determining the level of care the patient will need and almost always in conjunction with all of the other steps it will help you to make a transport decision. Finally you will need to have a partner hold c-spine. Especially if they have suffered a fall, motor vehicle collision, or any injury involving the neck, head, or spine. This is also where knowing the mechanism of injury comes in.
Knowing how to perform a patient assessment is a vital part of the emergency care process. This will be a part of your skills and knowledge required in your training in the Emergency medical field, especially that of an Emergency medical technician. This will also help anyone who is in any field in which responds to medical emergency calls such as first responders and volunteer firefighters as well as paid firefighters.
An abdominal aortic aneurysm (AAA) is when the area of the aorta that carries blood to the abdomen, pelvis, and legs balloons and dangerously swells. There are five types of aortic aneurysms, but abdominal aortic aneurysms account for 75% of these. Most of these types of aneurysms occur below the kidneys but can occur at the kidney level or above. People most at risk for having an abdominal aortic aneurysm are men aged 40-80. Obesity, smoking, high blood pressure, and emphysema may also heighten the chances for developing this type of aneurysm.
Aneurysms develop at a slow rate usually over the course of years and may not have any symptoms. An AHA PALS course may be required in order to treat such a condition. Some abdominal aortic aneurysms are discovered by abdominal ultrasounds or a CT scan of the abdomen. However, if an aneurysm develops quickly (like a rupture or a tear) the following symptoms may come on quickly: rapid heart rate, clammy skin, nausea and vomiting, pain in abdomen or back that radiates down to legs, groin, or buttocks. If any combination of these symptoms should arise quickly, the patient should seek medical attention immediately. Upon arriving at the health care facility, the physician will perform an abdominal exam. Checking of the pulse and checking for sensation in the legs will give the physician a clue that the patient may in fact have an aneurysm. Upon the exam of the abdomen, if a doctor finds the abdomen has a mass, is stiff, or has a pulsating sensation, these symptoms could also signal an abdominal aortic aneurysm.
Treatments are conditional on the size and severity of the aneurysm. Small aneurysms can be treated with medication to prevent enlargement, and monitoring is essential to track the size of the bulge. More severe aneurysms endovascular surgery is performed by inserting a stent graph through the leg artery into the aorta to reinforce the weakened part of the aorta preventing the vessel from rupturing. Also, a benefit to endovascular surgery is that is more easily tolerated by older patients. In emergency situations that require prompt attention such as rupture or rapid dilation, open abdominal surgery may be required. During this procedure, an incision is made and the weakened section of the aorta is replaced with a graft and sutured in to place.
When found ahead of time, the prognosis for the patient is very good as surgery often times can keep a rupture or tear from occurring. Likewise, if severe symptoms mentioned above are experienced it is essential to have a medical profession examine the patient.