AAA

Symptomatic AAA
Abdominal pain, shock and pulsatile mass -> OR
May present less dramatically, with back, flank or groin pain, syncope, transient hypotension; emboli to feet or acute claudication; or with upper GI bleed (aorto-enteric fistula)

[ ] Bedside US for FAST and to evaluate aorta
- Many AAAs rupture retroperitoneal and will be FAST-negative
[ ] 2 large IVs
[ ] type & cross 4 units
[ ] Avoid hypertension; aim for SBP 90, HR 60-80
- Esmolol gtt 500 mcg/kg/min load, f/b gtt 50 mcg/kg/min titrate by 50s to goal & …
- Then Nitroprusside gtt 0.5-3 mcg/kg/min IV
or
- Nicardipine
or
- Labetolol
[ ] Consider Tranexamic Acid per CRASH-2 dosing protocol 1 gram over 10 mins f/b 1 gram over 8 hours

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