Background: Ruptured abdominal aortic aneurysm (rAAA) is a surgical catastrophe. Surgical outcome is poor. There is controversy whether rAAA should be treated by open or endovascular repair (rEVAR). rEVAR is very resource demanding. Team training and protocols of treatment have been advocated to optimise performance and outcome. In this study, we look at improving awareness and performance involving all stakeholders involved in the treatment of rAAA in our hospital group.
Methods: A surgical skills training program involving lectures, bench models and virtual reality simulators for rAAA was completed in all the referring hospitals in our hospital group. Recruits included emergency department (ED) staff, general surgeons, anaesthesia, vascular trainees and surgical nurses. A questionnaire of 19 questions covering adequacy of training, knowledge, management of rAAA and transfer was completed by attendants.
Results: A total of 61 participants completed the questionnaire, Beaumont Hospital (n=24), Connolly Hospital (n=14), our Lady of Lords Drogheda Hospital (n=10) and Cavan Hospital (n=13). Only 15 (24.6%) participants received a training in rAAA management; 27 (44.3%) participants stated that there is a protocol of management in ED and perform Focused Assessment with Sonography for Trauma (FAST) scan; 42 (68.9%) of referring doctors will contact vascular surgeon prior to performing computed tomography angiography; 41 (67.2%) doctors were happy about the accessibility of vascular surgeon on call. Of the 61 participants, 59 (96.7%) agreed about importance to have protocols in management patients with rAAA.
Conclusions: To improve outcome and team performance resources are needed to raise awareness, expedite hospital transfer and develop protocols for patients with rAAA.
