Ruptured abdominal aortic aneurysm

In this instance, transfer to the operating theatre was delayed because the cardiac arrest team was not aware of the diagnosis of abdominal aortic aneurysm and did not have access to the medical notes. Diagnosis of abdominal aortic aneurysm during cardiac arrest can be difficult because, in the absence of a recordable blood pressure, there may be no pulsatile abdominal mass. However, the diagnosis should be considered in all cases of electromechanical dissociation in patients over the age of 60 years and considered the leading cause of electromechanical dissociation in all patients with a pre-existing diagnosis of abdominal aortic aneurysm. Fixed dilated pupils are an unreliable indicator of prognosis in cardiac arrest where large amounts of adrenaline have been given. It is well known that large, tender abdominal aortic aneurysms require the earliest possible surgical repair-to delay until an intensive care bed becomes available risks death of the patient. A further delay in transferring this patient to the operating theatre occurred after he collapsed. This was due to the cardiac arrest team not having access to the patient's notes. This case shows that, in selected patients, aneurysm repair after prolonged cardiac arrest and severe metabolic acidosis is justified provided that good fluid resuscitation and cardiac massage has been given. In these circumstances a good functional outcome can occasionally be achieved.