Key result
Pre-hospital ultrasound identifies extensive aortic dissection in an unstable man, facilitating rapid transport to surgery.
Why the study?
Pre-hospital ultrasound has been demonstrated feasible in trauma, cardiac arrest, and respiratory insufficiency, but its use for early aortic evaluation is not established.
Does pre-hospital ultrasound identify aortic dissection in a hemodynamically unstable patient with syncope?
Case Report (n=1)
Does pre-hospital ultrasound identify aortic dissection in a hemodynamically unstable patient with syncope?
Pre-hospital ultrasound can rapidly identify aortic dissection in hemodynamically unstable patients, facilitating prompt surgical referral.
Hypothesis-generating for pre-hospital ultrasound in aortic dissection; prospective studies needed before changing triage protocols.
Background: Several studies have demonstrated the feasibility of pre-hospital ultrasound (US) in patients with trauma, cardiac arrest, and respiratory insufficiency. It should be rapid, problem based and the use of specific protocols (focused assessment of sonography for trauma, focused echocardiography in life support, and rapid ultrasound for shock and hypotension) prevents delays. Case Presentation: We present a case of a 50-year-old man with a syncope while he was working. When the ambulance arrived, he was hemodynamically unstable, indicated dorsal–lumbar pain, an asymmetry of the radial pulses was found, and the electrocardiography did not register any ST segment alterations. A pre-hospital US showed a dilation of the ascendant aorta and a floating flap inside the aortic arch and the abdominal aorta. The computed tomography scan confirmed a dissection from the aortic bulb to the left femoral artery and the patient was transported rapidly to the nearest heart and thoracic surgeries. Conclusion: The evaluation of the aorta should be considered a new indication of pre-hospital US.
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Zanatta et al. (2018) conducted a case report in Aortic dissection (n=1). Pre-hospital ultrasound was evaluated on Identification of aortic dissection. Pre-hospital ultrasound successfully identified an extensive aortic dissection in a hemodynamically unstable 50-year-old man, facilitating rapid transport to surgery.
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