Leaking AAA

Published

Specializes in ER.

I worked my first night and had an elderly woman die of a leaking AAA. She chose not to go to surgery and just get comfort care with her family around her. Very sad, but understandable. I had not encountered this diagnosis before so it was interesting to see. She was presenting very much like a kidney stone but the pain was in her abdomen. Lots and lots of drugs before she felt comfortable.

The next night I got two more leaking AAA's (having never seen them before that week). One was ruled out, and the other transferred out to a larger facility. Funny how they come in spurts. The gentleman that was transferred out was restless and ornery, didn't want to hang around for all our foolish testing. I told him "I had someone die of this last night, so you're going to have to put up with me being a little fussy and cautious about how you're taken care of tonight." Got a big "you tell him!" from his son.

The first patient was cold and clammy, but I didn't want to clean her until her pain was under control. Then I was wary about turning her and having her die when the family was out of the room. After a few hours I couldn't stand it any more, and got someone to help me change her and fluff pillows. Family was as good and loving as they could be, but after she was changed one of them took one look and burst into tears. She looked too "hospital," and not like herself. So they asked for an extra blanket, scrunched it up and put it on the patient to make things messier and more comfy. It's so hard to decide what the right thing is- I didn't want them to think we left her in wet sheets and neglected her. So now this hardened cranky ER nurse got another look at how every patient belongs to someone's family.

Up Vote Up Vote ×
Specializes in Hospital Education Coordinator.

People are amazing. You will never be bored as a nurse

Up Vote Up Vote ×

My grandfather died of a AAA. He also decided against surgery and it was like waiting for a ticking time bomb to explode which it did six months after being diagnosed. He just didn't want to go through all the trauma of surgery and such at his age, really can't blame him. We miss him every day!

Up Vote Up Vote ×
Specializes in ICU.
People are amazing. You will never be bored as a nurse

LOL Give it time. :D

Up Vote Up Vote ×
Specializes in CVICU.
My grandfather died of a AAA. He also decided against surgery and it was like waiting for a ticking time bomb to explode which it did six months after being diagnosed. He just didn't want to go through all the trauma of surgery and such at his age, really can't blame him. We miss him every day!
As a CVICU RN, I've recovered many AAA's. The recovery can sometimes (and in my experience, more often than not) be brutal depending on the patient and the situation, so I'd never blame anyone who decided that they'd rather live out the rest of whatever time they had than go through that.
Up Vote Up Vote ×
Specializes in Trauma/ED.

I think I'm about 30% survival on these cases in my career...we are very aggressive and have a great vascular and general surgery team at my hospital but still seem to lose a lot. BTW I'm talking about ruptures not leaks...the kind where you are using the rapid infuser and the massive transfusion protocol.

These are challenging cases that test your skills at the bedside...

Up Vote Up Vote ×
Specializes in CVICU.
I think I'm about 30% survival on these cases in my career...we are very aggressive and have a great vascular and general surgery team at my hospital but still seem to lose a lot. BTW I'm talking about ruptures not leaks...the kind where you are using the rapid infuser and the massive transfusion protocol.

These are challenging cases that test your skills at the bedside...

We have about the same survival rate, maybe even lower.
Up Vote Up Vote ×
+ Join the Discussion