National patient charity welcomes Royal Colleges' updated guidance on Aortic Dissection diagnosis
Posted on 1st February 2024
The publication of updated national guidance on the diagnosis of Aortic Dissection by two Royal Colleges has been welcomed by the national patient charity Aortic Dissection Awareness UK & Ireland
The Royal College of Emergency Medicine (RCEM) and the Royal College of Radiologists (RCR) published the updated best practice guidance Diagnosis of Thoracic Aortic Dissection in the Emergency Department on 30th January 2024.
Misdiagnosis and delay in acute Aortic Dissection is a national patient safety issue, highlighted by the national patient charity's THINK AORTA campaign since 2018. Responding to patient concerns and advocacy, RCEM/RCR's updated best practice guidance makes the following recommendations:
1. All clinicians working in the emergency department should be made aware of the difficulties in excluding the diagnosis of Thoracic Aortic Dissection (TAD) and the need to be aware of local policies and resources to assist in this as part of their induction.
2. Each emergency department must have agreed protocols between themselves and their radiology department regarding requests for CT Aortograms in cases of suspected thoracic aortic dissection.
3. Thoracic aortic dissection is a time critical emergency and provision must be available for the ED to rapidly access CT Aortograms throughout the whole 24hr period.
4. If the ED suspects a patient has a TAD it is the role of the ED to request the scan and act on the result. This responsibility should not be passed onto another clinical team.
5. All emergency departments should have a local protocol or pathway detailing the actions to be taken once a diagnosis of TAD has been made. This should include details of blood pressure management and local urgent referral pathways to specialist surgical centres, where appropriate.
The updated guidance includes a copy of the life-saving THINK AORTA poster, which provides up-to-date information on the symptoms and patient risk factors associated with Aortic Dissection, physical examination and diagnostic warnings.
Mr. Gareth Owens (photo), Chair of the national patient charity and leader of the global THINK AORTA campaign, said:
"When I had an Aortic Dissection, my life was saved by prompt diagnosis via a CT scan at the Royal London Hospital. Many patients are not so fortunate. Our partners at RCEM and RCR take the THINK AORTA campaign very seriously and are working with us to address the challenge of diagnosing acute Aortic Dissection, which causes more deaths in the UK every year than road traffic accidents. We welcome this updated guidance and commend it to everyone working in Emergency Medicine, Radiology and Patient Safety as a must-read. I'd like to personally thank RCEM President, Dr. Adrian Boyle and RCR President, Dr. Katharine Halliday for the way in which they and their teams have listened to patients and taken action on this issue. This will save lives."