When should I refer a patient with suspected aortic dissection to secondary care, and what information should I provide with the referral?

You should refer a patient with suspected aortic dissection to secondary care as an emergency NICE CKS. Immediate hospital admission is recommended due to the high risk of death or serious morbidity associated with suspected aortic dissection NICE CKS. This urgent referral is necessary if there is any suspicion of a serious cause for the patient's chest pain or any concern regarding their general well-being NICE CKS. Aortic dissection should be considered as a life-threatening cause of chest pain, particularly if an acute coronary syndrome (ACS) is less likely based on clinical assessment and a resting 12-lead ECG NICE CG95.

When referring a patient with suspected aortic dissection, you should include the following information:

• Clinical assessment findings: Detail the nature of the chest pain and any other associated symptoms NICE CG95.
• Vital signs: Provide measurements for pulse, blood pressure, heart rhythm, and oxygen saturation NICE CKS.
• Resting 12-lead ECG results: Take a resting 12-lead ECG as soon as possible and send the recording with the patient to the hospital NICE CG95,NICE CKS. Ensure that recording and sending the ECG does not delay transfer to the hospital NICE CG95,NICE CKS.
• Patient history: Include relevant risk factors and a careful history establishing the rate of onset and time to peak intensity of symptoms NICE NG228,NICE NG156.
• Immediate management provided: Document any pre-hospital interventions, such as aspirin if given for suspected ACS NICE CKS.