Aortic dissection is a life-threatening acute condition that should be considered if an acute coronary syndrome (ACS) is less likely NICE CG95. It is associated with a high risk of death or serious morbidity NICE CKS.
In the emergency setting, if aortic dissection is suspected, urgent hospital admission should be arranged NICE CKS. Narrative review articles recommend immediate admission NICE CKS.
While awaiting transfer to a specialist unit, the patient should be continuously monitored NICE CG95. General supportive measures for chest pain, which may accompany aortic dissection, include sitting the person up NICE CKS. Supplemental oxygen should be offered if oxygen saturation (SpO2) is less than 94% NICE CKS. For those not at risk of hypercapnic respiratory failure, the target SpO2 is 94–98% using a simple face mask at 5–10 L/min NICE CKS. For individuals with chronic obstructive pulmonary disease (COPD) who are at risk of hypercapnic respiratory failure, the target SpO2 is 88–92% using a 28% Venturi mask at 4 L/min NICE CKS.