What are the recommended management protocols for aortic dissection in the emergency setting before transfer to a specialist unit?

Aortic dissection is a life-threatening acute condition that should be considered if an acute coronary syndrome (ACS) is less likely ³. It is associated with a high risk of death or serious morbidity ⁶.

In the emergency setting, if aortic dissection is suspected, urgent hospital admission should be arranged ⁶. Narrative review articles recommend immediate admission ⁶.

While awaiting transfer to a specialist unit, the patient should be continuously monitored ³. General supportive measures for chest pain, which may accompany aortic dissection, include sitting the person up ⁶. Supplemental oxygen should be offered if oxygen saturation (SpO2) is less than 94% ⁶. 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 ⁶. 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 ⁶.