From the Guidelines
An ISBAR scenario for an Abdominal Aortic Aneurysm (AAA) should prioritize a structured communication approach to convey critical information effectively during a medical handover, focusing on identification, situation, background, assessment, and recommendation, as outlined in the most recent guidelines 1.
Key Components of ISBAR for AAA
- Identification: The healthcare provider identifies themselves and the patient, including relevant details like name, age, and medical record number.
- Situation: Briefly state that the patient has been diagnosed with an AAA, specifying the size (e.g., 5.5cm) and whether it's symptomatic or asymptomatic.
- Background: Include relevant medical history such as hypertension, smoking status, family history of aneurysms, and previous vascular surgeries.
- Assessment: Detail the current clinical findings including vital signs, abdominal examination results, pain assessment, and relevant imaging results confirming the AAA diagnosis.
- Recommendation: Outline the proposed management plan, which might include immediate surgical intervention for a ruptured or symptomatic AAA, elective repair for aneurysms larger than 5.5cm, or surveillance imaging for smaller aneurysms, as recommended by the 2024 ESC guidelines for the management of peripheral arterial and aortic diseases 1.
Importance of Recent Guidelines
The most recent guidelines, such as those from 2024 1, emphasize the importance of a comprehensive approach to managing AAA, including screening, diagnosis, and treatment. Screening is recommended in men aged ≥65 years and with a history of smoking to reduce the risk of death from ruptured AAA 1.
Management Plan
The management plan should be based on the size of the aneurysm and the patient's symptoms. For aneurysms larger than 5.5cm, elective repair is recommended 1. For smaller aneurysms, surveillance imaging is recommended, with the frequency of imaging depending on the size of the aneurysm and the patient's risk factors 1.
Conclusion is not allowed, so the answer will be ended here.
From the Research
ISBAR Scenario for Abdominal Aortic Aneurysm (AAA)
- I: Identify the patient's condition: The patient has been diagnosed with an abdominal aortic aneurysm (AAA), which is a localized dilatation of the abdominal aorta of ≥ 3 cm 2.
- S: Situation: The patient is at risk of aneurysm rupture, which can be life-threatening. The current imaging strategies, such as ultrasound, contrast-enhanced CT angiography, and non-contrast MR angiography, play a crucial role in the diagnosis, monitoring, and treatment planning of AAA patients 2, 3.
- B: Background: The patient's medical history, including cardiovascular risk factors, should be taken into account when managing AAA. General management of cardiovascular risk factors remains key to reducing all-cause mortality for patients with AAA 4.
- A: Assessment: The patient's aneurysm size and growth rate should be monitored regularly using imaging techniques. Beta-blockers have been considered as a potential therapy to reduce aneurysm growth, but recent studies have shown that they do not significantly influence aortic aneurysm growth 5, 6.
- R: Recommendation: The patient should be closely monitored and managed by a multidisciplinary team, including vascular surgeons, radiologists, and cardiologists. The treatment plan should be individualized based on the patient's condition, aneurysm size, and growth rate, as well as their overall health status 2, 3, 4.