Inclusion: Adult ≥ 18 with suspected acute nontraumatic thoracic aortic dissection
Exclusion: Traumatic aortic dissection, pediatric, pregnant
Level A: None
Level B:
CTA to exclude thoracic aortic dissection (accuracy similar to that of TEE and MRA).
Do not rely on abnormal bedside TTE result to definitively establish diagnosis
Level C:
Do not use clinical decision rules alone to identify very low risk acute thoracic aortic dissection. Decision to pursue further work up discretion of EP.
Do not rely on d-dimer alone to exclude the diagnosis of aortic dissection
Immediate surgical consultation or transfer to higher level of care if TTE suggestive or dissection
Decrease BP and pulse if elevated. No specific targets.
CTA to exclude thoracic aortic dissection (accuracy similar to that of TEE and MRA).
Do not rely on abnormal bedside TTE result to definitively establish diagnosis
Do not use clinical decision rules alone to identify very low risk acute thoracic aortic dissection. Decision to pursue further work up discretion of EP.
Do not rely on d-dimer alone to exclude the diagnosis of aortic dissection
Immediate surgical consultation or transfer to higher level of care if TTE suggestive or dissection
Decrease BP and pulse if elevated. No specific targets.
ACEP clinical policies
Sign out tools
Reexamination sample documentation
Mass casualty incident triage
STOPP/START criteria
Denver screening criteria
Critical care documentation
Clinical decision rules list