If you are a cardiologist or A&E doctor at a local or referral hospital who has diagnosed, or strongly suspects, acute aortic dissection in a patient (AAD), you can refer them to Harefield, Hammersmith and Royal Brompton hospitals by doing the following:
Call the on-call surgical centre on 0203 313 2222
Arrange a transfer
- when you get through to the on-call surgical centre, ask to speak to the on-call specialist aortic surgeon and arrange an immediate transfer
- call the ambulance service to arrange the immediate transfer of the AAD patient to the on-call surgical centre. You must clearly confirm the details of the on-call aortic surgeon and the on-call centre
- you must also confirm the availability of an anaesthetist (SpR or consultant) from your hospital, who can travel in the ambulance
- make sure and confirm that an ambulance service paramedic is available and able to travel in the ambulance to the on-call surgical centre. If your on-call surgical centre is:
- Hammersmith Hospital, go to the Medical Emergency Unit
- Harefield Hospital, go to the main reception via emergency vehicles' lane
- Brompton Hospital, go to the main reception on Sydney Street
- prepare for an immediate transfer by putting the patient on i/v medication to manage the pain and blood pressure, as per AAD clinical protocol
- complete a log-sheet
- the patient will be transferred into the ambulance along with notes, a completed log-sheet, DVD and CT-scan, as well as other diagnostic images
In the ambulance
Enroute to the on-call surgical centre, you should follow AAD clinical protocol and update the patient’s notes, if necessary. If the patient has a cardiac arrest, an aorta rupture, or any other deterioration in their condition, you should continue on to the surgical centre. The ambulance crew/anaesthetist should contact the on-call surgeon (0203 313 2222), if they need assistance.
When the ambulance crew and anaesthetist hand the patient over to the on-call surgeon at the surgical centre, the arrival time should be recorded on the log-sheet before being handed over with the notes and dvd.
The ambulance should return and move on to the next call while the anaesthetist later returns to the secondary hospital, by taxi, once all the i/v lines, syringe pump and all other equipment has been retrieved from the patient.