New Resource for Nurses to Recognize Aortic Dissection in Emergency Situation

PORT WASHINGTON, NY, May 21 – Now available from the National Marfan Foundation is a new booklet designed specifically for emergency triage nurses, Aortic Dissection: Red Flags for the Emergency Triage Nurse. This pocket-sized booklet discusses the signs and symptoms that may indicate an aortic dissection with a focus on Marfan syndrome, a high risk factor for the life threatening condition.

As the first healthcare provider seen by most people who visit the emergency department, the triage nurse plays a vital role in assuring that patients are properly moved along for treatment. It is critical that emergency nurses know the "red flags" that could indicate a dissection, and take note of certain physical characteristics of the patient during the initial observation and assessment.

Approximately half of the people with Marfan syndrome, a connective tissue disorder, do not know they have the condition; therefore, they may not include it in their medical history. Some of the outward skeletal signs of Marfan syndrome are frequently (but not always) apparent – tall, thin stature; arms and legs disproportionately long as compared to the trunk; scoliosis; indented or protruding chest bone – providing some clues during triage of the serious underlying problem that may be occurring.

As stated in the booklet, "A patient with an aortic dissection may not appear to be the 'typical' chest pain patient – s/he may be younger, tall/thin, and have no known risk factors for heart disease...Even if a person has never been told s/he has Marfan syndrome, physical characteristics of the disorder should be considered significant and the possibility of aortic dissection should be strongly considered."

The booklet focuses on triage and assessment, with specific details about the initial observation; typical complaints from patients who present with aortic dissection; vital signs; signs and symptoms; medical history; and nursing assessment. Real-life case studies are also included to demonstrate the variability of these cases and how effective triage can make the difference between life and death.

Diane Sixsmith, MD, FACEP, Chair of Emergency Medicine at New York Hospital Medical Center Queens and member of the NMF’s Board of Directors, who provided oversight to the booklet, asserted the significance of emergency nurses being aware of aortic dissection.

"This is an excellent resource to aid in recognizing a life-threatening condition. Reading it may help [an emergency department nurse] save someone’s life," she said.

The new booklet is now included in the NMF’s Emergency Medicine Campaign kit which features a comprehensive array of helpful resources for emergency healthcare professionals. To obtain the kit, visit the NMF’s online Marketplace (scroll to the Emergency Medicine Campaign Kit listing towards the bottom of the page). The booklet may also be ordered individually or in packs of 10 for a nominal shipping and handling fee. Contact Jonathan Martin, Director of Education and Public Awareness, with questions at jmartin@marfan.org, or by phone at 800-8-MARFAN x. 16.

The NMF's Emergency Medicine Campaign

Preventing deaths in the emergency department from undiagnosed Marfan syndrome and unrecognized and untreated aortic dissection is the objective of the NMF’s Emergency Medicine Campaign, which was developed with the support of the family of Rent playwright Jonathan Larson, who died from an aortic dissection (believed to be caused by Marfan syndrome) after being sent home from two New York City hospitals. The goal of the campaign is to educate emergency department personnel about the risk factors for aortic dissection and how to correctly recognize, diagnose and treat a dissection.

Since its inception, the campaign has expanded to reach emergency physicians, nurses, hospital administrators and risk managers, and paramedics/emergency medicine technicians. The Foundation has developed and disseminated an array of medical education materials, including a CME-accredited video for physicians, Emergency Diagnosis and Treatment of Aortic Dissection; a booklet and PowerPoint presentation that is used in grand rounds presentations; a poster for non-patient areas of hospital emergency departments; and an education advisory for pre-hospital emergency providers about treating aortic dissection that was developed in conjunction with the State Emergency Medical Advisory Committee, New York State Department of Health.

The NMF has also produced an Emergency Alert Wallet Card that has been disseminated to more than 30,000 people with Marfan syndrome to date.