For Professionals

Referring a Patient within North West

Streamline your patient referral process in the North West region with this resource. It offers clear service information, Standard operating policy information and direct telephone instructions to ensure efficient and effective patient referrals.

Acute Aortic Syndrome Pathway

Type A Aortic Dissection

Medical Management:

  • IV access
  • Labetalol infusion
  • Urinary catheter
  • Arterialline
  • Oxygen
  • Analgesia

Target BP: Below 120mmHg

Identify high risk features to referrer:

  • Uncontrolled BP (>120mmHg)
  • Peri-assist
  • Obvious cardiac tamponade
  • Evidence of myocardial infarction
  • Evidence of general low cardiac output and/or malperfusion (lactate >4)
  • Evidence of limb ischaemia, gut ischaemia or stroke

Safe versus timely transfer:

  • Medical escort with controlled BP
  • Do not “scoop and run”

Discuss transfer arrangement with receiving centre.

Type B Aortic Dissection

Medical management in Critical Care environment:

  • IV access
  • Labetalol infusion
  • Urinary catheter
  • Arterial line
  • Oxygen
  • Analgesia

Target BP: Below 120mmHg

Identify “Complicated” acute Type B dissection

  • Paraplegia
  • Visceral and renal malperfusion
  • Ischaemic limbs
  • Enlarging pleural effusions
  • Persistent pain
  • Rapid expansion
  • Retrograde Type A
  • Uncontrolled BP
  • Patients with Complicated Type B aortic dissection will require safe and timely transfer.
  • Patients with Uncomplicated acute Type B aortic dissection will be managed in referring centre with remote support.

Liverpool (LHCH)

Tel: 0151 228 1616

  • Aortic Fellow (Switch)
  • Cardiac Surgery Registrar (Switch)
  • On-Call Aortic Surgeon (Switch)
  • Clinical Leads: Miss D Harrington & Prof Vallabhaneni

Manchester (MRI/Wythenshawe)

Tel: 0300 330 9444

  • Cardiac Surgery Registrar for Type A (Switch)
  • Vascular Surgery Registrar for Type B (Switch)
  • On-call Aortic and Vascular Surgeon (Switch)
  • Clinical Leads: Mr Waterworth & Mr Murry

Blackpool (BVH)

Tel: 01253 3000 000

  • Cardiac Surgery Registrar (Switch)
  • On-call Aortic Surgeon (Switch)
  • Clinical Leads: Mr Bitter & Miss Drinkwater

North West Network Acute Aortic Services

Patients in the North West of England, North of Wales and Isle of Man, presenting with emergencies of the aorta are referred into our network of specialist care:

Cardiac Surgery:

  • Blackpool Victoria Hospital (LHFT)
  • Manchester Royal Infirmary (MUHFT)
  • Manchester Wythenshawe Hospital (MUHFT)

Vascular Surgery:

  • Preston Hospital (LHFT)
  • Aintree University Hospital (LUHFT)
  • Manchester Royal Infirmary (MUHFT)

Manchester, Liverpool and Preston/Blackpool all have their own teams of specialists for managing acute Type A and Type B aortic dissection.

Selected patients may warrant transfer to other centres based on complexity and capacity.