Proved dissection

If the patient presents to a community hospital without cardiac surgical facilities, arrangements should be made for emergency transfer to an appropriate unit. All patients with dissection should be moved to a cardiothoracic unit as soon as possible following initial stabilization, type A dissections to receive emergency surgery and type B dissections so that they are well placed to receive surgery should they deteriorate. The mode of transfer is not particularly important, but the patient should be monitored adequately, blood pressure control should be maintained throughout, appropriate staff and equipment should be carried, and sudden acceleration and deceleration should be avoided.

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