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It is difficult to diagnosis a ruptured AAA with POCUS. However, based on one systematic review and meta-analysis, POCUS has a sensitivity of 97.8% and a specificity of 97% for diagnosing AAA in patients supsected of having a ruptured AAA.
Remeber:
- The normal abdominal aorta should measure under 3 cm.
- The proximal iliacs should measure under 1.5 cm.
- Measure the aortic diameter from leading edge to leading edge.
Laslty, make sure you are measuring the aortic wall and not a mural thrombus.
References
Fernando SM, Tran A, Cheng W, Rochwerg B, Strauss SA, Mutter E, McIsaac DI, Kyeremanteng K, Kubelik D, Jetty P, Nagpal SK, Thiruganasambandamoorthy V, Roberts DJ, Perry JJ. Accuracy of presenting symptoms, physical examination, and imaging for diagnosis of ruptured abdominal aortic aneurysm: Systematic review and meta-analysis. Acad Emerg Med. 2022 Apr;29(4):486-496. doi: 10.1111/acem.14475.