Pop goes the aneurysm

The case A previously healthy 45-year-old man developed headaches and blurry vision. Workup revealed a large cerebral aneurysm requiring a heroic procedure. In effect, his face would be taken apart to get at the aneurysm. The lesion itself was extremely large, and the neurosurgeon was quite concerned about whether he'd be able to “get the clamp around the base.” After an initial tracheostomy and 5 hours of dissection, a faint and barely audible pop! was heard, followed by a nonfaint and easily audible “oh, shit!” from the surgeon. The patient's blood pressure rose to 260, and his heart rate fell from 90, to 80, to 70, and didn't stop until reaching 40. A glance over the ether screen revealed a brain ballooning out of the skull. The brain was stretched so taut that there were no sulci present, just “lines on a globe” where the sulci used to be. Patient care Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Communicate effectively and demonstrate caring and respectful behavior when interacting with patients and their families. No family is in the room, and the patient is under general anesthesia, so we don't have to sweat about caring and respectful behavior in our interaction. We can show the most respect by reacting like lightning to the developing catastrophe. Gather essential and accurate information about their patients.