function and to manage and reduce the vasospasm to facilitate coiling of the unruptured aneurysm as soon as possible. Hydrocephalus was seen on the scan and therefore Mrs S was taken from CT angiogram to theatre, where an extraventricular drain (EVD) was inserted. Following this procedure she was transferred to the intensive care unit (ICU) for stabilisation and monitoring. She remained sedated, intubated and mechanically ventilated overnight as she required increasing amounts of ventilatory support to maintain adequate gaseous exchange and was agitated when her sedation was reduced. Her admission observations are outlined in Table 1. Mrs S’s monitoring and treatment plan during the acute stage of her bleed was clearly and precisely prescribed (Box 1).