The year 2014 has passed, and in addition to the many memories of international accidents, we ended up with a ruptured abdominal aortic aneurysm that did not make it to surgery. In retrospect, some details are worth noting. The patient was found to have an abdominal aortic aneurysm 4 years ago, which was more than 4 centimeters in diameter at the time, and was not treated; on the evening of December 29, he had sudden abdominal pain, and a ruptured abdominal aortic aneurysm was confirmed by CT at the local hospital. The family contacted me through a friend and I agreed to see them. However, the news came from other sources afterwards that the patient’s blood pressure was only 50 mmHg and he could not come. At noon on the 30th, the patient’s family suddenly called and said that they were almost at our hospital. After that, although we finished the preoperative preparation quickly, the operation room was not vacated because the operation in the hybrid operation room was not finished. The patient died while waiting. From this case, we can learn the following lessons: 1, to pay attention to the regular follow-up of abdominal aortic aneurysm: in general, abdominal aortic aneurysm diameter more than 5cm is an absolute indication for early surgery, 3-5cm can be elective surgery. However, those less than 5cm are not worry-free. It is reported that the annual rupture rate of aneurysm diameter 5-6cm is 6.6%, and 19% when the diameter reaches 7cm; it is reported that the 5-year rupture rate of abdominal aortic aneurysm with maximum aneurysm diameter of 4cm is 10%-15%, about 20% when 5cm, about 33% when 6cm, and 75%-90% when 7cm or more. Considering that the size of Chinese people is smaller than Caucasians, aneurysms smaller than 5 cm should not be taken lightly and should be monitored by ultrasound or CT every 3 to 6 months at the hospital. 2. If rupture occurs, the main symptoms are sudden onset of back pain, decreased blood pressure with sweating, and increased heart rate, you should go to the nearest hospital as soon as possible. If local conditions are limited, more than 3 effective intravenous accesses (18G or 16G cannula) should be opened, and transfer to higher level hospital should be contacted as soon as possible under the condition of ensuring fluid and blood transfusion. 3, If local can do some early treatment, I hope at least one blocking balloon can be placed, so as to effectively reduce bleeding and buy time. I can instruct the local community on the specific placement method. 4. Most doctors in Beijing do not give their personal phone numbers to patients or their families, but when a patient is critically ill and needs to be transferred urgently, I will agree to give the phone number to the patient’s family, and the family must notify me at the first opportunity before they leave, and keep in communication with me along the way so that I can know the exact time the patient is expected to arrive, arrange for the doctor to receive the patient, adjust the surgery plan, and leave the operating room so that the patient can start treatment in time after arrival. 5. 5. When transferring patients from abroad to our hospital, we should bring the results of local examination and treatment as far as possible. 6.Family members are advised to bring enough cash or bank cards (our hospital can swipe cards) to ensure that valuable resuscitation time is not delayed due to various details. A ruptured abdominal aortic aneurysm is very critical, once ruptured, the mortality rate is up to 80%, for such a critical patient, time is very precious every second. We hope that no more patients will die of sudden abdominal aortic aneurysm rupture in 2015.