Rupture of a carotid artery is the most serious and dreaded complication that nurses caring for head and neck cancer patients will face. This event, said to complicate 3–4% of all major head and neck procedures, has an extremely high mortality rate.4,6,9Loss of the protective layer, the adventitia, surrounding the artery precedes a rupture. Awareness of the factors that lead to this breakdown is the first step in preventing a blowout. However, because there are no warning signs that can be used to predict exactly when a rupture will occur, preparation is another essential aspect of patient care. Educating staff to act swiftly and precisely in such a crisis will help to ensure a more positive outcome.