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Utilizing the Six Thinking Caps

Application of the “Six Thinking Hats” of de Bono in decision making on how to solve a problem produces better output due to the integration of different perspectives instead of over-lapping them.

Edward de Bono’s six thinking modes are: white hat which is objective and covers facts, figures, and information; red hat is subjective in nature that includes emotions and opinions, intuition, and feelings; yellow hat is also an objective aspect that is comprised of positive facets ,and praise; black hat is another objective mode that contains negative facets, criticism, and judgment; green hat for the creative or speculative nature covers generation of ideas, provocations, and new approaches; and lastly the blue hat is focused on the overview of the subject which integrates the other hats for a consolidated output(Walter, 1995).

This case study is exercising the application of the six thinking hats in order to come up with the best resolution of the case. White Hat Hemorrhagic stroke is a bleeding inside the skull due to rupture of brain blood vessels that lead to damage in the brain tissue. Intracerebral hemorrhage and subarachnoid hemorrhage are two basic types of hemorrhagic stroke. Hemorrhages that occur within the brain are termed as intracerebral hemorrhages. Bleeding between the pia mater and the arachnoid mater of the brain is called subarachnoid hemorrhage.

Intracerebral hemorrhage is common in geriatric people above 60 and this is the cause of 10% of the stroke cases(Merck & Co. , 2007). Brain surgery or neurosurgery is performed by opening the skull (craniotomy) in order to manage the lesions of structures inside the brain. This procedure is performed for treatment of tumors, damages of tissues, abnormalities in blood vessels, aneurysms, and blood clots or hematomas in the brain. Like any surgical procedures brain surgery involves risks that include: mental functions loss, blood vessels injury, brain tissue injury, and nerve or muscle injuries(Medicine, 2007).

Brain surgery for the treatment of hemorrhagic stroke is done only in cases where an intensive bleeding has occurred and there is observable rapid worsening of the patient’s condition(“Stroke Guide,” 2007). Diagnosis of the intensiveness of the bleeding must be done before considering surgery as treatment modality. Using this mode of thinking the family and the ethics committee considers the facts about the patient. The condition of the patient is thoroughly analyzed including the health of the patient and the capacity of the patient’s condition to cope up with the surgery.

Symptomatic treatment of clinical signs of the patient’s condition should be done prior to any attempts to treat the primary cause of the patient. The purpose of which is to stabilize the patient’s condition and prevent greater loss to the function and normal physiology of the patient’s body. Red Hat The patient’s children are afraid that even though the surgery is done it will not do any good in alleviating the condition of their mother. The children also worry that their mother might want to undergo the surgery if she has the capacity to decide for herself.

The doctor’s opinion on the other hand is to perform the surgery so that a correction of the ruptured blood vessels can be done. Black Hat The patient must be thoroughly examined because if she is too weak and the surgery is performed her body might not be able to survive the surgery. In treatment of hemorrhagic stroke cases the immediate steps are in accordance with the need to stabilize the patient’s condition. Airway should be patent and this might need the use of mechanical ventilation. The discrepancy in blood pressure of the patient also needs to be corrected immediately.

Management actions should also be done to prevent the patient from developing increased intracranial pressure. Magnetic resonance imaging (MRI) scan of the patient should also be obtained to identify the cause of bleeding. Other tests such as complete blood cell count, bleeding time, and cerebrospinal fluid exam along with the analysis and interpretation of the results needs to be done so that prompt treatments of other problems can be instituted. In a way the prevention of complications will also be prevented. Prognosis of the patient’s condition needs to be established so that it can serve as basis for treatments that to be done.

For example, if the prognosis of the patient’s condition is poor less invasive treatments are recommended but if the prognosis is good the patient has a high tendency of surviving surgery and improvement of condition. Yellow Hat Surgery of the brain of patients with hemorrhagic stroke will help in the prevention of the recurrence of the stroke. The surgery is beneficial not only for the removal of blood clots but also in correcting the loss of the integrity of the ruptured blood vessels so that normal function and the flow of blood in these blood vessels will be restored(“Hemorrhagic Stroke,”).

The possibility of improving the patient’s condition can be attained also through the surgical procedure because the primary cause of the stroke can be treated thus the complications will be lessened. Green Hat Factor VIIa is a promising treatment for hemorrhagic stroke patients and the purpose of this substance is to stop the bleeding(“Hemorrhagic Stroke,”). An alternative procedure for the treatment of hemorrhagic stroke is the minimally invasive or endovascular treatment that utilizes a Wingspan intracranial stent that can upon obstructed blood vessels in the brain(ScienceDaily, 2007).

Blue Hat Negative beliefs of the patient’s children with regards to performing brain surgery can be eliminated by letting the doctor explain about the why the surgery is needed, the risks and benefits of the surgery. Costs of the operation along with post operative treatments should also be discussed to the patient’s family. The rate of the possibility of improving the patient’s condition through surgery should also be discussed with the patient’s family. After the facts, risks, benefits, and other details are discussed the family of the patient will have to decide if the surgery is done.

If they prefer the surgery, it will have to be explained that though the success rate of recovery with the condition due to surgery is high the risk is still there. Usually the assurance that the doctor’s will do everything they can for the patient will help in pacifying the patient’s family. If they chose not to have their family member operated, there are also treatments and management procedure of the condition that is non-surgical.


Hemorrhagic Stroke. from http://www. intelihealth. com/IH/ihtIH? t=10812&p=~br,IHW|~st,408|~r,WSIHW000|~b,*| Medicine, U. S. N. L. o. (2007). Brain Surgery.Medical Encyclopedia Retrieved October 31, 2007, from http://www. nlm. nih. gov/medlineplus/ency/article/003018. htm Merck & Co. , I. (2007). The Merck Manuals Online Medical Library. Retrieved October 31, 2007, from http://www. merck. com/mmhe/sec06/ch086/ch086d. html. ScienceDaily. (2007). Brain Surgery Without The Surgery? Science News Retrieved October 31, 2007 Stroke Guide. (2007). Retrieved October 31, 2007, from http://www. webmd. com/stroke/guide/stroke-treatment-overview Walter, J. C. I. (1995). Six Thinking Hats: Argumentativeness and Response to Thinking Model Rochester Institute of Technology.

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