Country doctor uses household drill on patient's skull
Over at BB Gadgets, Rob posts the heartwarming tale of Rob Carson, a country doctor in Maryborough, Australia, who saved a 12-year-old boy's life by drilling a hole in his skull using a Black And Decker drill. The young fellow, Nicholas Rossi, had fallen off his bike and had a brain hemorrhage. Needing to relieve the pressure on the boy's brain, Carson grabbed a drill from the small hospital's maintenance closet and performed the trepanation. From The Age (fantastic photo from fox.out22's Flickr stream):
Over the telephone, Melbourne neurosurgeon David Wallace walked (Carson) through the procedure..."Doctor Driller Saves Boy's Life"
''They stabilised Nicholas to start off with (and) they put him under anaesthetic and then Dr Carson came out and he said that he had 'one shot at this' and said what he wants to do is to drill into Nicholas' head to relieve pressure on the brain,'' (Nicholas Rossi's father) said.
Dr Carson drilled a hole just below the bruise mark, above Nicholas' ear, until a blood clot came out. He used forceps to increase the hole to about a centimetre in diameter, then inserted a drainage tube to keep the blood flowing out of the boy's skull...
Nicholas was airlifted to Melbourne's Royal Children's Hospital an hour later and was released on Tuesday - his 13th birthday.
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neuroscience ftw!
There are some sources who think trepanation in prehistoric times was often used for the same reason. And it worked since most trepanning cases seemed to survive the surgery.
Hero!
Why'd they go through all this trouble and risk? Everyone knows if they'd just prayed hard enough everything would have worked out.
I guess it was because the drilling was close to his ear that the story was "hear-warming"?
Sarah Palin would be proud.
(I know, cheap shot, couldn't resist.)
People, People, this is not uncommon at all.
Regular drills are used in surgeries quite often, and why not? Why make a special drill? What would a 'surgical drill' do that a regular one doesn't?
Oh that reminds me, gotta torrent that Braindrill album...
Everything was fine until the doctor tried to clean up the area using a shop-vac.
I would expect a "surgical drillbit" to be sharper than anything you could get at a hardware store, but I don't think the drill itself has much use for any special features. Maybe something easier to clean, that doesn't go into high speed if you squeeze the trigger too much...
#7, a surgical drill would probably be designed specifically to bore through bone, and ideally would not be kept in a rusty toolbox in a dusty closet.
David: Glad to see you fixed that typo, though it rendered my previous comment simply a lame pun. =D
Hey, this wasn't some kind of medieval "letting out evil spirits," Lobster. It was actually medically necessary in this case. Most people need trepanation like a hole in the head, though.
@ #9 posted by Moriarty
I think surgical drills, at least those for skulls, have an auto-stop feature designed to detect when the skull has been drilled through so the brain is protected.
Or I could be wrong, and the cucumber that drilled into my head was wearing nylons and a yes please I'll have some toast.
@#10 Lobster
"a surgical drill would probably be designed specifically to bore through bone"
I would think the drill bit would be more important than the device providing the rotational torque.
@#13 Dbarak
That's an awesome idea, though im not sure how one would implement it.
What a coincidence! Yesterday I was admiring this
http://www.shorpy.com/node/6154
photo of ancient Peruvian trepanation work, and commented that modern trepanation is done with a Black & Decker drill. Little did I know just how right I was...
Maybe something easier to clean
Maybe? If you can't stick it into an autoclave, it doesn't belong in someone's body.
Usually they use a hole saw, not a drill bit.
But in an emergency, anything sterilizable will do.
Stick the drill in a ziplock bag, punch the bit through and scrub it with betadyne and alcohol, drill away. Any crap on the drill, and of course the brush and commutator dust that is generated during normal us, stays in the bag.
In a US hospital, the big deal is the special hospital-grade plug. But that's a complete sham anyway, just pure snake oil to drive up the price of a plug.
no fear, Nutbastard, I always use my Stryker for my little "projects".
http://columbus.craigslist.org/bfs/1179462806.html
"that smells great!"
http://www.youtube.com/watch?v=noupHDxmUTE
There is a movie called The English Surgeon about an english neurosurgeon who sometimes flies to Ukraine to provide some help to one poor hospital. It features footage of surgeons shopping at the local market for proper drills and some footage of the actual surgery. I mean, it's pretty cool and also quite moving.
One review is here:
http://www.mindhacks.com/blog/2008/03/the_english_surgeon.html
"One of the most gripping scenes is where the two surgeons open a patient's skull using a Bosch power drill only to find the battery is going flat as they proceed."
;)
Egon, this reminds me of the time you tried to drill a hole through your head.
That would have worked if you hadn't stopped me...
Boring!
(sorry.)
Aside from the improvisational use of the Black & Decker, this isn't really unusual at all-- the AHA practice guidelines recommend so-called "burr-hole craniotomy" for certain intracranial hemorrhages that can't be stabilized medically.
If I'm remembering correctly (IANAneurosurgeon), this is usually done with a drill called a craniotome, which is air-driven and has a clutch that prevents splattering the gray goo once you've punched through the cranium.
This simple country doctor (Dammit, Jim!) gets Sullenberger points for doing this successfully, but the procedure itself isn't that difficult provided you can send someone down to Home Depot for a big enough skull clamp.
(But don't try this at home with your Black & Decker Silly Driller, kids!)
McCoy: Tearing of the middle meningeal artery...
Doctor: What's your degree in? Dentistry?
McCoy: How do you explain slowing pulse, low respitory rate, and coma!
Doctor: Fundoscopic examination...
McCoy: Fundoscopic examination is unrevealing in these cases!
Doctor: A simple evacaution of the expanding epidural hematoma will relieve the pressure!
McCoy: My God man! Drilling holes in his head's not the answer! The artery must be repaired! Now put away your butcher knives and let me save this patient before its too late!
The mechanical make-up of a surgical drill isn't that much different from a regular one. What makes this story special is the massive risk involved - a household drill is much more difficult to properly sterilize. No doubt they had to bag it all, making it even more difficult to use. I'm no surgeon, but I would assume that a surgical drill probably has better speed control as well.
Sorry to nitpick, but it was actually a deWalt drill. Or maybe Black & Decker has now become a brand-generic shorthand for any power drill.
Hey Takuan, the kid wasn't wearing a helmet when he fell off hts bike.
This is drillbit karma.
Don't Start. Just don't start.
*sniff?...... is...is someone wishing ill upon a child?
@13 (Dbarak), 14 (NutBastard):
I read an interview with the doctor featured in the documentary that Anon@20 linked to. It was mentioned in there that the proper cranial drills do have an autostop feature that stops the drill as soon as it has got through the skull.
@26 dewalt and black & decker are essentially the same thing nowadays. both live under the same corporate umbrella and are made from the same parts.
why not breed GM lampreys?
http://www.miseagrant.umich.edu/photos/ais/images/highrez/SL-s09.jpg
I guess only time will tell whether Nicholas' greatly increased brainbloodvolume will give him superhuman powers of cognition.
What was that old quote from the original novel,
M*A*S*H, regarding another trepanation...
"He might make it, even if all I really did was hit him in the head with an axe."
House episode with Mira Sorvino.
Unicorn chaser please!
-"Sarah Palin would be proud."
LOL!! AMEN BROTHER!!
www.parada.ws
the amazing thing is that this news item was almost immediately eclipsed by an Australian woman vacationing in Thailand who stole a barmat, and was in danger of being jailed for five years.
ok
http://christwire.org/wp-content/uploads/2009/04/a-unicorn-women.jpg
The drill BITS used for burr holes often (but not always) have a stop on them. I have such a bit in my toolbox, but my digital camera is broken so a photo is not forthcoming. If someone out there needs to see one, I can borrow a camera in a few days, but really it looks just like this:
http://www.climaxmetal.com/Drill_Stop_Kit.htm
The DRILL for a burr hole is usually a hand drill, allowing the neurosurgeon more control. The stop is no promise that the surgeon won't go through some of the sometimes delicate membranes around your brain. The surgeons I work with have a great feel for when they're about to go through, and can predict it within partial turns of the drill.
A craniotomy uses a totally different cutting device, and it not what was done in this case.
I assume that the patient reported on here had a CT scan, otherwise there was much risk that the bleeding was on the other side of the brain from the injury (called contracoup). Get it wrong, make things worse.
http://en.wikipedia.org/wiki/Contracoup_coup_injury
This is a pretty excellent piece of emergency care for someone without the proper tools!
Jonathan
The FiatRN
hmmm...I imagine in field conditions in the absence of any equipment altogether it would be possible to relieve cranial swelling by diligent and careful gnawing...
@36 Annnd also the Grey's Anatomy episode with the ferry crash.
#41,
I doubt a doctor Maryborough would have access to a CT. I am pretty sure they would have drilled without any imaging before hand.
The Royal Childrens Hospital definitely has CT and MRI equipment. I was there recently because my nephew is in that hospital being treated for Fungal Meningitis, which is another story in itself.
The same thing happened in Western Australia a couple of years ago. Not sure if the patient was a child on that occasion though. Distance is often a problem for medical care in remote areas of Australia. My uncle used to fly for the Royal Flying Doctor service here. I am sure he has some stories to tell.
I don't know if this operation is that safe; the boy doesn't look too well in the news picture above.
Never thought I'd read about our own Doctor on Boing Boing! Lovely man, lovely caring wife (unfortunately no longer practicing) too...
Could you please change the article to reflect the Doctor's name? It's Carson, not Carlson...
And Frogmarch: He's hardly a simple country Doctor. The town of Maryborough (not as remote as you may think) has some exceptional medical talent. Many simply came for the treechange and we are the better for it. The town has a population of around 8750 people but supports a much greater district. Large enough to require an Aldi, Coles, Woolworths and Kmart. We are hardly a "remote" country town.
The hospital recently acquired new ultrasound equipment - nearest CT & MRI are located in Ballarat and Bendigo.
We moved here 5 years ago and we decided to leave our small city minds behind and enjoy what the district has to offer. Its a much nicer environment to write software in.