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Fri May 22 07:24:02 BST 2009

p.s. the GP said he was much more afraid of seeing the boy die in front of him than he was of using the Black and Decker.

here is the article that was in The Australian:

A COUNTRY doctor has saved the life of a dying 12-year-old boy by using a household drill to bore into his brain after the boy had a bike accident.
Handyman doctor saves boy

A local GP removed a blood clot in the brain of a 12-year-old boy by using an everyday house drill....
The emergency "operation", by local GP Rob Carsonin the Victorian country town of Maryborough, was yesterday hailed by a leading neurosurgeon as "one of the gutsiest life-saving efforts imaginable". 
The drama happened late last Friday when Nicholas Rossi fell off his bike while riding in a quiet cul de sac outside a friend's house in Maryborough, a town of 7000 people 170km northwest of Melbourne. Nicholas was not wearing a helmet and the impact of his head hitting the pavement knocked him momentarily unconscious. 
"He was a bit delirious at first, but then he stood up and said he was fine," his father, Michael Rossi, told The Australian yesterday. When he got home, Nicholas kept complaining of a headache and his mother, Karen, a trained nurse, took him to the district hospital where Dr Carson, a local GP, was on duty. 
The doctor kept him for observation, but an hour later Nicholas began to drift in and out of consciousness and have spasms. 
Dr Carson recognised it as a sign of internal bleeding in the skull that places acute pressure on the brain - the same deadly condition that recently claimed the life of actress Natasha Richardson, wife of Hollywood actor Liam Neeson. He also noticed that one of the boy's pupils was larger than the other - another sign of the internal bleeding. 
The boy had fractured his skull and torn a tiny artery between the bone and the brain just above his ear. This created internal bleeding that became trapped between his skull and brain and formed into a huge blood clot, placing pressure on the brain. 
If Dr Carson did not act within minutes, the boy would die. 
"Dr Carson came over to us and said, 'I am going to have to drill into (Nicholas) to relieve the pressure on the brain - we've got one shot at this and one shot only'," Mr Rossi recalled. 
The small hospital was not equipped with neurological drills, so Dr Carson obtained a household De Walt drill, used for boring holes in wood, from a hospital maintenance room. 
He telephoned leading Melbourne neurosurgeon David Wallace to help talk him through the procedure, which he had never tried before. 
Mr Wallace told Dr Carson where to aim the drill and how deep to go. 
The GP disinfected the drill and drilled into the skull just below the bruise mark on the side of the head above the ear where the trauma had occurred. 
"He drilled into my son's head and we heard the suction," Mr Rossi said. 
Dr Carson drilled until a blood clot fell out. Blood then kept flowing out. The GP then used forceps to make the drilled hole slightly bigger until it was about 1cm in diameter. Then a draining tube was placed in to allow the blood to continue to keep flowing out. Nicholas was being transfused with fresh blood in his arm at the same time. 
Dr Carson knew the procedure had worked when he checked the pupil and found it had returned to normal size. 
The actions of Dr Carson, assisted by anesthetist David Tynan and a team of hospital nurses, kept Nicholas alive until he was airlifted an hour later to Melbourne's Royal Children's Hospital. 
Since then Nicholas's condition has improved so much that he was released from hospital yesterday. 
Dr Carson is a reluctant hero, telling The Australian he was just doing his job. 
"If you are in that situation you just do those things," he said. 
"It is not a personal achievement, it is just a part of the job and I had a very good team of people helping me." 
Mr Rossi was not so shy. "He saved our son's life," he said. 
"David Wallace told us he could not believe Rob Carson had the guts - and it does take guts - to drill into his head. 
"He said it was the difference between a patient arriving at the hospital dead or alive." 
Nicholas turned 13 yesterday. 
"He has started his teenage years with a bang," Mr Rossi said. "But life can change in a minute - tell your kids to always wear a helmet."

________________________________
From: Jenny Moncur <jmoncur at netspace.net.au>
To: Trauma and Critical Care mailing list <trauma-list at trauma.org>
Sent: Thursday, May 21, 2009 12:32:03 PM
Subject: Re: Australian doctor uses household drill to save boy

Yep - he did have a critical lesion.
The child rapidly became unconscious, started fitting and then blew a pupil.
Family took him to local hospital.

The local doctor evacuated a clot and 400ml of blood from the epidural space by drilling just above the right ear.

He was in phone contact with a neurosurgeon at the major trauma centre in Melbourne who talked him through the procedure.
This was in part facilitated by our State Trauma system which fast tracks communications between regional and remote medical facilities with the major trauma centres.
The surgeons can give advise to the remote doctor or paramedics over the phone for immediate care needs of the patient meanwhile arranging for transfer to the appropriate centre.

This kid also had a pretty level headed and gutsy local doctor and anaesthetist at the regional hospital.

He looks well.

Jen
IC Paramedic
Victoria, Oz
----- Original Message ----- From: "Rob Ojala" <Rob.Ojala at cdhb.govt.nz>
To: "Trauma and Critical Care mailing list" <trauma-list at trauma.org>
Sent: Thursday, May 21, 2009 12:07 PM
Subject: RE: Australian doctor uses household drill to save boy

based on recent opinions expressed on this list....[and assuming this child really did have a critical lesion]...i suspect he was lucky to be living in Australia :-(

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Australian doctor uses household drill to save boy