Blind burr holes

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Dr. Voss,

If the patient does not wake up - you do not report it.


Sanjay Gupta
Tel: 207 576 3296


--- On Tue, 5/26/09, Miranda Voss <mvossak at yahoo.co.uk> wrote:

> From: Miranda Voss <mvossak at yahoo.co.uk>
> Subject: Re: Blind burr holes
> To: trauma-list at trauma.org
> Date: Tuesday, May 26, 2009, 6:27 AM
> 
> No, truly blind, most recently in Burundi just after the
> war when we couldn't even get a plain x ray. 
> 
> Didn't realise the Australian case was post-scan and
> thought the general flavour of the posts suggested that all
> you need in a remote environment is a Black and Decker, a
> doctor with a bit of backbone and a non litiginous
> environment and all will be well. Clearly not! My
> misunderstanding.
> 
> It can be very difficult to find the clot without a scan
> and I hope I never have to do it again.
> 
> Miranda Voss
> Worcester, South Africa. 
> 
> 
> The Australian story was post-CT demonstrating an
> extra-axial
> collection.....are your cases truly blind or post CT? - 
> 
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]
> On Behalf Of Miranda Voss
> Sent: Monday, 25 May 2009 9:00 p.m.
> To: trauma-list at trauma.org
> Subject: Blind burr holes
> 
> 
> Re: Congratulations to Australian Doctor
> 
> I also read this case with great admiration for the doctor,
> the system
> and the outcome. However, I would like to give another
> perspective on
> blind burr holes. 
> 
> I have had to do it a handful of times when in the bush
> with no
> possibility of referral/advice (NOT South Africa) and I
> think it is a
> HORRIBLE operation. I have only done it with documented
> decrease in
> consciousness and localising signs, but I have never found
> a nice
> hematoma that could be evacuated with good results; either
> high pressure
> brain has come pouring out of the burr hole, or
> occasionally there has
> been bleeding that I have not been able to stop
> satisfactorily. It has
> always left me feeling far from warm and fuzzy and to be
> honest, I am
> now very reluctant to do it.
> 
> Am I the only general surgeon/occasional skull trephiner
> who has never
> had a patient waking up on the end of the drill?
> 
> Miranda Voss
> Worcester, South Africa
> 
> 
> From: "ramalinga reddy" <drarumalla at yahoo.com>
> To: trauma-list at trauma.org
> Congrats to Rob Carson for saving the chaild
> Many times doctors are afraid to do such thing for fear of
> legal
> implications
> It is the medical faculty which should educate the general
> public so
> that 
> litigations are minimised and doctors do such things
> confidently
> Hats off to Dr RobCarson
> 
> 
> Dr.A.R.Reddy 
> SKS Neuro Hospitals 
> Mobile: 9849018017
> 
> --- On Fri, 22/5/09, trauma-list-request at trauma.org
> <trauma-list-request at trauma.org>
> wrote:
> 
> 
> 
> 
>       
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