GP saves boy with a home drill

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http://www.theaustralian.news.com.au/story/0,25197,25509892-601,00.html

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.

The emergency "operation", by local GP Rob Carson in 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."
 
thats great. who says you need some great equipment and all the best support to do amazing shit? One doc, alone and unafraid, getting some the way he thought would be best. Well done.
 
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