Thursday, May 21, 2009

Nurse, the Black & Decker..........

A country GP in small-town Australia saved a boy's life by using a household power drill to bore into his skull after he fell off his bicycle and suffered a serious head injury. Nick Rossi, 12, was brought to the local hospital in Maryborough, Victoria, by his parents, after he complained of a headache.

Rob Carson, who was on duty, quickly realised the boy had potentially fatal bleeding on the brain. With no neurological instruments available in the small hospital, he sent for a handyman's drill from the maintenance room.

A neurosurgeon in Melbourne then talked Dr Carson through the procedure by telephone. Dr Carson told Nick's parents, who were waiting anxiously: "I've got one shot at this, and one shot only. I'm going to drill into Nick's head and try to relieve the pressure [on the brain]." Afterwards he told the boy's father, Michael Rossi, that all he could remember saying at the time was "Get the Black & Decker".

In the event, it turned out to be a |De Walt drill that Dr Carson used to bore into Nick's skull and release a blood clot. David Tynan, the anaesthetist who was tasked with overseeing events in the hospital's emergency room, said yesterday: "It was pretty scary. You obviously worry, are you pushing hard enough or pushing too hard, but then when some blood came out after we'd gone through the skull, we realised we'd made the right decision."

The injury was similar to the one suffered by the actress Natasha Richardson, who died in March after failing to get immediate medical attention following a fall on a Canadian ski slope.

Nick Rossi, who has since made a full recovery, fell off his bicycle last Friday while riding without a helmet in a quiet road near a friend's house. He hit his head on the pavement and passed out briefly, but then seemed fine.

However, his mother, Karen, a nurse, decided to take him to hospital after discovering a lump behind his ear. Once in hospital, the boy began to deteriorate, suffering breathing difficulties and drifting in and out of consciousness. Dr Carson noticed that one of his pupils was bigger than the other, a tell-tale sign of a bloodclot, and realised he had only minutes to make a hole in his skull and relieve the pressure on his brain. The neurosurgeon, David Wallace, explained to him where to aim the drill and how deep to go.

"All of a sudden the emergency ward was turned into an operating theatre," Mr Rossi told local radio yesterday. "We didn't see anything, but we heard the noises, heard the drill. It was just one of those surreal experiences."

The procedure took just over a minute, after which Nick was airlifted to a children's hospital in Melbourne, 100 miles away. He was discharged on Tuesday, his 13th birthday.

Dr Carson remained modest about his role in the procedure. He told The Australian newspaper: "If you are in that situation, you just do those things. It is just part of the job and I had a very good team of people helping me."

But Dr Wallace, the neurosurgeon, said it had taken incredible guts and skill. "He later told me that what Dr Carson did was extremely brave," Mr Rossi said. "To have done that with a household drill ? he said it was unbelievable." Nick's father added: "He saved our son's life."

In a short break after delivering a baby yesterday, Dr Carson told local radio: "The actual procedure itself was not as terrifying as the possible outcome if I didn't do it."

He agreed that it was probably "one of the highlights" of his career in country hospitals.

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