Other uses for common equipment

[Doctor Bob]

Australian doctor uses household drill to save boy
Tuesday, May 19, 2009; 9:00 PM

MELBOURNE, Australia -- A doctor in rural Australia used a household drill to bore a hole into the skull of a boy with a severe head injury, saving his life.
Nicholas Rossi fell off his bike on Friday in the small Victoria state city of Maryborough, hitting his head on the pavement, his family told The Australian newspaper in a story published Wednesday. By the time Rossi got to the hospital, he was slipping in and out of consciousness.
The doctor on duty, Rob Carson, quickly recognized the 13-year-old was experiencing potentially fatal bleeding on the brain and knew he had only minutes to drill a hole through the boy's skull to relieve the pressure.
But the small hospital was not equipped with neurological drills _ so Carson grabbed a household drill from the maintenance room.
"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,'" the boy's father, Michael Rossi, told The Australian.
Carson called a Melbourne neurosurgeon for help, and the specialist talked Carson through the procedure _ which he had never before attempted _ by telling him where to aim the drill and how deep to go. Soon, a blood clot fell out, relieving the pressure on the boy's brain.
Rossi was airlifted to a larger hospital in Melbourne and released Tuesday _ his 13th birthday.
Carson was modest about his feat.
"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," he told the newspaper.
Michael Rossi was more effusive.
"He saved our son's life," he said.

If we aren't careful, soon the maintenance workers will be stealing our procedures, once they realize we're using their equipment.

So what other "off label" uses for equipment hanging around the hospital have you come up with?

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[TexasTriathlete]

Holy crap, that is not what I expected when I clicked on this. If that happened in the states, and it didn't work (or probably even if it did), I can only imagine the lawsuit.

One time I used a soft restraint to suspend a pt's foot from the overhead lamp in the trauma bay. He had part of an iron gate stuck through his leg, between the tib & fib, and we needed him prone, with the leg elevated. It was my moment of zen as a member of ED ancillary staff.

 

[RxnMan]

Using an ET tube to drain an extremely fragile enterotomy in an open abdomen.

 

[USCDiver]

Stacking multiple foleys with inflated balloons in the esophagus in place of a blakemore tube.

 

[beyond all hope]

When I worked in mexico, the neurosurgeon actually used a sterilized Black and Decker. It was in a resealable plastic bag. Worked just fine.

18 G IV as central line. That's all I can think of right now.

 

[Febrifuge]

Surely I'm not the only one who's seen the nasal cannula hooked up to a bag of saline, in order to irrigate an eye?

 

[Dwindlin]

Surely I'm not the only one who's seen the nasal cannula hooked up to a bag of saline, in order to irrigate an eye?

I do this alot pre-hospital.

 

[kungfufishing]

Wait so you put it up their nose until it is coming out of their eyes, like a horned toad?

(this is sarcasm, please no reply)


tape together 2 sets of three tongue depressors and use as a sort of clothespin for nosebleeds. those people never hold it for as long as you ask em to otherwise.

 

[Hawkeye Kid]

Stacking multiple foleys with inflated balloons in the esophagus in place of a blakemore tube.

Or one foley up the nose for a posterior bleed. Did this for the first time last night and it worked like a charm.

 

[telenurse]

I was working for the VA, and had a pt with a soft silicone trach, the side where the trach ties broke, and we had no replacements, and being the VA, RT wouldn't help, and the pt was on a hospitalist's service and it was around 2300. I worked a quick fix by making a hole in the side of the trach with a needle, pushing a paperclip and twill tape through it and around to the trach ties. It worked for 12 hours until he was fitted with a different type of trach.

 

[EctopicFetus]

Some are obvious though havent been mentioned.

1) tongue depressor sticks to relocate a jaw (as a means of protecting ones fingers)
2) foley in place of a G tube
3) We once placed a foley catheter into the pericardium to help it drain
4) Using the rubbing alcohol pads as an antiemetic

 

[e30ftw]

last ditch effort but have seen it:

ED thoracotomy -> penetrating cardiac injury -> foley in hole, staples around foley -> OR -> morgue.

foleys are useful.

 

[Hamhock]

last ditch effort but have seen it:

ED thoracotomy -> penetrating cardiac injury -> foley in hole, staples around foley -> OR -> morgue.

foleys are useful.

I saw this done by a trauma surgeon once and have read about it since.

I would add to your sequence: Foley into hold in LV -- traction on Foley -- transfuse through Foley -- GOMER

HH

 

[e30ftw]

PRBCs straight to the LV!



dermabond as a dental splint.

 

[doctorFred]

-- for large skin tears than need to be sutured but will just pull through - steri strips on either side, suture directly through steri strips.
-- NG tube in an oropharyngeal airway in a cup of ice, puts a nasopharygneally-shaped curve in the ng tube to pass easier
-- cut an ortho glass splint 90 percent of the way down the middle, fold in half, notch sits over the thumb - easy sugar tong splint
-- silver nitrate or electro-gun cautery on oozing post-op wounds (wouldn't recommend this one, but i tried it once!)
-- a-line catheters for u/s guided deep peripheral IVs - long catheter and wire-guided. so easy.

that's all i can think of for now.

p.s. -- what's with the auto correcting i to "me" and tried to "treid"? is this some internet lolmeme thing?

 

[Hair Police]

I think it's April 1st...

 

[deleted109597]

-- for large skin tears than need to be sutured but will just pull through - steri strips on either side, suture directly through steri strips.

Save more time by not suturing those. Steristrips and dermabond work just as well, and take a ton less time.

 

[deleted6669]

nasal cannula prongs to direct o2 into needle crich airway; 1 prong over/into needle hub, occlude other prong 1 second on,4 seconds off to deliver 02.

 

[doctorFred]

Save more time by not suturin' those. Steristrips and dermabond work just as well, and take a ton less time.

usually you can get away with that. not always., particularly with oozers on coumadin/etc.

 

[spyderdoc]

I had this guy with a megacolon who came in regularly with a 9 month sized abdomen and obstipation. They previously used Foley's or rectal tubes to decompress him, but they always got clogged up. So on his umpteenth visit, RNs grumbling, and uncomfortable patient, I thought to use a large diameter chest tube. I clamped the open end, inserted the tube, connected it to a Foley bag, and it decompressed him very nicely. Only thing is that the Foley bag blew up like a balloon, and had to be clamped and changed a few times until he was decompressed. No way we were going to deflate those bags int he ER, so later on we were laughing at the thought of these bags exploding in the incinerator, so funny. Nonetheless, it worked like a charm. I figured there was very low likelihood to perf given how dilated the rectal vault was.

 

[gan911]

1/2 plastic speculum makes the best lighted tongue depressor for anything in the mouth. esp the big blue one

 

[Spinach Dip]

*takes notes*

 

[deleted92121]

using stethoscope as tourniquet for placing an EJ . . . works great in the field

 

[doctorFred]

using stethoscope as tourniquet for placing an EJ . . . works great in the field

otherwise known as strangling the patient?

 

[deleted92121]

otherwise known as strangling the patient?

That's just a bonus . . .

Seriously, place the stethoscope on the patient with binaural on the neck lightly and it'll pop the EJ up quickly. Works well.

 

[Spinach Dip]

This thread has inspired me to write a new book:

101 Uses for a Foley Catheter

 

[pagemmapants]

Doesn't Paul Auerbach have a list of 101 things to do with a safety pin?

Including evacuate thrombosed hemorrhoids. Ouch.