Thumbellino

[orthodoc]

Originally Posted by Pete Zicato

Ortho. You sounded all Mothery until the PS. That sounded painful and scary.

It's a failing of us female docs.

Trephinating a hematoma scares patients, but it actually doesn't hurt at all. The trick is to hold the finger (or thumb) against a firm surface to minimize movement, hold your hand so that the patient can't see the cautery end of the trephinator (which is glowing), and tap very lightly in the center of the hematoma. It takes only one or two gentle taps and the hematoma releases. You don't touch the nail bed (that would be painful), you just go through the nail, which has no nerve endings. People get tremendous relief with it. You have to do it within 12-24 hours, though, or the hematoma starts to clot down and it doesn't help.