How To Drain Your Subungual Hematoma (blood pocket under finger-nail) with a Drill Bit

Have you ever smashed your finger in something and immediately get a black finger nail?  Well along with that sweet Hot Topic look comes a throbbing pain that, even for those with high pain thresholds, can be unbearable. It's hard to even sleep with this kind of pain! So, the best thing to do is drain the blood pocket under the nail and relieve the pressure build-up.

Some use the heated pin method. But that can lead to a little more pain than necessary. Also, there is hardly any pain associated with the drill bit method except for the slight pressure you are applying. Fingernails don't have nerve endings, and by moving very slowly with a drill bit, you can reach the blood pocket without touching your nail bed!

finally, you get a satisfying eruption of crimson that, if performed soon after the injury, has a geyser effect. it's quite nice.

Step 1: Smash Finger

I happened to accidentally crush my finger with a welding tank.

Step 2: Ice and Elevate your finger

Do this immediately to instantly relieve pain and swelling

Step 3: Find and sterilize/heat drill bit

Find the smallest drill bit you have access to and sterilize it either by heating it or using rubbing alcohol

Step 4: Start Drilling

slowly twist drill bit (by hand) into fingernail where blood clot lives, furthest from cuticle.

continue to twist slowly until you penetrate the bottom of the nail

do not use a drill for this...

(note bourbon)

Step 5: Presto

blood will form instantly once you've penetrated.

squeeze finger to relieve the pressure

Step 6: Apply anti-spectic

apply anti-spectic

Comments

[schaude]

if you do this you could close the hole later on, after desinfecting it, with super glue (sekundenkleber). just polish it after drying and be lucky with your "like new"-nail!

by the way, super glue is what surgeons use nowadays closing flesh wounds.

[rjr162]

Very tue, but the Medical grade uses 2-Octyl cyanoacrylate vs your standard Super Glue (which use Methyl, Ethyl or n-butyl and can be more prone to cause irritation and/or reactions)

[Klesa]

LMFAO!!! Oh god... Lol. I cant help but laugh at all the comments. But being as a "physician" has spoke on the page and thoroughly explained that it's ok but doesn't recommended it should "NAIL" it. :D Happy poking. :P

[mseba]

this is stupid you can get many viruses even std-s in good conditions by drilling holes in your body ,

[lukeyj15]

STDs? I don't know how one would contract an STD from drilling a hole into one's fingernail. The only way I foresee that happening is if one were to classify AIDS as an STD, didn't sterilise the drill bit, and let someone else use the drill bit before them that had AIDS, without them cleaning the drill bit. Using a completely new drill bit out of the packet that is sterilised with alcohol and then a flame will guarantee that you will not get AIDS or an STD from this procedure.

[byoung12]

HAHAHA the shadow of the bit makes it look like a horror film. How the blood is flowing fresh and the bit is still stuck in there :) lol.

[ScooterNZ]

The drill bit has a series of concentric flutes running up the shaft to remove swarf while drilling. The flutes perform the same function for the blood.

[TheBlackSharpie]

The first time I saw this ible I thought "Eww gross, I hope I never have to do that!" Well what do you know, I injured my toenail today and it is starting to bleed under the nail. I might have to do this procedure in the near future.

[lime3D]

I just read through the first 40 comments, and can't believe all the folks that are saying NOT to do this.

I think this is a fantastic instructable, and now that I've read it, I'll know exactly what to do if the next time I need to.

Thanks for publishing this.

To all those people that are freaking out about drilling holes... haven't you ever heard about body piercing? C'mon.

I don't know about using superglue, but it seams to me that a dab of anti-bacterial ointment and a band-aid should do the trick.

Thanks for publishing this.

[FlatLinerMEDIC]

SWEEEEET

[mrwolfe]

Thanks for writing this up. I've been performing the same procedure for years - whenever I happen to be clumsier than usual!

I initially used a heated paperclip and a sewing needle, but started using a 0.5mm or 1mm drill bit, mainly because I usually have one handy in the workshop. Sterilisation is a good idea, although I never thought of sterilising the drill bit and so far I have never had an infection.

[C1337us]

Smashed my thumb in a car door and it turned alll black and I couldn't sleep that night once. Great instructable!

[medicman]

Hi, I too am a "health care professional", a physician. While by the book ethics would prevent me from telling anyone it's OK to do this at home, I really can't find much wrong with the theory behind this home brew trephination procedure. The only thing I would add is that the procedure should be performed in a room with little air flow (avoid open windows or fans that might kick bacteria around); and most importantly, the nail needs to be disinfected BEFORE the procedure as well as after. That way you wont be pushing surface bacteria into the newly made wound. Also. be sure and twist the drill bit by hand as the author of this 'ible did. I have seen wounds where people thought they could use a drill but the drill ended up pulling the bit itself into the nail and making a far worse wound than what was started with. Last, the best way to sterilize the drill bit is rubbing alcohol and heat. Dip the bit in the alcohol, and light it on fire and let the alcohol burn away.

In this economy it's just not possible for everyone to have health insurance. It's a shame, but it is the way it is. If people will be trying to relieve pain themselves it's definitely better to have access to the right info than to guess at it. Any other "health professionals" are welcome to chime in, but it's better in my opinion to put knowledge out there than to criticize others for doing the same.

[flamekiller]

I believe you are doing your duty as a physician in recommending safe practices for performing this procedure. Would you agree that draining a SH will probably prevent the nail from falling off?

I've smashed my finger before and gotten little hematomas under the nail, but nothing severe enough to warrant draining. Those hurt like hell; I can't even imagine one like the one pictured.

[medicman]

No, draining the nail will increase the chances that your nail will stay on. Whether or not the nail falls off is depends only on the initial trauma. If the trauma sufficiently destroys the connection between the nail and nail bed then the nail will eventually fall off, drained or not. The only benefit to draining is the relief of pain. When the injury first occurs, the blood flowing to the area has no where to go and creates pressure by being caught between the nail and nail bed. This pressure can cause a lot of pain, but will not be sufficient to further traumatize the nail plate/nail bed connection. If the subungual hematoma is not drained After 24 hours, the pain should subside naturally as the pressure will be normalized by then. If the trephination procedure has not been performed within 24 hours of the initial trauma, then performing it after that will not reduce pain, since at that point any pain is from the trauma itself and not from the pressure of blood under the nail. So essentially, if this procedure is not performed within 24 hours of the injury, there can only be negative consequences to the procedure (possible infection, further trauma, etc). In fact the hospital I work at will not perform this procedure on injuries more than a day old.

[ebowman1]

Thank you for backing up exactly what I was saying earlier.
Sincerely, The Crazy Female ER nurse. ;)

[djimdy]

And if you have to go to a hospital, dig out your cash and negotiate, I say. Do your best to cut out the unholy scourge that is "Health Insurance," as if there is such a thing as insuring one's health.

[flamekiller]

... or is the bourbon for steadying your hands?

[grannyjones]

sure beats the heck out of a 4 hour, $600 visit to the ER

[mstar]

It's amazing how many people got so freaked out over this suggestion. Years ago I smashed a thumbnail removing a truck bearing and the guy I was working for gave me a brand new 1/16" drill bit and told me how to do it. I put it off for a few hours, being somewhat squemish, but when the trobbing started up in earnest, I did the deed. You spin the drill bit between your fingers to make the hole and it only takes a few seconds. You can feel it grab just before it breaks through and the blood pocket on the other side keeps it from ever touching flesh. The relief is instantaneous.

[Jet_Snake]

lol Drain Your Subungual Hematoma and then ask a doctor if can remove the bit

[kevinhannan]

whatever next? diy amputations?

[dablakh0l]

Nah... DIY trepanation. You just need a bigger drill!

[mseba]

good idea

[tdc2202]

If you don't have insurance and no money - yeah, maybe!

[johangoude]

http://guyism.com/lifestyle/diy-amputations-and-9-other-life-saving-self-surgeries.html :)

[lolmongoose]

I love you.

[kwhit190211]

Drilling a fingernail is about as old as the hills. Personally, as many times I have smashed my fingernails & had blood under the nail, I just leave it alone.To put a hole in the nail leaves a entry for infection later on. It only hurts for a little while,anyways so just grin & bare it. As far as broken fingers are concerned, I've broken them all at least twice,they hurt. But, even if you go to the doctors there's nothing they can do. Broken fingers are like broken ribs. I've had both. Their both the pits as there is nothing that can be done. There are things out there that you just have to bare the pain to. Get use to it!!

[AndyPipkin]

Heat a sewing needle until it's red hot, and burn a hole through the nail with that, I have found that much easier.

[Darthtater517]

The part about drinking the Kentucky Straight Bourbon Whiskey that's in the background was left out. When should this be done???

[codongolev]

you put some of that in a glass, hold the glass in the hand that still has the drill bit in it, then go up to meet your daughter's new boyfriend. when up there, you take a swig, act like you didn't notice the drill bit until right then, pull it out, shake the blood off, and offer the hand for a handshake.

or at least I expect that's what it's for.

[porternick]

I always did this with a heated sewing needle. Something about using a drill bit freaks me out, even if it is hand powered.

[Ayce]

No it will heal on its own! Don't do this.

[Patman27]

Have you ever had a subungaual hematoma?

I can't help but think that you haven't based on your comment. The throbbing, nagging pain can get unbearable. Take this from a guy who's dropped an ice skate on his big toe. Been there, done that.

[Ayce]

Yes as a matter of fact I have. I've slammed a hammer down on my left thumb and since the thumb was not broken I did not go to the hospital. Yes it was painful but nothing that was life threatening.
No one should ever try and put holes in their body with a drill! It is very unwise.

[SewLolita]

uhhh.... actually, if you go to a hospital (which you do, if you suspect the fingertip's bone could be fractured) THEY DO THIS. Because aside from the pressure hurting WAY more than the injury (...which, given how hard you need to slam your finger for this to happen, is a LOT) you're less likely to have the entire nail fall off (...then take half a year to grow back, during whick time the VERY sensitive nail bed area is exposed. Have you ever had an exposed nail bed? it's not fun.) than if you left it 'heal on it's own'.

[Portland_Jon]

After you have used antiseptic and dried the wound use either cyanoacrylate glue or fast epoxy resin to seal the hole.

[xenobiologista]

There are cyanoacrylate-based first aid skin adhesives that you can get in the same row as plasters ("Band-Aids") in some pharmacies, if you can get a hold of those, that's better than using regular superglue which stings horribly.

[ebowman1]

The only thing about doing this is possibly more risk of infection. If poking the hole is done sterile then covering it with epoxy might prevent bacteria from being introduced later on. If for some reason bacteria was introduced when the hole was poked then directly after you "trap" the bacteria in and it has no where to go but in your skin and blood. Best thing to do is use antibiotic ointment and not to soak it.

[xenobiologista]

You forgot the "disinfect your own finger" bit. We're all covered in germs that get alone fine on the outsides of our bodies but not on the insides. You could use rubbing alcohol on your skin too or something like povidone iodine ("Betadine").