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

Picture of 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.

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Step 1: Smash Finger

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

Step 2: Ice and Elevate your finger

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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

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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

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blood will form instantly once you've penetrated.

squeeze finger to relieve the pressure

Step 6: Apply anti-spectic

apply anti-spectic
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Thanks for the tips works Good , was wondering at first kind of weird, but tried it no pain and relief the pressure .

WendyA313 days ago

I got this done at the clinic because I couldn't bare the pain, even after 2 days later - the pain got worse.

I didn't bleed out fast though. Just been oozing bits of blood for the past couple of days. Not sure how to stop the bleeding. Been following instructions with using triple antibiotic ointmnet (or neosporin) and keeping a band-aid over it.

Literally just did this at work because the pain was unbearable. you are a life saver & now all the mechanics think im a bad ass. My finger feels soooooooooo much better

Wow no all u have to do is heat up a needle with a lighter and poke it through your nail until it bleeds you went to far
holly-g1 year ago
@ ebowman1-
nosocomial ring a bell?
holly-g1 year ago
touché sir! Live on!! hehehe.
holly-g1 year ago
Draining the nail most definitely dictates how well the nail will fall off; or possibly aiding in saving the nail!!! Some of the "medical personnel" here appear to provide misstated opinions, possibly? Follow the guide or possibly create your own ; but this one is tried and true. Best regards, Author!
holly-g1 year ago
@ medicman you should know rubbing alcohol will not sterilize anything, ethyl alcohol is what you need, not isopropyl. Consult any sanitizer bottle or reference it. Good try though.
msawtell1 year ago
This will work but, you run the risk of excessive damage. I am a nurse and a mom who has had to relieve the pressure from under one of my kid's fingernail. This works quickly and painlessly.The finger nail is hurting so bad from the pressure it doesn't feel much of anything else.
Clean hands well before and after. Heat a large sewing needle in a flame until it is glowing cherry red. touch it firmly to the center of the bruised area of the nail. Press with firm but gentle pressure. Reheat needle and repeat if necessary. Cover with bandaid when finished.
lakazdi1 year ago
this seems quite irresponsible. all I see is the potential for a mistake and the comment "but I saw how to do it on the internet"
schaude2 years ago
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 schaude2 years ago
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)
Klesa2 years ago
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
mseba2 years ago
this is stupid you can get many viruses even std-s in good conditions by drilling holes in your body ,
lukeyj15 mseba2 years ago
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.
byoung122 years ago
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.
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.
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.
lime3D2 years ago
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.
mrwolfe2 years ago
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.
C1337us2 years ago
Smashed my thumb in a car door and it turned alll black and I couldn't sleep that night once. Great instructable!
medicman2 years ago
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.
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.
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.
Thank you for backing up exactly what I was saying earlier.
Sincerely, The Crazy Female ER nurse. ;)
djimdy ebowman12 years ago
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.
flamekiller2 years ago
... or is the bourbon for steadying your hands?
grannyjones2 years ago
sure beats the heck out of a 4 hour, $600 visit to the ER
mstar2 years ago
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_Snake2 years ago
lol Drain Your Subungual Hematoma and then ask a doctor if can remove the bit
kevinhannan2 years ago
whatever next? diy amputations?
Nah... DIY trepanation. You just need a bigger drill!
good idea
If you don't have insurance and no money - yeah, maybe! :)
I love you.
kwhit1902112 years ago
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!!
AndyPipkin2 years ago
Heat a sewing needle until it's red hot, and burn a hole through the nail with that, I have found that much easier.
The part about drinking the Kentucky Straight Bourbon Whiskey that's in the background was left out. When should this be done???
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