Tuesday, October 13, 2015

Medical Uses for Paper Clips

The ordinary paperclip has some novel applications for medical use. In the operating room we had access to an assortment of cutting, drilling, and scraping instruments. Sometimes a simple paper clip can do a more effective job than a surgical instrument. When a clumsy nurse got their finger pinched by a autoclave door clamp, a nasty hematoma developed under the nail. A wise old surgeon was quick with a fast, painless, cheap, and satisfying treatment method for both nurse and doctor.

 I really love some aspects of old time healthcare. If you had a problem and someone had a cure for it, it was done. No insurance company BS. No in network baloney. The problem was fixed.

The paper clip was straightened out and one end heated to red hot by a gas cooking stove in the break room. The red hot end of the paper clip was positioned directly over the hematoma and with light pressure, a drainage hole burned through the nail. This produces a very characteristic odor (like singed hair) because nails are made out of keratin the same protein found in hair. Works like a charm. I suspect the treatment today would involve specialty surgeons, lasers, electric drills, and cost hundreds  of dollars.
WOW.. Talk about a hot foot. The operator here is using a hemostat to hold the paper clip. This is really not necessary. The blowtorch seems like overkill too. When I saw this being done the paperclip was straightened and the very tip of it heated. I think you would have better control with the hand held technique. If you carefully heat just the tip of the paperclip you can hand hold the other end.  The idea is to release pressure as soon as the nail bed is penetrated or the patient will scream in pain. Nail beds are full of nerves.

Dr. Oddo, our internationally famous neurosurgeon, claimed that in 3rd world countries paper clips were used in place of Raney Clips on skin flaps. I guess this would probably be functional and a good example of using what is readily available. A neuro resident once gave Dr. Oddo one of those skeptical, eyerolling type of looks when he was relating the paper clip in lieu of Raney Clip story. Dr Oddo  promptly replied. "The proof is in the pudding. Nurse Fool I want a medicine cup filled with paper clips on your Mayo stand for our next crani."  Dr. Oddo  had a definite penchant for medicine glasses and there was always a line up of glassware on my mayo stand. One glass always held Methylene blue (please see my blue finger bigot post if interested), another held patty sponges in an epinephrine based sauce, and now another one with paper clips. All those glasses lined up made the scrub nurse feel like a bartender at the Biltmore.

 During the surgery, Dr. Oddo deftly applied the paperclips to  the skin flap. I bet this was not the first time he had done this, as he was very adept with handling the paperclips. We were all impressed, but I had a couple of fully loaded Raney Clip appliers ready to go in case one of the paper clips let go. Luckily, it was a brief  short case and all went well. Brief case sounded to businessman like for my taste, but you know what they say about oldfools!

On wet plate X-rays of trauma patients suffering gunshot wounds, radiology residents would mark the exit and entrance wounds with paper clips to serve as reference points for the surgeons  in the OR. The paper clip could even be bent to indicate the suspected direction of the bullet's travel. Paper clips were a crude but effective tool for X-ray marking. Whenever anyone noticed an X-ray with paper clip reference marks it suggested expeditious handling because you knew it belonged to someone with a serious trauma that needed emergency treatment in the OR. We always ran from point A to Point B when moving these films about the hospital.

Surgeons and residents always huddled around the X-ray viewer box before starting the trauma surgery. They were an unusually up tight, anal retentive group, but I could always get them to laugh and relax by calmly asking, "What kind of weapon shoots paper clips?" Surgeons never got tired of this joke and it worked every time especially with a new rotation of residents.

Another use of the lowly paper clip in neuro is for sensory testing of  2 point discrimination. There is a fancy device known as an aesthesiometer  that I have never heard of, but learned about when I googled 2 point discrimination.  An ordinary paper clip works just as well when straightened out and then bent in half. It is easy to bend the paper clip to vary the distance between the points when touching the patients skin.

I bet I am just scratching the surface with these paper clip uses. Does anyone have experience with other paper clip functions in nursing or medicine?


  1. Years ago, I developed a fairly mild case of Bell's palsy... The head PT guy made a sling for my droopy upper lip, using a paper clip and a rubber band! The band went around my ear; one end of the opened paper clip was slung on that, and the other end hooked on my lip ~
    It worked like a charm!!

    1. very creative. a PT earns my respect since I am one.

  2. I am glad it resolved your problem. Your mention of sling brought forth another memory. In ortho we used to straighten out paper clips and twist a small loop on one end with a hemostat. Wallah! an instant under the cast itch scratcher. Just insert the paper clip in a finger or toe opening and scratch away to your heart's delight. More severe itch relief called for a coat hanger scratcher.

  3. I'm sure the scratcher worked, but weren't you worried about it digging into skin?

  4. The goal of the hospitals was to do inpatient admissions, fill up the beds and more emphasis was given to acute inpatient care. jack in the box for diabetic