Atraumatic Spinal Needles

00:00
07:50
Sign in or subscribe to listen

No me gusta!

The flash player was unable to start. If you have a flash blocker then try unblocking the flash content - it should be visible below.

Alastair M. -

This winds me up too! In our hospital I have developed an LP pack that has a 25G and 22G whittacre needle in it and removed all the quinke (cutting) needles to force change about 3 years ago. I then went to the medical hand over with a pre- anaesthetised portion of my thigh and showed the 22G would go through the skin. In real cases though I normally use the introducer from the 25 to creat a guide hole. I'm glad I am not the only one.

Samuel B., MD -

Size matters too. Using a 24 or 25 G needle markedly reduces the incidence of PDPH compared to a 22G - there are tons of references supporting this; but using a 24/25 G needle requires a 20G introducer needle to give it some support as it travels through the tissues. It's not hard to use at all - really - anesthetists do it all the time. In the 25 yo female "headache nyd" patient (probably isn't anything but I need CSF to prove it), who is at very high risk of PDPH, using the smaller needle makes good sense; save the 22G for the 75 yo "query meningitis" patient who is at lower risk for PDPH and will be a more difficult stick with the 24/25G. Sure it takes a minute or two longer to get the CSF, but it still doesn't take long to get 0.5 ml in 4 tubes which is all you need. The extra time you spend up front doing the procedure "expertly" saves so much time (yours and the patients') and discomfort at the other end if an epidural blood patch (or 3 days of bedrest) can be avoided.
Just do it - RIGHT!

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.

To download files, you need to subscribe.

Sign up today for full access to all episodes.
Little Tubes, Little Labs Full episode audio for MD edition 217:13 min - 303 MB - M4AEM:RAP 2017 April French Edition Français 38:53 min - 53 MB - MP3EM:RAP 2017 April Spanish Edition Español 103:05 min - 141 MB - MP3EM:RAP 2017 April Canadian Edition Canadian 15:44 min - 22 MB - MP3EM:RAP 2017 April Australian Edition Australian 25:20 min - 35 MB - MP3EM:RAP 2017 April German Edition Deutsche 73:56 min - 102 MB - MP3EM:RAP 2017 April Board Review Answers 216 KB - PDFEM:RAP 2017 April Board Review Questions 169 KB - PDFEM:RAP 2017 April Individual Files - MP3 288 MB - ZIPEM:RAP April Written Summary 577 KB - PDF