Great segment! Would have liked to have heard more discussion on the benefits or risk of the use of various needle sizes, type of spinal needle used (cutting vs. non-cutting), and orientation of the bevel.
I was a bit disappointed in this segment. Pencil tipped needles (sprotte or whitacre) have been shown to be the best way to prevent post LP HA's and these were under represented in the segment. Having researched some of data on these devices I have started using them in my practice. No they are not likely stocked in your ER, but our anesthesia colleagues use these every day and with a few simple phone calls I was able to get a supply for my use at all the ERs I work in. They take just a little getting used to, but seem to work well and reviewing the data seems to suggest that they are better for our patients. I'm not sure of specific ER studies on their use but I was hoping this would be addressed....
Mark - we totally agree. Our issue is that many places (and all of ours who did this segment) don't carry those needles so we wanted to discuss the other, medical options. Great point, though. If you've got these needles and have experience with them, they are your best bet for prevention.
To join the conversation, you need to subscribe.
Sign up today for full access to all episodes and to join the conversation.
A Totally Mental Month of Education!Full episode audio for MD edition285:23 min - 332 MB - M4AEM:RAP 2015 May Canadian EditionCanadian17:44 min - 24 MB - MP3EM:RAP 2015 Peut Résumé en FrancaisFrançais59:38 min - 82 MB - MP3EM:RAP 2015 Mayo Resumen EspañolEspañol74:07 min - 85 MB - MP3EM:RAP 2015 May Aussie EditionAustralian62:22 min - 86 MB - MP3EM:RAP 2015 May MP3329 MB - ZIPEM:RAP 2015 May Written Summary1 MB - PDFEM:RAP 2015 May Board Review Answers415 KB - PDFEM:RAP 2015 May Board Review Questions416 KB - PDFEM:RAP Español Mayo 20151 MB - PDF
EC - May 22, 2015 3:40 AM
Great segment! Would have liked to have heard more discussion on the benefits or risk of the use of various needle sizes, type of spinal needle used (cutting vs. non-cutting), and orientation of the bevel.
Mark C. - June 13, 2015 12:58 PM
I was a bit disappointed in this segment. Pencil tipped needles (sprotte or whitacre) have been shown to be the best way to prevent post LP HA's and these were under represented in the segment.
Having researched some of data on these devices I have started using them in my practice. No they are not likely stocked in your ER, but our anesthesia colleagues use these every day and with a few simple phone calls I was able to get a supply for my use at all the ERs I work in. They take just a little getting used to, but seem to work well and reviewing the data seems to suggest that they are better for our patients. I'm not sure of specific ER studies on their use but I was hoping this would be addressed....
Anand S., M.D. - June 13, 2015 1:03 PM
Mark - we totally agree. Our issue is that many places (and all of ours who did this segment) don't carry those needles so we wanted to discuss the other, medical options. Great point, though. If you've got these needles and have experience with them, they are your best bet for prevention.