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How to Perform a Lumbar Puncture—Reply
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In Reply: Dr Kaufman suggests that the method for skin preparation outlined in our review should be abandoned. Unfortunately, we were unable to find any randomized trials of the effect of sterile technique (including application of antiseptics, use of sterile drapes, or use of sterile gown and gloves) on adverse events. Instead, we had to rely on current standard of practice, which we derived from a survey of 120 medicine residents and discussion with several expert clinicians.
Dr Piwinski and colleagues have suggested that reinsertion of the stylet should not be advocated because of the risk for needlestick injury. They also note the hypothesis that the flow of anesthetic could prevent entrapment of dural tissue in the needle hole. Although we were unable to find evidence to support this theory, this outcome certainly is possible. Our article focused on the use of diagnostic lumbar puncture and the evidence from our . . . [Full Text of this Article]
Sharon E. Straus, MD, MSc, FRCPC
sharon.straus@utoronto.ca
Jayna Holroyd-Leduc, MD, FRCPC
University of Calgary
Calgary, Alberta
RELATED LETTERS
How to Perform a Lumbar Puncture
Jeffrey L. Kaufman
JAMA. 2007;297(8):810.
EXTRACT
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How to Perform a Lumbar Puncture
Stephen Piwinski, Wendell Johnson, and Michelle Kawasaki
JAMA. 2007;297(8):810-811.
EXTRACT
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RELATED ARTICLE
How Do I Perform a Lumbar Puncture and Analyze the Results to Diagnose Bacterial Meningitis?
Sharon E. Straus, Kevin E. Thorpe, and Jayna Holroyd-Leduc
JAMA. 2006;296(16):2012-2022.
ABSTRACT
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