We have moved recently from eye-balling only (observations carried out
in Microbiology) to a spectrophotometric scan based on detecting
bilirubin. However, at our hospital, the principal purpose of the scan,
in clinical management terms, is to support a request for a patient with
suspected SAH to be admitted to our local neurosurgical unit at a
different hospital. Then we discovered that the laboratory which
services that unit uses a method based on detecting oxyhaemoglobin. So,
we paused to review the situation. Then the spectrophotometer broke.....
At the moment a visual inspection only is performed during the
out-of-hours periods. With the spectrophotometer out of action, our
contingency plan is to send the CSF sample with the patient if a
neurosurgical transfer is considered. This at least prevents a second
lumbar puncture.
--
Robert Hill
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