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Ah, you see what happens when you "respond to questions"! ----- Original Message ----- From: "Paul Bailey" <[log in to unmask]> To: <[log in to unmask]> Sent: Wednesday, March 01, 2006 1:57 AM Subject: Re: SAH and LP > Quoting James Cameron <[log in to unmask]>: > >> The easiest way to access the CSF in GCS 15 patients is getting them to >> sit >> and curl forwards as much as possible to open up the gap. This reduces >> 'digging around'. > > OK, let's not get into a 'my way of doing the procedure is better than > your > way' conversation. I do it with the patient lying on their side. You do > it > with them sitting up. You might find it easier that way. That doesn't > mean > that I do! > >> It's how anaesthetists do it on labour ward. It does mean >> you can't measure their opening pressure, but in the patient with 'LASH' >> you're looking for SAH not Benign Intracranial Hypertension anyway. > > I don't measure their opening pressure anyway. > > >> Sedation not needed (and best avoided) this way. > > What evidence do you have that sedation is best avoided in this situation? > Didactic statements like that are easily made and purely a matter of > opinion. > I believe the complete opposite and I'm happy to say that I don't have any > evidence to support it either. Other than what I witness when I see my > colleagues doing them without local. And the feedback that I get from my > nursing colleagues that my way is 'kinder' to the patient. I'm not in any > way > attempting to get the rest of you to do things my way, I was just > responding > to a question from Adrian about my own personal practice. > > PB