LAUSR

Background Among patients who have lumbar punctures, atraumatic (Whitacre, pencil point) needles are associated with a reduced incidence of post-lumbar puncture headache and a reduced rate of reattendance to hospital for additional treatment, while having similar efficacy to conventional (Quincke) needles.¹ We aimed to change practice in one ward of our hospital from using conventional needles for lumbar puncture to using atraumatic needles in order to reduce reattendances with post-lumbar puncture headache. Summary of project Current practice in our hospital is that most lumbar punctures for acute medical admissions are performed in the Clinical Assessment Unit (CAU) by junior doctors using conventional needles. We performed a baseline audit of the rate of reattendances with headache within 7 days of lumbar puncture in the CAU over the previous 24 months. We now intend to hold a simulation session run by senior anaesthetics doctors to teach the CAU doctors how to use atraumatic needles, then prospectively measure the rate of reattendances with headache following lumbar puncture once atraumatic needles are being used. Summary of results Results of baseline audit and prospective data are awaited. Discussions, conclusions and recommendations We hope to show through this project that a change from using conventional needles to using atraumatic needles can result in a lower rate of reattendances with post-lumbar puncture headache. If successful, we would aim to expand the project to other areas of our hospital and health trust. References Atraumatic versus conventional lumbar puncture needles: a systematic review and meta-analysis. Nath S, et al. Lancet. 2018.