- Joined
- Dec 3, 2012
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- 23
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CA1 resident on OB, learning the ropes of CSEs. Watched a senior advance the touhy slowly (mm by mm) get great LOR (intermittent technique). When he removed the LOR syringe, saw a few drops of clear fluids gush out. It seemed not to slow down, and I thought it was a wet tap. The resident pulled needle back just a touch and re-checked for LOR. This time he did not have any fluid come back when he removed the LOR syringe. Spinal needle went in with a 'visible' pop and clear fluid obtained.
I was told that the fluid coming back was just the saline in the LOR syringe and that he pulled back and rechecked just to be safe.
I haven't watched a lot of CSEs and am wondering if this is normal. Does saline from LOR syringe backflow like that when the loss is felt, or is this a wet tap? What do you think of pulling back the Touhy and threading the catheter, is that safe?
What does a wet tap look like - is it clear fluid gushing out with no signs of stopping? Or can it look like a few cc falling out of the touhy that usually stops in a 5-10 seconds (or is that just the saline injected for detection of LOR) ?
Our patient did fine following the CSE. Occurrence of PDPH remains to be seen.
I was told that the fluid coming back was just the saline in the LOR syringe and that he pulled back and rechecked just to be safe.
I haven't watched a lot of CSEs and am wondering if this is normal. Does saline from LOR syringe backflow like that when the loss is felt, or is this a wet tap? What do you think of pulling back the Touhy and threading the catheter, is that safe?
What does a wet tap look like - is it clear fluid gushing out with no signs of stopping? Or can it look like a few cc falling out of the touhy that usually stops in a 5-10 seconds (or is that just the saline injected for detection of LOR) ?
Our patient did fine following the CSE. Occurrence of PDPH remains to be seen.