Urgent question! Interlaminar epidurals with spinal needles vs. touhy and LOR

[Ligament]

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Hey all,

Ok, this will sound really stupid...I need some technical advice ASAP.

I'm doing some locum tenens coverage tommorow. The fellow that owns the practice uses either whitacre or quincke spinal needles for his paramedian interlaminar epidurals.

So I've never used the above, always have used a touhy needle with LOR using air for my paramedian interlaminars.

Unfortunately we did not coordinate my need for touhy needles very well.

Anyway, any last minute pointers for me using whitacres or quincke's for paramedian interlaminar epidurals?

I'll be able to switch the procedures to TFESIs at will, so this may be a non issue, however just in case there is a patient that really needs an ILESI and nothing else....

Thanks!

 

[lobelsteve]

Hey all,

Ok, this will sound really stupid...I need some technical advice ASAP.

I'm doing some locum tenens coverage tommorow. The fellow that owns the practice uses either whitacre or quincke spinal needles for his paramedian interlaminar epidurals.

So I've never used the above, always have used a touhy needle with LOR using air for my paramedian interlaminars.

Unfortunately we did not coordinate my need for touhy needles very well.

Anyway, any last minute pointers for me using whitacres or quincke's for paramedian interlaminar epidurals?

I'll be able to switch the procedures to TFESIs at will, so this may be a non issue, however just in case there is a patient that really needs an ILESI and nothing else....

Thanks!

Bring your own Tuohys until you can order a box for the new job. Changing the way you do procedures can have terrible consequences for your patients. Even going from a 17G to a 20G Tuohy takes some getting used to. I'd recommend AP for the first inch, then go lateral to set depth. Unless you usually touch os on the lamina below your entry site. Then touch lamina, walk off superiorly, and go lateral while checking LOR.

Speaking from experience....I miss my 17G TUohy.