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    The Significance of Traumatic Lumbar Punctures and HeMoStep’s Role


    The lumbar puncture (LP) has been a staple in clinical practice since 1895, primarily performed in emergency departments (ED) for diagnosing conditions like subarachnoid haemorrhage (SAH) and meningitis. However, a challenge clinicians face is distinguishing between a ‘champagne tap‘ (clear fluid with no red blood cells) and a ‘traumatic tap‘ (fluid contaminated with red blood cells due to needle trauma). Such traumatic taps can lead to false diagnoses, complicating patient care.

    A comprehensive retrospective study was undertaken at an urban, university tertiary care referral center with a vast annual ED footfall. The study aimed to determine the incidence of traumatic LPs, employing two distinct thresholds based on the number of red blood cells (RBCs) present in the cerebrospinal fluid (CSF) tubes.

    Out of 786 CSF samples studied, 15.6% exhibited traumatic LP characteristics using a 400 RBCs threshold, while 10.5% met the criteria at a 1,000 RBCs threshold. Alarmingly, the incidence was higher in non-ED settings compared to ED environments, emphasizing the need for precision in LP procedures across all hospital sections.

    The ambiguity surrounding the definition of traumatic LPs has led to varied estimates in literature, ranging between 10% to 20%. This study’s findings challenge the often-cited 20% figure, suggesting it might be an overestimation.

    Given the clinical implications, accurate detection of blood contamination in CSF becomes paramount. Misdiagnoses can result in unnecessary treatments or, worse, overlooking a genuine Subarachnoid haemorrhage (SAH). Furthermore, our study underscores the expertise and experience of practitioners conducting LPs. ED-performed LPs showed a higher rate of ‘champagne taps,’ indicating the role of experience in minimizing traumatic taps.

    Our pioneering kit, is designed explicitly to detect and quantify blood contamination in CSF. By providing precise measurements, it minimizes the guesswork, thereby reducing the chances of false-positive or false-negative diagnoses. With its accuracy, HeMoStep ensures that clinicians can confidently differentiate between a traumatic tap and a genuine SAH, significantly improving patient outcomes.

    The implications of using HeMoStep extend across various neurological conditions and procedures:

    • Subarachnoid Haemorrhage: Accurate detection of SAH is paramount. HeMoStep aids in distinguishing between genuine cases and those influenced by traumatic taps, ensuring timely and appropriate interventions.
    • Meningitis: In cases of suspected meningitis, HeMoStep can confirm the absence of blood contamination in CSF samples, providing clearer diagnostic pathways.
    • Other Neurological Disorders: Beyond SAH and meningitis, HeMoStep’s precision can assist in diagnosing a range of neurological conditions where CSF analysis is pivotal.
    • Medical Decisions: By minimizing the chances of false diagnoses, HeMoStep supports clinicians in making informed decisions, reducing unnecessary treatments, hospital stays, and associated costs for patients.

    The landscape of diagnostic procedures like LPs demands accuracy. With the introduction of HeMoStep, healthcare professionals are equipped with a tool that elevates the precision of CSF sample analysis. By addressing the challenges of traumatic taps and ensuring clearer diagnoses, HeMoStep stands as a beacon of innovation, fostering improved patient outcomes and streamlined medical decisions in neurology.

    If you are interested in having more information about our HeMoStep Kit, visit our product page, there you can discover how it works.


    ► Immunostep products related with this article:

    1. HeMoStep Kit: https://immunostep.com/immunology/hemostep-kit/


    1. Kaushal H Shah- et al (2003). Incidence of traumatic lumbar puncture. Acad Emerg Med. Feb;10(2):151-4. https://doi.org/10.1197/aemj.10.2.151