A comparison of simple tests to distinguish cerebrospinal fluid from saline.
OBJECTIVE
This prospective study was undertaken to determine if anesthesiologists of different levels of training, using simple tests, can distinguish cerebrospinal fluid (CSF) from saline.


METHODS
Thirty-two anaesthetists, divided into four groups, dependent upon levels of training, participated in the study. Each was asked to distinguish saline from an artificial CSF solution using four different tests: tactile temperature, glucose strip, pH strip, and turbidity when mixed with thiopental.


RESULTS
Participants identified cerebrospinal fluid correctly with 84% accuracy using the temperature test, 97% using the glucose test, 91% using the pH test, and 50% using the thiopentone test. More than half of the participants guessed while using the thiopentone test, and those who did not guess were only 47% accurate.


CONCLUSIONS
Level of training made no difference in distinguishing CSF from saline. No one test was 100% reliable. Clinical utility of the thiopentone test appears to be limited. The temperature, glucose, and pH tests, when used together, appear to be a useful way of distinguishing CSF from saline.
Walker
D S
DS
Department of Anesthesia, Stanford University Medical Center, CA 94305-5115, USA.
Brock-Utne
J G
JG
D000776:Anesthesiology / Q000193:education*; D002555:Cerebrospinal Fluid; D005947:Glucose / Q000032:analysis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D011446:Prospective Studies; D012965:Sodium Chloride; D013696:Temperature
D012965:Sodium Chloride; D005947:Glucose