title: A comparison of simple tests to distinguish cerebrospinal fluid from saline.
abstract: 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.
authors.affiliation: Department of Anesthesia, Stanford University Medical Center, CA 94305-5115, USA.
authors.forename: D S
authors.initials: DS
authors.lastname: Walker
authors.forename: J G
authors.initials: JG
authors.lastname: Brock-Utne
mesh_terms: 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
chemical_list: D012965:Sodium Chloride; D005947:Glucose