title: "Traumatic tap" proportion in pediatric lumbar puncture.
abstract: OBJECTIVE
  To determine the frequency of "traumatic" or "bloody" tap when pediatric lumbar puncture is performed by a physician who has completed training and performs the procedure frequently.
  
  
  METHODS
  The author identified 100 sequential patients presenting to a pediatric emergency department requiring lumbar puncture for clinical indications. Demographic information, cerebrospinal cell counts, and other relevant data were later obtained by retrospective chart review. Cell count results were categorized according to several previously used criteria: greater than 400, greater than 1000, and greater than 10,000/unsuccessful.
  
  
  RESULTS
  One procedure yielded only a small amount of bloody fluid on which no cell count was performed. The remaining 99 procedures yielded red blood cell counts less than 1000.
  
  
  CONCLUSIONS
  The proportion of bloody or traumatic results from pediatric lumbar puncture reported from pediatric training centers is typically in the 20% to 30% range. This represents an overestimation of a more ideal proportion possible when the procedure is performed by a physician who has completed training and performs the procedure frequently.
authors.affiliation: East Tennessee Children's Hospital, Knoxville, TN, USA. epappano@aol.com
authors.forename: Dante
authors.initials: D
authors.lastname: Pappano
mesh_terms: D002983:Clinical Competence; D004906:Erythrocyte Count; D006801:Humans; D015999:Multivariate Analysis; D013129:Spinal Puncture / Q000009:adverse effects* / Q000706:statistics & numerical data