title: Paediatric lumbar punctures: How do paediatric and emergency doctors differ?
abstract: OBJECTIVE
  The objective of the study was to identify any differences between emergency physicians and emergency trainees and paediatricians and paediatric trainees in performing paediatric lumbar punctures (LPs).
  
  
  METHODS
  Anonymous cross-sectional electronic survey was distributed to emergency physicians, emergency trainees, paediatricians and paediatric trainees within three hospitals of a single public health network. There were four standardised clinical scenarios (neonate, infant, young child and adolescent), with accompanying questions relating to neurological evaluation and imaging prior to LP, the use of written consent forms and parental presence during the procedure.
  
  
  RESULTS
  Paediatricians and paediatric trainees have greater confidence performing LP on neonates and infants, while emergency physicians and emergency trainees are more confident in older children. The only differences in self-reported neurological examination prior to LP was paediatricians and paediatric trainees being more likely to perform fundoscopy than were emergency physicians and emergency trainees in infants (21% vs 8%, P = 0.03) and young children (44% vs 16%, P < 0.001). Less than half of both groups of doctors would obtain written consent for paediatric LPs. Emergency physicians and emergency trainees were much more likely to encourage parents to remain in the room during the procedure than their paediatric counterparts (95% vs 37%, P < 0.0001).
  
  
  CONCLUSIONS
  Paediatricians and paediatric trainees are more likely to be confident in performing LP in very young children than are emergency physicians and emergency trainees. They are more likely to perform fundoscopy prior to the procedure, but are much less likely to encourage parental presence during the LP.
authors.affiliation: Emergency Department, Monash Medical Centre, Monash Health, Melbourne, Victoria, Australia.
authors.forename: Chee Cheen
authors.initials: CC
authors.lastname: Yeong
authors.affiliation: Emergency Department, Monash Medical Centre, Monash Health, Melbourne, Victoria, Australia.|School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.|Paediatric Emergency Medicine Centre of Research Excellence, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
authors.forename: Simon S
authors.initials: SS
authors.lastname: Craig
authors.affiliation: Emergency Department, Monash Medical Centre, Monash Health, Melbourne, Victoria, Australia.|School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.|Paediatric Emergency Medicine Centre of Research Excellence, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.|Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: John A
authors.identifier: http://orcid.org/0000-0002-3615-3821
authors.initials: JA
authors.lastname: Cheek
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D002983:Clinical Competence / Q000592:standards / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000592:standards* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics / Q000592:standards* / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology*; D020377:Self Efficacy; D013129:Spinal Puncture / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014739:Victoria
keywords: emergency medicine; lumbar puncture; paediatrics