I hate tapping big kids. By tapping, I mean performing a lumbar puncture on them. By big kids, I mean anybody over twelve months. This weekend, I took a hellacious PICU call (thirty hours with no sleep thanks to one child who kept me baffled all of Saturday night and most of Sunday morning). During the day, we admitted a teenager who presented with some very abnormal neurologic symptoms, and the decision was made to do an LP. Since I was not on the admitting team and was just helping out another resident, I stood by and watched as she attempted the tap. She was very confident and did a great job, but for some reason, she didn't get CSF. I was so not thrilled about trying for it; feeling for landmarks on a well-nourished 16 year old female is so much harder than feeling for them on a skinny two month old! I said a quick prayer, marked my spot, and went for it. With a few adjusts of the needle, I suddenly had CSF ... clear, beautiful CSF pouring into my vials. We measured an opening pressure, collected our precious samples, and quickly wrapped up.
A few hours later, we were running labs and vitals. Lo and behold, I had a champagne tap. :)
I needed that.
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