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A comparison of simple tests to distinguish cerebrospinal fluid from saline
1Department of Anesthesia, Stanford University Medical Center, CA 94305-5115, USA.
Purpose:
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.
Conclusion:
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.