Pediatric Residents’ Dexterity in Performing Lumbar Punctures

Introduction: Lumbar puncture (LP) is a commonly needed procedure in pediatric medicine. In teaching hospitals, it is usually taught to junior residents by senior residents.

Objectives: The goal of this study was to determine the dexterity of pediatrics residents in performing this procedure.

Patients and Methods: All pediatric residents of Shiraz University of Medical Sciences were enrolled in this study. A presumptive case, a 6-year-old patient, suspected of meningitis was presented to them and they were asked to perform lumbar puncture on a manikin while they were observed by two attending physicians. A check list containing 14 items was completed for each participant and finally data were analyzed statistically.

Results: The part of lumbar punctures least considered by pediatric residents was using sedation. There were significant differences between residents of different levels regarding sedating the patients and performing LP. However, there were no significant differences between them in regards to infection control and preparing the patient before starting lumbar puncture. Male and female residents were not different in performing any part of lumbar puncture.

Discussion: Pediatrics residents’ dexterity in performing lumbar punctures is not ideal. Many of them do not consider using of sedation prior to performing lumbar punctures. With increasing years of education, their attention to sedation of the patient and their technique of LP improves, but their competence regarding infection control does not. It is necessary for them to learn this procedure by frequent theoretical and practical learning sessions.