Never forget basics

Description

A patient with open fracture of both bones of a leg was posted for wound debridement and external fixation. L3–L4 space was identified by the loss of resistance technique with Tuohy's needle. An epidural catheter was passed through the Tuohy's needle. Aspiration of epidural catheter resulted in cerebro spinal fluid (CSF) tap. We tried to pull the catheter while the needle was in situ. Although there was a little resistance, we could remove the catheter. When we inspected the catheter, it was found that epidural catheter tip with only the 8 cm mark was visible (figure 1). Immediately the Tuohy's needle was removed and it was concluded that the epidural catheter tip was neither palpable nor visible. The patient was given general anaesthesia and allowed surgeons to proceed with the planned surgery. We decided to document and explain to the patient about sheared catheter and not...

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