Wearing facemasks when performing lumbar punctures: a snapshot of current practice amongst trainee doctors

Rajiv Malhotra¹, Sara Kelly^2
1Weston General Hospital, Weston-super-Mare, Somerset; ²University Hospital Coventry and Warwickshire, Coventry, UK

Purpose: Infective complications of lumbar puncture are not common, but are a significant source of mortality. Causative pathogens have been traced to the oropharynx of the operator, and it is likely that wearing facemasks will minimize the risk of iatrogenic meningitis. The aim of this survey was to assess whether doctors currently wear facemasks when performing lumbar punctures.
Methods: We constructed an anonymous survey asking about the use of a facemask when performing lumbar punctures. This was distributed to trainee doctors in medical specialties at the West Midlands and Severn Deaneries in the UK.
Results: The response rate was 72% (72/100). Responders had performed, on average, a total of 15 (range 3–22) lumbar punctures. Only 27 of the doctors (37.5%) wore a facemask when performing lumbar punctures. CT 1–2 doctors were five times more likely than registrars to wear a facemask (53% versus 10%). Similarly, the likelihood of wearing a facemask decreased with the number of times the procedure had been performed.
Discussion: There are varying practices regarding the use of facemasks for lumbar punctures amongst doctors, with significant differences according to grade and level of experience. Facemasks should be used as part of a “maximal sterile precautions” approach to reduce the risk of infective complications.

Keywords: infection control, iatrogenic meningitis, facemasks