RasmusR

Thanks for the picture - it's difficult to see the bevel on the pictures, but from the label it seems like it's a "traumatic" needle (Quincke bevel) - if it was atraumatic, shouldn't it be a pencil-point type (eg. Whitacre/Sprotte)?

Which company produce the atraumatic needles for neonates? I prepared a simulation course for neonatal LP puncture, and read a lot of literature on the subject then - at that point there wasn’t much evidence regarding atraumatic needles in neonates. The study would also be a bit harder to do than adults - as they can’t report pain/headache, the endpoint would probably have to be differences in eg. ComfortNEO score - but I guess it’s a question about when. Stefan, you say that you use SC needles - do these have a stylet? I’ve always learnt you should avoid needles without stylets, as there’s a (small) risk of introducing an epidermoid tumor. Furthermore there is quite good evidence that using early stylet removal will increase the chance of a clean LP.

It's a bit of a mess, and not very standardized in our practice and guidelines. Birthweight for gestational age is often based on the Marsal growth curves (https://www.ncbi.nlm.nih.gov/pubmed/8819552) in our guidelines, but we also have the Fenton curves in Epic. Growth after birth is often based on a mixture of WHO, whatever growth chart is available on paper in the department and now the new Danish reference curves (http://onlinelibrary.wiley.com/doi/10.1111/apa.12468/abstract). To make things even better, depending on the department you are accessing Epic, the choice of growth curves differs... I made a simple app for iOS with the Marsal growth curves (with the sparse text in Danish) - it's handy if you use the Marsal curves in your daily practice: https://itunes.apple.com/dk/app/gestationsalder/id1055021841?mt=8