The Champagne Tap: Time to Pop the Cork?

TitleThe Champagne Tap: Time to Pop the Cork?
Publication TypeJournal Article
Year of Publication2020
AuthorsGreen RS, Cruz AT, Freedman SB, Fleming AH, Balamuth F, Pruitt CM, Lyons TW, Okada PJ, Thompson AD, Mistry RD, Aronson PL, Nigrovic LE
Corporate AuthorsHERPES SIMPLEX VIRUS STUDY GROUP OF THE PEDIATRIC EMERGENCY MEDICINE COLLABORATIVE RESEARCH COMMITTEE(PEM CRC)
JournalAcad Emerg Med
Volume27
Issue11
Pagination1194-1198
Date Published2020 11
ISSN1553-2712
KeywordsCross-Sectional Studies, Erythrocyte Count, Humans, Infant, Infant, Newborn, Leukocyte Count, Retrospective Studies, Spinal Puncture
Abstract

BACKGROUND: A "champagne tap" is a lumbar puncture with no cerebrospinal fluid (CSF) red blood cells (RBCs). Clinicians disagree whether the absence of CSF white blood cells (WBCs) is also required.

AIMS: As supervising providers frequently reward trainees after a champagne tap, we investigated how varying the definition impacted the frequency of trainee accolades.

MATERIALS & METHODS: We performed a secondary analysis of a retrospective cross-sectional study of infants ≤60 days of age who had a CSF culture performed in the emergency department (ED) at one of 20 centers participating in a Pediatric Emergency Medicine Collaborative Research Committee (PEM CRC) endorsed study. Our primary outcomes were a champagne tap defined by either a CSF RBC count of 0 cells/mm regardless of CSF WBC count or both CSF RBC and WBC counts of 0 cells/mm .

RESULTS: Of the 23,618 eligible encounters, 20,358 (86.2%) had both a CSF RBC and WBC count obtained. Overall, 3,147 (13.3%) had a CSF RBC count of 0 cells/mm and 377 (1.6%) had both CSF WBC and RBC counts of 0 cells/mm (relative rate 8.35, 95% confidence interval 7.51 to 9.27).

CONCLUSIONS: In infants, a lumbar puncture with a CSF RBC count of 0 cells/mm regardless of the CSF WBC count occurred eight-times more frequently than one with both CSF WBC and RBC counts of 0 cells/mm . A broader champagne tap definition would allow more frequent recognition of procedural success, with the potential to foster a supportive community during medical training, potentially protecting against burnout.

DOI10.1111/acem.13966
Alternate JournalAcad Emerg Med
PubMed ID32187765