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Editor,—We read with interest the article on the depth of insertion of a lumbar puncture needle.1 There are various points we would like to make. First, the height of the child has to be recorded before applying the quoted formula or referring to the graph produced by the study. In our experience, having worked at busy casualty and acute paediatric units, height is probably more difficult than weight to measure in an acutely unwell child, who is distressed and extremely unwilling to be separated from their parents. Second, in most cases of failed attempts, it is because the needle is off midline rather than not being inserted to an adequate depth. So if one could ensure correct needle orientation and proper positioning of the patient, a reasonably high success rate in obtaining an uncontaminated cerebrospinal fluid sample should be achievable.
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