Urine Test Strips to Exclude Cerebral Spinal Fluid Blood West J Emerg Med. 2011;12(1):63-66

When I did my elective in South Africa we used to diagnose TB in the casualty dept. by sticking a cannula in the pleural effusion, sucking out some fluid, diluting it 1:9 with tap water and then dropping some on a urine dipstick. If you had 3+ of protein you had TB.

These guys did a somewhat similar idea with CSF samples looking for blood.

Absolutely cracking idea for a study.

Few problems (which they acknowledge)

– they looked at whatever CSF came into the lab that wasn’t grossly xanthocromic. Lots of these weren’t for SAH and indeed they don’t tell us how many were +ve for SAH

– it’s not clear if time delay to testing would be relevant. They tell us it was within a week but it’s not clear if it’s significant

They found moderate (about 90%) sensitivity and specificity in the 50s. Not good enough for SAH in my opinion. Gold standard was spectrophotometery here, which is better than a guy in a lab holding up the tube against a sheet of white paper deciding if it looks a bit yellow or not.

Worth some follow up study

PS the Werstern Journal of Emergency Medicine has some nice stuff but doesn’t appear to be on PubMed?

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