Lumbar Puncture Made Simple

Part 2 of a Three-Part Mini-Series on Lumbar Puncture   This month we are back (no pun intended) with the second part of our mini-series focused on perfect patient positioning and lumbar puncture (LP). Part one can be found at http://bit.ly/ProceduralPause.   Now that you have the proper skills to position your patient for an LP, the procedure should be pretty simple, right? The answer is yes! We want you all to be experts. We know that you can and will master an LP after reading these short and sweet LP guidelines and clinical pearls.   Lumbar puncture in the emergency department. Manual of Clinical Anesthesiology; Lippincott Williams & Wilkins, 2011.   You have already decided you will complete an LP. A few common reasons an LP may be indicated in the emergency department include: n Headache with a fever (rule out meningitis or a central nervous system infection) n Sudden “thunderclap” headache (rule out subarachnoid hemorrhage) n Altered mental status n Idiopathic intracranial hypertension   Always remember to consider the risks and benefits for any procedure and refer to the contraindications. Obtain informed consent before you perfectly position your patient and get sterile! Make sure you review the risks and benefits with each patient.   Contraindications Absolute n Infection at the puncture site   Relative n Thrombocytopenia (platelets <50,000) n Coagulopathy n Prior surgery at the puncture site (i.e., discectomy or fusion) n Presence of increased...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs