lumbar puncture

Question 1

who to you have to discuss LP wth

Answer 1

ED consultant or senior doctor

Question 2

how to coucel patient

Answer 2

sterilise lower bakc
insert a small needle into the slace between bones and back
drops of spinal fluid are collected and sent to the laboritory

Question 3

serious complications of LP

Answer 3

spinal cord damage, nerve damaage, bleeding and infection

Question 4

what happens after LP

Answer 4

child may complain of headache or back ache - may be offered paracetamol
child will have a small dresing on lower back for 24 hours

Question 5

what should you do before LP

Answer 5

a capillary/venous blood glucose level should be obtained immidiately before the procedure for comparison with CSF glucose

Question 6

indications for LP

Answer 6

suspected meningitis or encephalitis
suspected sub-arachnoid with normal CT
measurement of opening pressure in supetced idiopathic intracranial hypertension
therapeutic reduction in ICP in iidiopathic intracranial hypertension
diagnosis of neuroinflammatory disorders

Question 7

contraindications

Answer 7

coma or decreased concious state
ssigns of raised ICP
in post seizure state
new focal neurological signs
suspected DIC/purpuric rash
local infection
coagulation defects
cardiovascular compromise/shock
respiratory compromise
thrombocytopaenia

Question 8

should patients mobilise after LP

Answer 8

yes

Question 9

interpretining CSF results

Answer 9

bacterial meningitis = high neutrophils, high pprotein, low glucose
viral meningitis = high lymphocytes