Lumbar puncture: Difference between revisions
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#Hemophilia, von Willebrand disease, other coagulopathies | #Hemophilia, von Willebrand disease, other coagulopathies | ||
#Trauma to lumbar vertebrae | #Trauma to lumbar vertebrae | ||
See also [[CT Before Lumbar Puncture]] | |||
==Procedure== | ==Procedure== | ||
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#Opening pressure should be measured with pt on side with legs extended | #Opening pressure should be measured with pt on side with legs extended | ||
#Collect 1mL in each tube | #Collect 1mL in each tube | ||
==Complications== | ==Complications== | ||
#[[Post-Lumbar Puncture Headache]] | #[[Post-Lumbar Puncture Headache]] | ||
#[[Spinal Epidural Hematoma]] | #[[Spinal Epidural Hematoma]] | ||
==Diagnosis== | |||
See [[CSF Studies]] | |||
==See Also== | ==See Also== | ||
*[[Meningitis]] | *[[Meningitis]] | ||
==Source== | ==Source== | ||
Revision as of 07:17, 3 March 2014
Contraindications
- Infection at LP site
- Platelet count <20K
- Platelet counts >50K are safe for LP
- INR >1.5
- Heparin administration in past 24hr
- Hemophilia, von Willebrand disease, other coagulopathies
- Trauma to lumbar vertebrae
See also CT Before Lumbar Puncture
Procedure
- Sterile prep L3-L4 and L4-L5 interspaces; prepare and confirm correct tubes in numerical order
- Positioning
- Pt on side: able to measure opening pressure
- Pt sitting: helpful for difficult habitus, but must move pt to measure opening pressure
- Needle selection
- 3.5 in atraumatic 22ga needle is ideal
- Needle >20ga almost doubles incidence of post-LP headache
- Anesthetize both superficial skin as well as along intended path of LP needle
- Insert needle with bevel facing the ceiling (if pt is on side)
- Opening pressure should be measured with pt on side with legs extended
- Collect 1mL in each tube
Complications
Diagnosis
See CSF Studies
See Also
Source
- Tintinalli
- Hasbun, R. et al, (Yale), NEJM, Dec 13, 2001.