MEDizzy
MEDizzy
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Hemang Mohanabout 2 years ago

What measures could be taken to reduce the risks for complications of lumbar puncture (LP)?

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Top rated comment
about 2 years ago

Lumbar puncture is a safe procedure, however, minor and major complications can arise even when standard infection control measures and appropriate techniques are used. The complications include: • Post-LP headache • Infection • Bleeding • Cerebral herniation • Minor neurologic symptoms such as radicular pain or numbness • Late onset of epidermoid tumors of the thecal sac • Back pain To minimize complications of lumbar puncture, the following measures should be taken: • Before the procedure, the doctor should explain the procedure, its benefits, risks, complications, and possible alternative options to the patient or the patient’s guardian and obtain signed informed consent. • The patient should be hydrated before the procedure to avoid a dry tap • Allowing a lumbar puncture or a pre–lumbar puncture CT scan to postpone the administration of intravenous (IV) antibiotics is never a good idea; meningitis can usually be detected by cell count, antigen detection, or both. • Avoid lumbar puncture in patients with neurologic symptoms suggestive of impending cerebral herniation (ie, deteriorating level of consciousness and brainstem signs that include pupillary changes, posturing, irregular respirations, and very recent seizure) • If doing the LP for possible subarachnoid hemorrhage, ensure 12 hours have passed since the onset of symptoms • Ensure the absence of infection or metalwork at the lumbar puncture site • Check for raised intracranial pressure, coagulopathies, and brain abscesses.

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