How is the risk for complications of lumbar puncture (LP) reduced?

Updated: Aug 02, 2018
  • Author: Gil Z Shlamovitz, MD, FACEP; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

The following measures should be taken to help minimize complications of lumbar puncture:

  • Explain the procedure, benefits, risks, complications, and alternative options to the patient or the patient’s representative, and obtain a signed informed consent

  • Before performing the lumbar puncture, ensure that patients are hydrated so as to avoid a dry tap

  • Never allow a lumbar puncture or a pre–lumbar puncture CT scan to delay administration of intravenous (IV) antibiotics; meningitis can usually be inferred from the cell count, antigen detection, or both

  • Avoid lumbar puncture in patients in whom the disease process has progressed to the neurologic findings associated with impending cerebral herniation (ie, deteriorating level of consciousness and brainstem signs that include pupillary changes, posturing, irregular respirations, and very recent seizure) [11, 12]


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