Lumbar Puncture

Procedures & Monitoring · ICU Decoded chapter 79 · Free in full

Cited to IDSA meningitis LP guidance.

Key points

Weigh indication against contraindication, doing CT first with focal signs, seizures, papilledema, immunocompromise, or GCS drop.
Measure opening pressure (in cryptococcus drain to <20 cm) and collect 4 tubes for cells, protein/glucose, Gram stain/culture, and special studies.
Post-dural puncture headache: use a smaller atraumatic needle; blood patch if severe.
In suspected meningitis, never hold antibiotics for the LP.

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