Lumbar puncture (LP) is a procedural skill that is required for practice in the emergency care setting, most often for diagnostic purposes. Rarely, it can also be used therapeutically, to alleviate the pain of patients presenting to the emergency department with acute headache from idiopathic intracranial hypertension. In either case, LP constitutes an invasive procedure in which the subarachnoid space is entered in order to obtain a sample of cerebrospinal fluid from one of the most vulnerable areas of the human anatomy. It is essential for the emergency clinician to carefully weigh the risks and benefits of LP, to ensure informed consent when possible, and to proceed in a manner that ensures optimal patient safety and effectiveness. This article reviews current recommendations and considerations around performing LP, in addition to the process for performing the procedure.
Keyphrases
- emergency department
- patient safety
- minimally invasive
- quality improvement
- healthcare
- end stage renal disease
- cerebrospinal fluid
- public health
- pain management
- endothelial cells
- blood pressure
- ejection fraction
- randomized controlled trial
- chronic kidney disease
- chronic pain
- newly diagnosed
- primary care
- systematic review
- ultrasound guided
- liver failure
- palliative care
- peritoneal dialysis
- patient reported outcomes
- prognostic factors
- spinal cord injury
- neuropathic pain
- spinal cord
- drug induced
- respiratory failure
- hepatitis b virus
- optical coherence tomography
- mechanical ventilation
- pluripotent stem cells
- emergency medical