Considerations for Performing Lumbar Puncture (LP)
Considerations for Performing Lumbar Puncture (LP)
Assess need for sedation or general anesthesia
Sedation or
anesthesia needed
anesthesia needed
- Sedation or Anesthesia Needed
- Consult Sedation Team
- Or
- Consult Anesthesia Resource Center (ARC)
- Call OR Board Runner, 5-4444 to schedule
- Requires Attending with OR privileges
- Ensure NPO, COVID testing
Assess need for image-guided LP in Interventional Radiology
Image-guided
Not-image-guided
- Order
- “IR Lumbar Puncture, Diagnostic” Include if sedation/GA needed Consider discussion with IR attending on call for other indications and/or if procedure is urgent
- Determine location of procedure if outside of ED:
- Sedation unit if with sedation OR if with anesthesia
- Treatment Room if no sedation/GA needed
- Consider using topical lidocaine, injectable lidocaine, or a single dose of Versed® to help
- Indications for Image-Guided LP
- Recent unsuccessful LP attempt
- Abnormal anatomy making LP technically difficult
- E.g., severe scoliosis, hx spinal surgery, indwelling hardware
- BMI > 35 or body habitus making LP difficult due to inability to identify landmarks
- Consider discussion with IR Attending for other indications and/or if procedure is urgent
- Note
- Use of sedation/general anesthesia alone is not an indication for image-guided LP
- IR Contact
- Weekdays: 8 a.m. - 4 p.m., call 53255
- Nights, weekends, holidays: 4 p.m. - 8 a.m., page IR attending on-call