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 Unsure if Sedation Needed
- Provider
- Orders Sedation Consult
- Call Sedation Provider, 11733
- Provider
- Orders ARC Consult
- Anesthesia Resource Center (ARC)
- Call Board Runner, 5-4444 to schedule
- Requires Attending with OR privileges
- Orders ARC Consult
- Assure 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
- Weekday: 8 a.m.- 4 p.m., call 53255
- Night, WE, holiday: 4p-8a, page IR attending on-call
- IR Contact
- Weekdays: 8 a.m. – 4 p.m Call 53255
- 4p-8a, page IR Attending on Call
- GA contact: 54444
- Sedation contact: 11733