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Lumbar Punctures in the Acute Medicine Department: indications and evaluation of use.
Acute Med. 2014;13(3):113-7
Authors: D'Cruz RF, Vellore AD
Abstract
Aims • Evaluate the use of lumbar puncture (LP) in the Acute Medical Department of a typical urban district general hospital. • Increase the proportion performed on appropriate patients. Methodology An observational, single-centre, retrospective examination of patients undergoing LP at Solihull Hospital over four consecutive months. Discussion of findings and LP indications with the Acute Medicine Department. Re-audit over four months. Results Total LPs performed fell by 65%. The proportion performed on patients presenting with red flags rose by 19% (p=0.0098). The proportion that yielded positive findings rose by 33% (p<0.0001). 72% of patients with red flags had negative LP. Conclusions Awareness of indications and observation of practice reduces total LPs performed and increases the proportion performed on appropriate patients.
PMID: 25229061 [PubMed - in process]