EM Clerkship

Deep Dive MW R9


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Indications for LP: CNS infection, SAH, Guillian Barree, IIH



Contraindications for LP: Space occupying lesion with mass effect ; severe thrombocytopenia and coagulopathy; cellulitis over LP site or concern for epidural abscess ; traumatic injury to spine



Complications for LP: Post LP Headache, spinal hematoma, brainstem herniation



Technique for LP: Positioning is everything.  Use US if necessary.  Check for CSF early and often.  



When to CT before LP?: AMS; focal neuro deficit; new onset seizures, known CNS lesions; immunosuppression; papilledema 
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EM ClerkshipBy Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD