When should you stop anticoagulation before a lumbar puncture?
at least 36 hours before, and 6–12 hours after LP. LP should be avoided if possible in patients on treatment dose fondaparinux as there is little evidence around the bleeding risk, and concerns about accumulation.
Can you have a spinal tap while on blood thinners?
If you will have epidural or spinal anesthesia, a spinal puncture, or an epidural injection for pain while receiving a blood-thinner such as enoxaparin (Lovenox or its generics), there is a risk for having bleeding around your spine that could cause you to become paralyzed.
Why LP is contraindicated in increased ICP?
While some patients with CT evidence of increased ICP have undergone LP without herniation, CT findings of increased ICP place patients at a dramatically increased risk for herniation if an LP is performed. Therefore, LP should be avoided when any signs of increased ICP are seen on CT.
What are contraindications for lumbar puncture?
Absolute contraindications for performing a LP include infected skin over the puncture site, increased intracranial pressure (ICP) from any space-occupying lesion (mass, abscess), and trauma or mass to lumbar vertebrae.
What are the indications and contraindications for lumbar puncture?
Lumbar puncture should be performed for the following indications: Suspicion of meningitis. Suspicion of subarachnoid hemorrhage (SAH) Suspicion of nervous system diseases such as Guillain-Barré syndrome and carcinomatous meningitis.
When is LP contraindicated?
LP is contraindicated in patients with a suspected spinal epidural abscess. Suspected bacteremia is not a contraindication to LP. We suggest the use of a face mask for diagnostic LP if the procedure is expected to be prolonged or difficult or if the operator has an upper respiratory tract infection.
What are the contraindications of lumbar puncture?
Who can perform a lumbar puncture?
A doctor, nurse practitioner (NP), nurse anesthesiologist, or physician assistant (PA) performs a lumbar puncture.
Which of the following procedure is contraindicated after lumbar puncture?
Table 1
| Contraindication for LP | Procedures to rule out contraindications |
|---|---|
| 1. Space-occupying lesion with mass effect, increase of intracranial pressure due to increased CSF pressure 2. Posterior fossa mass 3. Arnold-Chiari malformation | Clinical neurological examination Fundoscopy |
What is an absolute contraindication?
Absolute contraindication means that event or substance could cause a life-threatening situation. A procedure or medicine that falls under this category must be avoided.