Lumbar Puncture

Visual evoked potentials show strong positive association with intracranial pressure in patients with cryptococcal meningitis

“…Accordingly, the detection of high ICP through an alternative of clinical and tomographic methods would be useful in monitoring of patients in order to indicate CSF drainage by spinal tap. While failure to address raised intracranial pressure could result in more residual neurological damage and death 1 , the unneeded repetition of spinal taps increases the risk of adverse events, including hemorrhage, bacterial infection, CSF hypotension, radicular involvement, epidermoid tumor, and brain herniation 28 . Therefore, to avoid unneeded lumbar punctures is desirable through the development of a reliable, non-invasive method to measure ICP that is easy to perform at the bedside and can identify the patients who must be subjected to spinal tap.…”

Safety and Cost-Effectiveness of a Simplified Method for Lumbar Puncture in Patients with Hematologic Malignancies

“…Red blood cell (RBC) contamination of cerebrospinal fluid (CSF) in the LP occurs in 8-19% of cases [11]. The most frequent complication is post-LP headache which occurs in 36.5-60% of patients [12]; other less frequent complications are brain herniation, cardiorespiratory compromise, local or referred pain, hemorrhage, subarachnoid epidermoid cyst, and CSF leak [12]. Infectious adverse events can be cellulitis, abscesses (spinal or epidural) or even meningitis [13].…”

“…Infectious adverse events can be cellulitis, abscesses (spinal or epidural) or even meningitis [13]. LPs are performed using resources that include sterile drapes, sterile gloves, gauze, masks, equipment for LP, a manometer, and anesthetic patches, among others [12]. Sometimes the support of fluoroscopy or ultrasound is needed during the procedure [14,15].…”

Blood and Body Fluid Exposures Among US Medical Students in Botswana

“…The session begins with a lecture on blood and body fluid exposure risk reduction, including strategies for handling contaminated needles without safety devices, such as bringing the sharps bin to the bedside and recapping using only one hand. Students watch the New England Journal of Medicine procedure videos, [5][6][7][8] and perform phlebotomy, IV placement, lumbar puncture, thoracentesis, and paracentesis on task trainers designed for these procedures, under instruction from physicians with experience in resource-limited settings. Students practice using equipment similar to what they will use in Botswana, such as IVs without retractable needles.…”

“…To understand how exposures affect students' experiences during the rotation, we asked students to check all of the following that applied: I felt embarrassed (9); I felt scared (9); I didn't want to tell anyone but I knew I had to (6); the exposure negatively impacted the rest of my trip (5); I felt less confident in my ability to do procedures (2); I didn't want to tell anyone so I kept it to myself (1); after the injury I was less likely to volunteer to do procedures (1). One student reflected, "Everyone found out … I felt socially isolated after my incident…I still feel humiliated.…”