Check out Drs. Flower and Bronner’s emDocs.net publication on
Lumbar Puncture and the Anticoagulated Patient
- Lumbar puncture is a diagnostic gold standard for several serious pathologies, but is not always emergent.
- Consider thrombosis vs hemorrhage risk.
- Obtain accurate medication list and last dose history in all patients before LP.
- Coagulation studies alone may not identify all patients at risk for bleeding complications.
- Do not delay abx, for CT or LP, in patients with high suspicion for meningitis.
- Do not restart anticoagulants immediately after LP.
- Do not let diagnostic testing obscure clinical judgement.
Congratulations Drs. Flower and Bronner!