Articles tagged "lumbar puncture"

In-person Procedural Education in the Era of COVID19

by Joseph Esherick, M.D., FAAFP, FHM

Medical procedural education in the era of COVID19 is still best conducted via HANDS-ON simulation-based procedural training. Procedural skills can NOT be attained via remote education, but in-person training must be conducted safely.

Which cirrhotic patients are at high risk for bleeding during hospital procedures?

by Joseph Esherick, M.D., FAAFP, FHM

This blog will offer some expert recommendations to help guide the safety of hospital procedures at different platelet and coagulation profiles.

Guidelines for Antiplatelet and Anticoagulation Discontinuation before a Lumbar Puncture

by Joseph Esherick, M.D., FAAFP, FHM

This blog summarizes the guidelines by the European Society of Anesthesiology (ESA), the American Society of Regional Anesthesiologists (ASRA) and the Association of British Neurologists regarding the timing of antiplatelet and anticoagulation discontinuation before a lumbar puncture.

Bedside Ultrasound Increases the Success Rate for Difficult Lumbar Punctures

by Joseph Esherick, M.D., FAAFP, FHM

The traditional landmark-guided needle lumbar puncture technique was first described by Heinrich Quincke in 1891 This technique utilizes the...

Periprocedural Bleeding Risk for Thrombocytopenia, Coagulopathy, Antiplatelets and Anticoagulation

by Joseph Esherick, M.D., FAAFP, FHM

This blog summarizes the 2019 Society of Interventional Radiology for Periprocedural Management of Image-guided Procedures with regards to thrombocytopenia, coagulopathies, antiplatelets and anticoagulation

Simulation Based Training Improves Airway Management Skills

by Joseph Esherick, M.D., FAAFP, FHM

Simulation-based procedural training has been shown to improve procedural competence, safety, operator confidence and most importantly patient safety for every bedside procedure studied. Now, a new systematic review and meta-analysis confirms that simulation-based training in airway management improves procedural competence with direct laryngoscopy, endotracheal intubation, video laryngoscopy, laryngeal mask airway insertion, and King tube airway insertion.

Risks for Post-Dural Puncture Headaches after Lumbar Puncture

by Joseph Esherick, M.D., FAAFP, FHM

Patients' being in a seated position during the procedure showed a trend to increased frequency of headaches both immediately and 24 hours after puncture. Also, removal of CSF volumes above 30 mL increased the risk of immediate post-procedure headaches.

Atraumatic Spinal Needles Significantly Decrease the Risk of Post-Dural Puncture Headaches or Spinal Headaches

by Joseph Esherick, M.D., FAAFP, FHM

Atraumatic spinal needles reduce the incidence and severity of post-dural puncture headaches, or spinal headaches, compared with traumatic spinal needles.

Essential to Administer Antibiotics Immediately if Bacterial Meningitis is Suspected

by Joseph Esherick, M.D., FAAFP, FHM

The amendment of the Swedish guidelines to remove impaired mental status as a contraindication for lumbar punctures without prior CT scan led to more favorable outcomes.

Lumbar puncture characteristics of traumatic LP versus subarachnoid hemorrhage

by Joseph Esherick, M.D., FAAFP, FHM

The combination of a red blood cell count less than 2000 × 106/L and no xanthochromia is sufficient to rule out aneurysmal SAH in patients with traumatic lumbar punctures.