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NICE

NICE

Lumbar puncture is not recommended if there is extensive or rapidly spreading purpura, infection at the lumbar puncture site, or risk factors for an evolving space-occupying lesion. It is also not recommended in the presence of any of these symptoms or signs, which could indicate increased intracranial pressure: new focal neurological characteristics (including seizures or posturing), abnormal pupillary reactions, a progressive and sustained drop in level of consciousness.

NICE

NICE

A lumbar puncture to obtain a cerebrospinal fluid sample is recommended when there is a strong clinical suspicion of early-onset neonatal infection or there are clinical symptoms or signs suggestive of meningitis. Lumbar puncture is the only test that can directly confirm the diagnosis of bacterial meningitis. Before performing a lumbar puncture, it is recommended to treat unprotected airway, respiratory compromise, septic shock, uncontrolled seizures, and risk of hemorrhage. Antibiotics can ...

NICE

NICE

Lumbar puncture is the only test that can directly confirm a diagnosis of bacterial meningitis. Antibiotics can affect the results of cerebrospinal fluid tests, so lumbar puncture needs to be performed before antibiotics when possible. The committee did not recommend a specific timeframe for performing lumbar puncture because they were concerned that it would be interpreted as a hard cutoff. The committee used their experience to highlight situations that need treating or stabilising before a ...

NICE

NICE

Bacterial meningitis is an inflammation of the membranes surrounding the brain and spinal cord, caused by a bacterial infection. We use the term "meningococcal disease" to refer to disease caused by invasive meningococcal infection (including bloodstream infection and meningitis). The main bacteria that cause meningitis in adults, children, and babies older than 3 months are Neisseria meningitidis (meningococcus) and Streptococcus pneumoniae (pneumococcus). Group B streptococci, Escherichia ...

Choosing Wisely ® : Things we do for no reason

Choosing Wisely ®: Things we do for no reason

Potassium is a highly regulated intracellular cation with serum concentrations maintained between 3.5 and 5.0 mmol/L.1 Deviations from this range impact cardiac function by altering physiologic membrane potential. Hyperkalemia (concentration >5.0 mmol/L) has depolarizing effects on myocytes, increasing the risk of cardiac arrhythmia. With increasing potassium levels, there is loss of P waves, development of sine-wave pattern conduction, atrioventricular (AV) junction delay, and ultimately ...