LP in neonates and children for suspected meningitis.
Indications
- • Suspected meningitis, encephalitis
Contraindications
- ⚠ Raised ICP with mass effect
- ⚠ Coagulopathy
- ⚠ Cardiorespiratory instability
Equipment
- • 22-G / 25-G spinal needle (neonate)
- • Sterile kit
- • EMLA cream
- • Assistant to hold
Positioning
- • Neonate — sitting with knees flexed OR lateral fetal (avoid neck flexion to protect airway).
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/5)
Tap to complete
EMLA cream 45 min prior.
Immediate complications
- ⚠ Failed tap
- ⚠ Traumatic tap
- ⚠ Apnea during positioning
Delayed complications
- • Post-LP headache (older kids)
Recognition
- • Desaturation
- • Bradycardia
Initial management
- • Position on side
- • Loosen flexion
Prevention
- • Avoid neck flexion
- • Monitor SpO2
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
