Do Not Do Recommendation

 

Do not perform a lumbar puncture without consultant instruction if any of the following contraindications are present:

  • signs suggesting raised intracranial pressure or reduced or fluctuating level of
  • consciousness (Glasgow Coma Scale score less than 9 or a drop of 3 points or more)
  • relative bradycardia and hypertension
  • focal neurological signs
  • abnormal posture or posturing
  • unequal, dilated or poorly responsive pupils
  • papilloedema
  • abnormal 'doll's eye' movements
  • shock
  • extensive or spreading purpura
  • after convulsions until stabilised
  • coagulation abnormalities or coagulation results outside the normal range or platelet
  • count below 100x109/litre or receiving anticoagulant therapy
  • local superficial infection at the lumbar puncture site
  • respiratory insufficiency in children.

(This recommendation is adapted from NICE's guideline [CG102] on meningitis (bacterial) and meningococcal septicaemia in under 16s.)

Do Not Do Recommendation Details

Recommendation:

Do not perform a lumbar puncture without consultant instruction if any of the following contraindications are present:

  • signs suggesting raised intracranial pressure or reduced or fluctuating level of
  • consciousness (Glasgow Coma Scale score less than 9 or a drop of 3 points or more)
  • relative bradycardia and hypertension
  • focal neurological signs
  • abnormal posture or posturing
  • unequal, dilated or poorly responsive pupils
  • papilloedema
  • abnormal 'doll's eye' movements
  • shock
  • extensive or spreading purpura
  • after convulsions until stabilised
  • coagulation abnormalities or coagulation results outside the normal range or platelet
  • count below 100x109/litre or receiving anticoagulant therapy
  • local superficial infection at the lumbar puncture site
  • respiratory insufficiency in children.

(This recommendation is adapted from NICE's guideline [CG102] on meningitis (bacterial) and meningococcal septicaemia in under 16s.)

Interventions:
lumbar puncture

Source guidance details

Guidance:
Sepsis: recognition, diagnosis and early management (NG51)
Published date:
December 2016
Paragraph number:
1.10.6
Page number:
38

View all NICE do not do from this Guidance