AI Snips
Chapters
Transcript
Episode notes
When In Doubt, Do The LP
- If you are even considering a lumbar puncture, do the LP because the result (positive or negative) will change management.
- A negative LP can be as clinically valuable as a positive one when patients are already on multiple antimicrobials.
Get Blood Cultures Then Start Antibiotics
- Obtain blood cultures before antibiotics because ~50% of bacterial meningitis patients have bacteremia and cultures can guide therapy and duration.
- Start empiric antibiotics promptly and avoid delaying them for LP logistics.
Reserve CT Before LP For High-Risk Signs
- Do not reflexively get head CT before LP; reserve CT for specific risk factors (immunocompromise, focal deficits, papilledema).
- If no risk factors exist, perform LP promptly rather than delay for imaging.