Investigations | Right Decisions

Perform diagnostic and other laboratory tests:

blood gas (bicarb, base deficit), lactate, glucose, FBC, U&E, Ca++, Mg++, PO4, clotting, CRP, blood cultures, whole blood (EDTA) for PCR, X-match.
Take throat swab.
If limited blood volume, prioritise blood gas, lactate, glucose, electrolytes, FBC, clotting.

Correct any dehydration.

Are there any of the following contraindications to lumbar puncture?

Clinical or radiological signs of raised intracranial pressure.

Shock

Recent not yet stabilised seizure.

Clotting study results (if available) outside normal range

Platelet count below 100 x 10⁹/L

Patient on anticoagulant therapy

Local superficial infection at LP site

Respiratory insufficiency.

None of the above.

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