Lumbar punctures in the Acute Medicine Department: indications and evaluation of use.

Aims: Evaluate the use of lumbar puncture (LP) in the Acute Medical Department of a typical urban district general hospital. Increase the proportion performed on appropriate patients.

Methodology: An observational, single-centre, retrospective examination of patients undergoing LP at Solihull Hospital over four consecutive months. Discussion of findings and LP indications with the Acute Medicine Department. Re-audit over four months.

Results: Total LPs performed fell by 65%. The proportion performed on patients presenting with red flags rose by 19% (p=0.0098). The proportion that yielded positive findings rose by 33% (p<0.0001). 72% of patients with red flags had negative LP.

Conclusions: Awareness of indications and observation of practice reduces total LPs performed and increases the proportion performed on appropriate patients.