title: Lumbar punctures in the Acute Medicine Department: indications and evaluation of use.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Heart of England NHS Foundation Trust, Birmingham.
authors.forename: Rebecca F M
authors.initials: RF
authors.lastname: D'Cruz
authors.affiliation: Heart of England NHS Foundation Trust, Birmingham.
authors.forename: Arun Dev
authors.initials: AD
authors.lastname: Vellore
mesh_terms: D054869:Clinical Audit; D004636:Emergency Service, Hospital; D005260:Female; D006767:Hospitals, District; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013129:Spinal Puncture / Q000379:methods*