insensitive technicians 
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 insensitive technicians


JE> A friend was recently admitted to North Carolina Memorial Hospital
JE> because of suspected meningitis.  Serious business.  They wanted to do
JE> a lumbar puncture, for which a CT scan is a prerequisite.

The last statement is actually not true.  There is a myth that
lumbar puncture can cause brain herniation in a patient with
increased intracranial pressure and/or an intracranial mass.  There
is zero credible evidence that LP causes herniation in these or any
other circumstances.  However, this is irrelevant to your question.

JE> I arrived in her hospital room about an hour after she had returned
JE> from the CT.   She was in tears.  Evidently the technicians in the CT
JE> lab had been very unpleasant to her.
JE> Is there anything I can do about these pigs ?

Sure.  Write a letter to the executive director of the hospital.  If
you don't know the names of the techs, give the exact date and time
of the scan.  One such letter and the techs get put on notice.  A
few more and they are out of a job.
---



Fri, 20 Oct 1995 03:59:00 GMT
 insensitive technicians

Quote:

>JE> A friend was recently admitted to North Carolina Memorial Hospital
>JE> because of suspected meningitis.  Serious business.  They wanted to do
>JE> a lumbar puncture, for which a CT scan is a prerequisite.

>The last statement is actually not true.  There is a myth that
>lumbar puncture can cause brain herniation in a patient with
>increased intracranial pressure and/or an intracranial mass.  There
>is zero credible evidence that LP causes herniation in these or any
>other circumstances.  However, this is irrelevant to your question.

Excuse me? There is *no* credible evidence that LP causes herniation in a
patient with raised ICP? Are you serious?

There is plenty. The phenomenon is known as 'coning', and if you bother to
search the Registrar's database in most places, you will find that there
are deaths caused by compression of the medulla through the foramen magnum,
coincident with an LP. You may be right about not needing a CT before LP, and
with a lot of care (as in manometry before taking samples) you can avoid this
disaster, but it happens. It used to happen a lot more often, before docs got
clued in, and it still does occasionally, with a fool taking the LP...

To put all that in perspective, the risk is small, vanishingly so in the
absence of severely raised intracranial pressure. But in cases of severely
raised ICP (not including benign IC hypertension - there's a different
mechanism involved there), there is a real risk of coning and consequent
death.




Mon, 23 Oct 1995 17:23:19 GMT
 
 [ 2 post ] 

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