Table 1

Reasons given for intentionally deferring lumbar puncture

Indication*Number of children (%)
Indication specified by UK National Institute for Health and Care Excellence (NICE) guideline13
 After convulsions until stabilised15 (18)
 Cardiorespiratory instability (including shock)14 (17)
 Signs suggesting raised intracranial pressure13 (16)
 Respiratory insufficiency12 (14)
 Abnormal coagulation and/or platelet count7 (8)
  Abnormal CT scan†2 (2)
Other indications
 No indication at admission9 (11)
 Failed initially6 (7)
 Parental refusal2 (2)
 High fever1 (1)
 Reason not given8
  • *Some children had >1 indication for deferring lumbar puncture. In total, 89 indications were cited for 83 children in whom lumbar puncture was intentionally deferred.