Haemostasis and Safety Measures before Lumbar Puncture in the Haematology Ward: The Danish Routines
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Haemostasis and Safety Measures before Lumbar Puncture in the Haematology Ward : The Danish Routines. / Møller, Anders; Bjerrum, Ole Weis; Afshari, Arash.
In: Acta Haematologica, Vol. 133, No. 1, 2015, p. 108-112.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Haemostasis and Safety Measures before Lumbar Puncture in the Haematology Ward
T2 - The Danish Routines
AU - Møller, Anders
AU - Bjerrum, Ole Weis
AU - Afshari, Arash
N1 - © 2014 S. Karger AG, Basel.
PY - 2015
Y1 - 2015
N2 - BACKGROUND/AIMS: Thrombocytopenia and the increasing use and variety of antithrombotic drugs is a challenge prior to lumbar puncture. This study examined the Danish haematology practice regarding drug pausation, assessment of haemostasis and whether fundoscopy is a routine safety measure.METHODS: An online survey with questions pertaining to precautions of haemostasis and application of fundoscopy was sent by e-mail to all 12 haematology wards in Denmark.RESULTS: Eleven sites participated. Five (45%) reported no pausation of antiplatelet drugs at all. The mean platelet limit prior to lumbar puncture was 50 × 10(9)/l (range 10-50 × 10(9)/l). Seven (64%) sites had an international normalised ratio limit of 1.5, and the remaining 4 had values between 1.0 and 2.5. Two (18%) reported occasional use of thromboelastography or platelet analysis to assess the bleeding risk. Fundoscopy is routinely performed in 4 (36%) departments.CONCLUSION: We report considerable variation in the routine handling of antithrombotics and thrombocytopenia in patients set for lumbar puncture in Danish haematology departments. The diversity may be explained by and related to different opinions in the literature. Common national guidelines are warranted and there is a need for studies to establish an evidence-based approach for the management of patients at risk of bleeding when lumbar puncture or another invasive procedure is indicated.
AB - BACKGROUND/AIMS: Thrombocytopenia and the increasing use and variety of antithrombotic drugs is a challenge prior to lumbar puncture. This study examined the Danish haematology practice regarding drug pausation, assessment of haemostasis and whether fundoscopy is a routine safety measure.METHODS: An online survey with questions pertaining to precautions of haemostasis and application of fundoscopy was sent by e-mail to all 12 haematology wards in Denmark.RESULTS: Eleven sites participated. Five (45%) reported no pausation of antiplatelet drugs at all. The mean platelet limit prior to lumbar puncture was 50 × 10(9)/l (range 10-50 × 10(9)/l). Seven (64%) sites had an international normalised ratio limit of 1.5, and the remaining 4 had values between 1.0 and 2.5. Two (18%) reported occasional use of thromboelastography or platelet analysis to assess the bleeding risk. Fundoscopy is routinely performed in 4 (36%) departments.CONCLUSION: We report considerable variation in the routine handling of antithrombotics and thrombocytopenia in patients set for lumbar puncture in Danish haematology departments. The diversity may be explained by and related to different opinions in the literature. Common national guidelines are warranted and there is a need for studies to establish an evidence-based approach for the management of patients at risk of bleeding when lumbar puncture or another invasive procedure is indicated.
KW - Denmark
KW - Health Care Surveys
KW - Hematology
KW - Hemostasis
KW - Hospital Units
KW - Humans
KW - Internet
KW - Patients' Rooms
KW - Platelet Count
KW - Platelet Function Tests
KW - Practice Patterns, Physicians'
KW - Spinal Puncture
KW - Surveys and Questionnaires
KW - Thrombocytopenia
U2 - 10.1159/000362357
DO - 10.1159/000362357
M3 - Journal article
C2 - 25247257
VL - 133
SP - 108
EP - 112
JO - Acta Haematologica
JF - Acta Haematologica
SN - 0001-5792
IS - 1
ER -
ID: 152272747