Causes Clinical features Investigations Immediate management Prevention Prognosis

Investigations capillary glucose d arterial blood gases d blood count c urea and electrolytes c glucose c calcium ECG d chest X-ray d CT head d Consider serum and urine drugs screen if overdose suspected d blood culture if evidence of infection d cervical spine X-rays if trauma d lumbar puncture if signs of raised intracranial pressure are absent on CT head, and an infection or intracranial haemorrhage are suspected d Arrange a CT brain before performing the lumbar puncture a . Use a narrow gauge, non-cutting needle a through a bleb of local anaesthetic c Replace the stylet before withdrawing the needle. a Send CSF for  Gram stain and cell count c culture a  glucose and protein c

Expiry date: September 2003
Levels of Evidence used in grading these guides