Lumbar Punsure Case Study

H. Problem statement
Lately, in modern community arise a misconception about the danger of lumbar puncture procedures which is said could cause paralysis to the patients. After explaining everything about procedure which is completely safe, some parents still refuse lumbar puncture procedures to their children as stated in world paediatric journal where lumbar puncture out of 55 families, only 24 of them declined the procedure (16). Furthermore, some disease or infection are not enough by history taking but it need clinical diagnosis by obtaining cerebrospinal fluids such as Neisseria Meningitis infection, we must know the underlying causes of meningitis itself before start any antibiotics treatment. Without lumbar puncture procedure, patient

Lumbar punctures were requested in 28 patients from 117 patients in their studies which 28 patients were suspected with meningitis and aged below 18 months’ age (17). Out of 28 requested for lumbar puncture procedures, only 20 parents gave their consent. The reasons for lumbar puncture procedures were mostly more than one. From their study, the most frequent reasons were fear of child being paralysed after done with lumbar puncture procedures (75.5%), fear of death to their children as complication of lumbar puncture procedures (37.5%), anxious about pain to the child (25.0%) (17). There were also reasons some parents fear about their child’s health status might worsen after procedures (12.5%) and one parent came out with religious reason (12.5%). Some parents believed lumbar puncture procedures could cause mental retardation to their children (17). Equally important reasons were their children were too small for procedures and it could cause unbearable pain to their children. Besides, some parents said the procedure way too dangerous since it involved in poking children spinal cord and it could weaken children’s kidney. Researchers postulate the arise in wrong belief among the community about lumbar puncture in some way could lead to paralysis to patients. Nevertheless, further and deeper studies among Malaysia community are needed

Even though complications such as coning and death from lumbar puncture is rare, these things must take into physician’s consideration before suggesting lumbar puncture to their patient. Other minor complications like headache and pain were resolved by time and spontaneously. Somehow, the decision to do or not do the lumbar puncture still lies with the individual clinician. Unfortunately, if the enormous belief regarding harmful of lumbar puncture spread among community like a catching fire, then decision whether to do or not to do the lumbar puncture not depend on physician anymore; but it depends on parent’s or patient’s decision and their erroneous belief. This kind of situation will make the confirmation of diagnosis meningitis or any central nervous system infection extremely difficult to confirm and can cause treatment unable to reach optimum level and lead to more complication. To change this belief and persuade parent and patient about lumbar puncture, lumbar puncture need definite indication and handled by experienced physicians so these two criteria may change perception and wrong belief among parent and patient about lumbar puncture thus make them believe lumbar puncture is safe and useful procedure. So far, not many studies conducted in developing country regarding parent’s and patient’s view