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Simple Febrile: Lumbar Puncture

We concur with the AAP (Duffner 2011) Clinical Practice Guideline do not recommend the routine performance of a lumbar puncture and laboratory testing of CSF for children who present to the ED following a simple febrile seizure. When considering the source of the infection that caused the fever, if meningitis is on the differential diagnosis list, a LP is warranted. We have included four retrospective cohort studies that reinforce the low yield of positive results from an examination of CSF in this population.

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.