1. The baby was nine weeks and there was a flu going through the house
2. Are you seriously saying that a spinal has as little risk as drawing blood? Seriously?
3. The infant’s temperature was dropping after subcue fluid intake. Observation is the course that should have been taken. Admit the baby if need be, OR do as the mother said and get a second opinion. YOU would have done that, as you stated. This ER idiot called CPS.
4. I don’t like to see infants out either.
Eric and Corissa Mueller have waited six years to get their say in court and allege that their constitutional rights as parents were violated simply because they preferred not to let a doctor stick a needle in their 5-week-old daughter's spine without more information.
If that's not true, then you can skip the rest of this post, because I have to admit the mortal sin of not reading the whole article...I stopped at the 5-week old part because that really is where the baby poop hits the fan.
I don't like 'set in stone' treatments, and I'm pretty comfortable with my clinical judgement, especially with kids, but even I won't break this one. A 5% chance of meningitis is 1 in 20. Meningitis is 'bad disease'...i.e. it kills. I'm not willing to bet my career or a child's life on those kinds of odds.
And yes, spinal taps really are that easy to do in infants, much easier and less painful than trying to find a tiny vein that can support an IV.
Observation is not at all supported in this case, infants are too fragile, and if you wait until they look bad, it may be too late. Admission would be for treatment, and once the antibiotics are started without the tap, you can't tell what you are treating anymore, so you are committed to a full hospital course of treatment. So now a baby who could have been discharged if the workup was negative is stuck in the hospital for 7-10+ days.
Armed with that information, I've been pretty successful with convincing parents about the LP when necessary...most just have a knee-jerk reaction to the idea or base it on their own experience. Once they are confident that we really do have the child's best interest at heart and are made aware of the potential dangers, they almost all will let us do what we need to do. I also wouldn't have a problem with a second opinion, but it would have to be quick and at our hospital, I wouldn't discharge or transfer the child for it (again...didn't read the article-itis :^))
O2