Clinical Practice Guidelines: Post-Dural Puncture Headache



PRISM Protocol

Post-dural puncture headache is a known potential consequence of a lumbar puncture and can lead to significant functional limitations for the patient.  This evidence based practice protocol applies to all patients presenting with symptoms suggestive of a post-dural puncture headache (PDPH) at Monroe Carell Jr. Children’s Hospital at Vanderbilt (MCJCHV).  The primary aim of this protocol is to formalize interdisciplinary collaboration to enhance the overall clinical care experience of patients presenting with post-dural puncture headaches at MCJCHV.  Secondary aims that support the primary aim include reduction of delays in initiation of conservative therapy, reduction of readmissions, timely consultation of the Pediatric Pain Service for performance of epidural blood patch, reduction of pain scores, and reduction in hospital length of stay.  The protocol outlines a clinical continuum of care that begins upon identification of a patient with a post-dural puncture headache. The potential exists that adherence to the protocol may reduce total hospital stay, initiate prompt treatment of post-dural puncture headaches, and restore function to children suffering with this condition.

Post-dural puncture headache guidelines team

  • Contact: Carrie Menser, Pediatric Anesthesiology
  • Andrew Franklin, Pediatric Anesthesiology
  • Christina Estrada, Emergency Medicine
  • Kris Rehm, Pediatrics & Hospital Medicine