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>...LP should be done, who does it - Emergency Department staff or the >medics? --> Medics, unless I have an ED SHO who wants to do it for educational purposes, in which case we still call the Medical Registrar (or experienced Medical SHO), hand the case over to them as per usual and "offer" to have our SHO "do it for them" so long as they supervise and critique... >If you do it yourselves do you make use of an Observation area to wait >until 12 hours after onset - if the patient presented earlier? --> I may well still allow the patient to end up in Obs (for the medics to do the LP) if he/she looks well enough to be a likely rapid discharge should the LP be negative (which is often). Although the use of an Obs ward bed is controlled by ED consultants, we allow some medical patienst there, so long as we are satisfied that they will likely be heading home early enough. Furthermore, we will very often end up discharging these medical patients if we happen by and the patient is fit for discharge and they have not pitched up yet. Obs ward nursing staff is ours and they know what we're likely to send home. All medical consultants accept our right to do this. Hence, sometimes such ?SAH patients are seen by ED, scanned by ED, turfed to medics to do LP in obs ward, then discharged by ED when results return without bothering to call medics to do it. Personally, I can't stand doing LPs. Yuch!