How is a lumbar puncture procedure done?

How is a lumbar puncture procedure done?

During a spinal tap (lumbar puncture) procedure, you typically lie on your side with your knees drawn up to your chest. Then a needle is inserted into your spinal canal — in your lower back — to collect cerebrospinal fluid for testing.

Is lumbar puncture a sterile procedure?

ASEPTIC TECHNIQUE Diagnostic Lumbar Puncture is an aseptic procedure, but as there is no direct injection into the spinal canal, the procedure can be done in the ward setting and does not need to be done in an operating theatre.

Who performs a lumbar puncture procedure?

Conclusion: LP is a routine procedure for many clinicians and although neurologists perform the largest number of LPs, they are doing only one fifth of all procedures.

What do I order for a lumbar puncture?

IX. Standard CSF Orders

• Tube 1. Gram Stain. Culture and sensitivity.
• Tube 2. CSF Glucose. CSF Protein.
• Tube 3. CSF Cell Count with Differential.
• Tube 4. CSF Latex Agglutination (Antigens)

Can a spinal tap paralyze you?

Because the needle is inserted well below where the spinal cord ends, there is almost no chance of nerve damage or paralysis.

Is lumbar puncture painful?

A lumbar puncture is usually not painful, as a patient is first given a local anesthetic. Most patients feel nothing except for the mild sting of the local anesthetic needle. It is possible to feel a pressure sensation as the needle goes in.

Is lumbar puncture safe?

A lumbar puncture is generally a safe procedure and serious side effects are uncommon. The most common side effects are: headaches, which can last for up to a week – you’ll be given painkillers at the hospital if you need them.

How long are you on bed rest after a lumbar puncture?

The duty physician advises you that the patient will require four hours bed rest after the lumbar puncture.

How long do you have to stay in hospital after a lumbar puncture?

After a lumbar puncture, you will usually stay in the hospital or practice for at least one hour, but more typically for up to four hours, depending on how much cerebrospinal fluid was extracted and whether the puncture was used for a treatment.

What can go wrong with a lumbar puncture?

When spinal fluid is removed during an LP, the risks include headache from a persistent spinal fluid leak, brain herniation, bleeding, and infection. Each of these complications are uncommon with the exception of headache, which can appear from hours to up to a day after a lumbar puncture.

What are the indications of lumbar puncture?

Lumbar puncture should be performed for the following indications:

• Suspicion of meningitis.
• Suspicion of subarachnoid hemorrhage (SAH)
• Suspicion of nervous system diseases such as Guillain-Barré syndrome and carcinomatous meningitis.
• Therapeutic relief of pseudotumor cerebri.

How much fluid is taken in a lumbar puncture?

Large Volume Lumbar Puncture: What Happens When the area is numb, the practitioner inserts the spinal needle, usually into the lower back area. Once the needle is properly positioned, the practitioner measures the pressure of your CSF and collects about 30 to 40 ml of the fluid.

What is normal lumbar pressure?

Normal CSF contains 0-5 mononuclear cells. The CSF pressure, measured at lumbar puncture (LP), is 100-180 mm of H2O (8-15 mm Hg) with the patient lying on the side and 200-300 mm with the patient sitting up.

What drugs can be detected in a spinal tap?

Classes of drugs evaluated in this study included: benzodiazepines, anticonvulsants, sedatives, opioids, antidepressants, anesthetics, and antihistamines. The majority of the drugs tested were readily detected in CSF specimens. The average CSF/blood ratio for most drugs was in the range of 0.05-0.50.

Why a spinal tap is done?

Most often, a spinal tap is done is to see if a child has meningitis (inflammation and infection of the covering of the brain and spinal cord). Other conditions that can be detected include Guillain Barré syndrome, multiple sclerosis, cancer that affects the nervous system, and bleeding in the brain.

What should you do before a lumbar puncture?

Maintain your regular eating schedule. There are no dietary or fluid restrictions before the test. Ask your doctor for specific guidelines about discontinuing alcohol use, aspirin products, and blood-thinning drugs before the procedure. Tell your doctor if you are allergic to latex or any medications.

Can I be sedated for a lumbar puncture?

This examination is usually done on an outpatient basis. A nurse or technologist will insert an intravenous (IV) line into a vein in your hand or arm to administer a sedative. This procedure may use moderate sedation. It does not require a breathing tube.

Can a spinal tap be done in a doctor’s office?

You may be asked to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood thinners a few days before your test. From start to finish, your spinal tap will take about 30 to 60 minutes. The test may be done in a medical office. Or it may be done in the emergency room or the hospital.

How do you sleep after a lumbar puncture?

Lying flat in bed after a lumbar puncture does not prevent you from getting a headache from the procedure. If you develop a headache after a lumbar puncture, lying flat for several hours may help. Rest when you feel tired. Getting enough sleep will help you recover.

What level is a lumbar puncture performed?

Therefore a lumbar puncture is generally performed at or below the L3-L4 interspace. As a general anatomical rule, the line drawn between the posterior iliac crests often corresponds closely to the level of L3-L4. The interspace is selected after palpation of the spinous processes at each lumbar level.

Can nurses do lumbar puncture?

Currently, three RNs are deemed competent to perform lumbar puncture.

Which needle is used for lumbar puncture?

22 or 25 Gauge needle with stylet. At times, to lower the intracranial pressure.

How do you calculate L4 L5?

Wearing nonsterile gloves, locate the L3-L4 interspace by palpating the right and left posterior superior iliac crests and moving the fingers medially toward the spine (see the image below). Palpate that interspace (L3-L4), the interspace above (L2-L3), and the interspace below (L4-L5) to find the widest space.