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Lumbar Puncture Guide for Clinicians

The document provides guidance on performing a lumbar puncture procedure including indications, contraindications, necessary equipment, steps for positioning the patient and passing the needle, consent requirements, tests to perform on cerebrospinal fluid samples obtained, tips for reducing complications, and emphasizing universal precautions. Proper patient positioning is identified as the most important step and complications that could occur include spinal headache, trauma, herniation, infection, and hemorrhage.

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Bhupesh Kumar
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78 views13 pages

Lumbar Puncture Guide for Clinicians

The document provides guidance on performing a lumbar puncture procedure including indications, contraindications, necessary equipment, steps for positioning the patient and passing the needle, consent requirements, tests to perform on cerebrospinal fluid samples obtained, tips for reducing complications, and emphasizing universal precautions. Proper patient positioning is identified as the most important step and complications that could occur include spinal headache, trauma, herniation, infection, and hemorrhage.

Uploaded by

Bhupesh Kumar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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CSI 201

Skills Lab 2
LUMBAR PUNCTURE
DARYL P. LOFASO, Ph.D.,M.Ed., RRT
Indications for Lumbar Puncture

To obtain CSF for Laboratory Examination


Administer Medications into subarachnoid space
Perform Myelography
Measure ICP
Dx CNS infections and Inflammatory Diseases
LP Contraindications
Infectionsat puncture site
Suspected CNS mass lesion
Increased ICP (relative)
Coagulation disorder (relative)
Lumbar Puncture Checklist
Check the indications
Know the risks and how to deal with serious
complications
Explain the issues to the patient
Check for allergy to lidocaine or iodine
Consider bleeding tendency / risks
Lumbar Puncture Equipment
Consent form (Signed)
Lab request forms and specimen bottles
Sterile Gloves, sterile gown, mask & eye
protection
Local anesthetic
LP Tray
Lumbar Puncture
What structures or layers with the needle pass
through before reaching the subarahnoid space?

Skin
Superficial fascia
Superspinous ligament
Interspinous ligament
Ligamentum flavum
Epidural space containing fatty
areolar tissue and the internal
vertebral venous plexus
Dura mater
Arachnoid mater
Subarachniod space
Invasive/Non-Invasive
Procedure Consents
 Date/Time of consent
 Indications
 Alternativetreatment
 Risk/Benefits
 Documentation that all questions have been answered
 Signature of patient or authorized representative before
procedure performed & appropriate witness –
Date/Time
Test CSF
 Appearance
 Protein
 Sugar
 Serology
 Cell Count
 Bacterial or Fungal
Cultures
Helpful Hints
What is the most important step before
performing a Lumbar Puncture?

Answer: Positioning the Patient


Culture Tubes
Tube 1: Gram stain, (AFB, fungal)
Tube 2: Glucose and Protein
Tube 3: Cell count (RBC, WBC with differentials)
Tube 4: Hold for possible (VDRL, India ink,
electrophoresis, antigen panel)
* (Tube sequence may varies per hospital)
Complications to LP
Spinal Headache
Trauma
Herniation
Infection
Hemorrhage
Bloody Tap
Invasive/Non-Invasive
Procedure Note
 Proper Patient Identification
 Site Verification
 Pre / Post Medication for pain control
 Intra / Post procedure monitoring
 Complications, if any
 Management of Complications
Universal Precautions
AllPatients are potentially infectious.
Good Handwashing is the key to reducing
nosocomial infections
Wash before and after patient contact
Wear a mask, eye protection, face shield, and
gown when needed

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