Lumbar Puncture

Chapter 36 Lumbar Puncture



Common indications


Lumbar puncture is a common procedure used in the evaluation of cerebrospinal fluid (CSF) and central nervous system (CNS) pressure. The most common indication for the procedure is to rule out CNS infections such as meningitis or encephalitis. The procedure is performed in adults and children.



Equipment


The equipment for performing a lumbar puncture is packaged in a complete instrument tray that includes a preparation kit, an anesthetic, a spinal needle, an optional pressure catheter system, and collection tubes labeled to indicate the order of the fluid withdrawn (Figure 36-1).


image

FIGURE 36-1 Lumbar puncture tray with essential contents.



Key steps



1. Anatomic landmarks: Place the patient in the flexed lateral decubitus position. Palpate the iliac crest and the lumbar spines at the midline. The iliac crest serves as the landmark that marks the interspace between the third and fourth lumbar (L3, L4) vertebrae. Mark this interspace (Figure 36-2).

2. Skin cleansing and anesthesia: Cleanse the skin with an antiseptic solution. Drape the skin with the fenestrated drape to maintain a sterile field. Anesthetize the skin and deep connective tissue with 1% lidocaine (Figure 36-3).

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Dec 12, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Lumbar Puncture

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