A lumbar puncture is not dangerous, as long as the doctors and nurses carrying it out follow the correct procedures. This includes checking that there are no contraindications (such as a sudden rise in pressure in the brain or an abnormality in the way in which blood clots). Show The doctors and nurses will take precautions to prevent any infection entering the body during the lumbar puncture. The spinal cord cannot be injured by a lumbar puncture that is correctly carried out, as the needle enters the spine below the lower end of the spinal cord. The body replaces the small amount of fluid that is removed for testing very quickly (in less than two days). If your child is too restless or upset to be able to get in position and hold still, we may have to postpone the lumbar puncture or carry it out with your child under general anaesthetic. Sometimes it is not easy for the doctor to locate the place where the needle should be inserted. Another doctor may be called to assist, but in some cases the procedure has to be stopped. The doctors will discuss with you when and if the lumbar puncture should be repeated. If a little bleeding occurs when the lumbar puncture is done, some of the blood may become mixed with the CSF, affecting the results of the test. After a lumbar puncture, a little fluid may leak out and collect under the skin. You may be able to see some swelling in the lower back, around where the lumbar puncture needle went in. This is not dangerous and will stop. Lying flat afterwards can prevent this leak from developing. Some children develop a headache after a lumbar puncture. This is due to the slight reduction in pressure around the brain, resulting from the procedure. This headache usually settles down of its own accord in 24 to 48 hours, but if necessary your child can be given paracetamol – unless you have been advised otherwise. Vomiting can also occur after a lumbar puncture. Resting quietly with regular sips of fluid can help. Talk to the doctor if vomiting is severe or lasts for more than a day or two.
Lumbar puncture, also known as spinal tap, is an invasive procedure where a hollow needle is inserted into the space surrounding the subarachnoid space in the lower back to obtain samples of cerebrospinal fluid (CSF) for qualitative analysis. Most of the disorders of the central nervous system are diagnosed in relation to the changes in the composition and dynamics of the CSF. A lumbar puncture may also be used to measure CSF, instill medications, or introduce contrast medium into the spinal canal. The procedure usually takes around 30 to 45 minutes and can be done on an outpatient basis at a hospital or clinic. One of the responsibilities of the nurse during a lumbar puncture is to provide information and instructions before, during and after the procedure. It will decrease fear and anxiety among the patient and their families, and it will also lessen the occurrence of potential complications post-lumbar puncture. IndicationLumbar puncture is indicated for the following reasons:
ContraindicationAbsolute contraindication for lumbar puncture are as follows:
EquipmentThe lumbar puncture kit contains:
ProcedureThe step-by-step procedure for a lumbar puncture (spinal tap) is as follows:
Nursing Responsibility for Lumbar PunctureThe following are the nursing interventions and nursing care considerations for a patient indicated for lumbar puncture: Before the procedureThe following are the nursing interventions prior to a lumbar puncture:
After the procedureThe nurse should note of the following nursing interventions post-lumbar puncture:
Normal ResultsCSF samples for analysis with normal values typically range as follows:
Abnormal ResultsThese are the abnormal findings that can be found in CSF analysis:
ComplicationsThe possible complications after a lumbar puncture are:
GalleryImages related to lumbar puncture:
ReferencesAdditional resources and references for this guide:
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