Lumber Puncture
- Lumber puncture also known as spinal taping.
- a process where needle are introduce into the subarachnoid space to collect CSF.
Purpose:
- CSF collection and analysis
- Check CSF pressure
- Myelography (iodine dye is injecting through LP for study of structure of spinal cord.)
- Drug administration
- Spinal anesthesia
Indication
- Lower limb surgery
- LSCS
- Meningitis
- Pott's spine
- Neuro degenerative disorder
Contraindication
Increase ICP
Procedure
1.Collect article:-
- spinal needle:- adult:-22 G child:-25 G
- 3 Sample collection vial:- cytological, viral, bacterial, or other examination.
- Manometer:- to check the CSF pressure.
- Betadine
- 2% lidocaine
- syringe
Position
- Fetal attitude
- C shape
- Lateral position with head and knee flexed inside.
Site of selection
- Adult:-L3-L4
- Infant:-L4-L5
- Most Common:-L4-L5
Insert needle in subarachnoid space then connect 3 way adaptor. connect manometer and check pressure. mercury rise in manometer and constant a point that is known as CSF pressure.
- Normal CSF pressure:-5-15 mm of Hg
- after sample collection dressing to the site.
- Position:-Flat position or supine position avoid pillow under back
- advantage of position :- to prevent headache.
- Most common complication after LP.
- Amount of the sample:-6-10 ml
- sample should be sending in lab in 1-2 hrs.
- Temperature for store the CSF:-
- 0-6 hrs :- Room temperature 22-24 Celsius
- 6-24 hrs:- 4 Celsius
- Serological Examination:- 20 Celsius.