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Explain To The Patient The Purpose of Lumbar Puncture, How and Where It's Done, and Who Will Perform The Procedure

A lumbar puncture, or spinal tap, is a procedure where a needle is inserted between vertebrae in the lower back to remove cerebrospinal fluid from the spinal canal for testing. The patient is positioned on their side with their back arched and knees drawn up. The skin over the lumbar area is cleaned and numbed before the needle is inserted between vertebrae and advanced until the ligament is felt to give way and enter the subarachnoid space. A small amount of cerebrospinal fluid is collected in test tubes for analysis. The patient must lie flat for several hours after to prevent complications.

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Christian Anthony L. Gamolo
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121 views3 pages

Explain To The Patient The Purpose of Lumbar Puncture, How and Where It's Done, and Who Will Perform The Procedure

A lumbar puncture, or spinal tap, is a procedure where a needle is inserted between vertebrae in the lower back to remove cerebrospinal fluid from the spinal canal for testing. The patient is positioned on their side with their back arched and knees drawn up. The skin over the lumbar area is cleaned and numbed before the needle is inserted between vertebrae and advanced until the ligament is felt to give way and enter the subarachnoid space. A small amount of cerebrospinal fluid is collected in test tubes for analysis. The patient must lie flat for several hours after to prevent complications.

Uploaded by

Christian Anthony L. Gamolo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Lumbar Puncture

 A lumbar puncture (spinal tap) is performed in your lower back, in the lumbar region. During a
lumbar puncture, a needle is inserted between two lumbar bones (vertebrae) to remove a
sample of cerebrospinal fluid. This is the fluid that surrounds your brain and spinal cord to
protect them from injury.

Purpose:

 A lumbar puncture may be done for various reasons. The most common reason is to remove a
small amount of CSF for testing.

Principles:

 ACEP’s clinical policy states that adults exhibiting signs of increased intracranial pressure need
imaging prior to a LP (Level C Recommendation) 

Procedure:

1. Explain the procedure to the patient and obtain consent.

- Explain to the patient the purpose of lumbar puncture, how and where it’s done,
and who will perform the procedure.
2. Secure equipment from the CSR and bring to bedside.

- For easier access to equipments

3. Obtain baseline vital signs. Have patient empty bladder.

- To know the condition of the patient

4. Screen. Assist patient to move nearer to side of bed.

- To provide privacy

5. Place patient in side lying position. Instruct to arch lumbar segment of his back and draw up his knees
to his abdomen, clasping his knees with his hands and his chin touching the chest. Return Demo Obese
Patient: Have the patient straddle a straight back chair (facing the back) and rest his head against his
arms which are folded on the back of the chair. Pedia (Child): The child may be held across the front of
the nurse, legs secured with one arm and head and arms secured with the other. (Infant): The very
young infant maybe placed in sitting position with his head allowed to fall forward thus arching his back.
The nurse holds his hands and feet and steadies his body with her hands.

- To make the spinal cord align

6. Expose the lumbar area. Do skin preparation. Disinfect area using cotton balls with Phisohex and
sterile water then dry.

- For easier access and to prevent contamination


7. Paint with betadine solution. Cover area with sterile drape towel by using picking forceps, if doctor is
not yet

- To prevent contamination

8. Open tray aseptically and place within physician's ready. reach.

- For easier access

9. Pour xylocaine to a medicine glass or alcoholize the rubber cap of the Xylocaine vial and offer to the
physician.

- To be used for sterilization

10. Prepare gloves for the physician.

- Prevent contamination

11. Provide stool. Assist the physician (throughout the procedure) in maintaining patient's position by
supporting behind knees and neck of the patient.

- For the lumbar area not change

12. Assist physician as necessary. a. Putting on gloves. b. Anesthetizing the area. c. Inserting of spinal
needle which should be introduced at L2-L4 interspace. The needle is advanced until the "give" of the
ligamentum flavum is felt and the needle enters the subarachnoid space. d. After the needle enters the
subarachnoid space, help the patient to slowly straighten his legs. e. Instruct the patient to breath
quietly (not to hold his breath or strain) and not to talk. f. The initial pressure reading is obtained by
measuring the level of the fluid column after it comes to rest. g. About 2-3 ml of spinal fluid is placed in
each 3 test tubes for observation, comparison, and laboratory analysis.

- To make it easier to the procedure

13. Receive bottles or specimen from the physician and label.

- For easier distinguishing

14. Apply sterile dressing on punctured area when spinal needle is removed.

- To prevent contamination

15. Instruct patient to lie flat on bed for at least 4-6 hours.

- For the lumbar area not to get moved around

16. Make patient comfortable and observe for untoward reactions: take vital signs.

- To make the patient much more comfortable

17. Send labeled specimen to laboratory with request form as soon as possible.

- To get results as soon as possible

18. Aftercare of the equipment.


- For next use of equipment

19. Chart.

- For documentation

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