(3) The physician will clean the puncture site area with sterile applicators
from the lumbar puncture tray.
(4)
The physician will drape the area with a fenestrated drape to provide a
sterile field.
(5) The physician will inject local anesthetic into the planned needle
puncture site.
(6) The physician will insert the spinal needle. The patient will feel some
pressure at this time.
(7) If the procedure is being performed to administer contrast media for
radiologic studies or spinal anesthetic, the physician will inject the dye or anesthetic.
(8) When the needle is in place, the physician will attach a manometer with
stopcock to the needle hub to read CSF pressure. (The patient may need to extend his
legs to provide a more accurate pressure reading.)
(9) The physician will detach the manometer and allow the fluid to drain
from the needle hub into four collection tubes.
(10) When there is approximately 2 or 3 ml of fluid in each tube, the physician
will hand them to the assistant, who will mark the tubes in sequence, stopper them
securely, and label them properly, as such:
(a)
Gram stain.
(b) Culture, sensitivity.
(c)
Cell count.
(c)
Protein and glucose.
(11) The physician will remove the spinal needle, apply pressure to the area
briefly, and apply a band-aid or small dressing.
(12) The entire procedure will last approximately 15 minutes.
e. Follow-up.
(1)
Send the CSF specimens to the laboratory immediately.
(2)
Instruct the patient to lie flat for several hours to reduce chance of
headache.
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