How to do lumbar puncture

How do you perform a lumbar puncture?

A local anesthetic is injected into your lower back to numb the puncture site before the needle is inserted. The local anesthetic will sting briefly as it’s injected. A thin, hollow needle is inserted between the two lower vertebrae (lumbar region), through the spinal membrane (dura) and into the spinal canal.

How do you Landmark a lumbar puncture?

Background: The anatomical landmark which is used to identify the correct level for lumbar puncture is the line connecting both iliac crests. This crosses the vertebra column at the level of the L4-L5 intervertebral space or L4 vertebra.

What is the best position for lumbar puncture?

Positioning — An LP can be performed with the patient in the lateral recumbent or prone positions or sitting upright. The lateral recumbent or prone positions are preferred over the upright position because they allow more accurate measurement of the opening pressure.

How long does a lumbar puncture procedure take?

A lumbar puncture takes around 30 to 45 minutes, but you’ll need to stay lying down at the hospital for at least another hour while the nurses monitor you. You’ll be able to go home the same day if you feel well enough, but you would not be able to drive yourself home.

What diseases can be found in spinal fluid?

Diseases detected by CSF analysis
  • meningitis.
  • encephalitis.
  • tuberculosis.
  • fungal infections.
  • West Nile virus.
  • eastern equine encephalitis virus (EEEV)

Is a lumbar puncture an emergency?

Lumbar puncture is a common emergency department procedure. It is most commonly used diagnostically to detect CNS infections, subarachnoid hemorrhage, and inflammatory processes. It can also be therapeutic in patients with idiopathic intracranial hypertension (IIH, or pseudotumor cerebri).

Why is lumbar puncture so painful?

There are lots of nerves within the fluid in the spinal canal but usually they have room to move out of the way. If one of the nerves is touched, it can give a nasty ache or pain, usually in a leg. Once the needle is in the right place, it takes a few seconds to get the sample.

Can a lumbar puncture paralyze you?

There is no threat to the nerve or experiencing paralysis since the needle is inserted where the spinal cord ends. Thus, the simple answer to your question is no; it doesn’t cause paralysis. Additionally, the spinal tap can help diagnose severe infection cases like meningitis or other central nervous system problems.

How big is the needle for a lumbar puncture?

Some authors have described a successful use of spinal needles as small as 25 gauge when performing a lumbar puncture. The investigators do not believe that the flow-rate difference between 22 and 24 gauge needles is significant enough to justify using the larger needles.

What should I avoid after a lumbar puncture?

Care after a spinal tap

The time spent flat after the tap will vary depending on why you received the procedure. Avoid strenuous or vigorous exercise for a day or so following the lumbar puncture. If you have a headache, lay down as much as possible and drink plenty of fluids.

How bad does a lumbar puncture hurt?

A lumbar puncture is usually not painful, as a patient is first given a local anesthetic. Most patients feel nothing except for the mild sting of the local anesthetic needle. It is possible to feel a pressure sensation as the needle goes in.

When should you not have a lumbar puncture?

Absolute contraindications for lumbar puncture are the presence of infected skin over the needle entry site and the presence of unequal pressures between the supratentorial and infratentorial compartments.

Can I go to work the day after a lumbar puncture?

Back pain can also be treated with pain relief medication. The dressing from the lumbar puncture can be removed the following day. Avoid strenuous activity for the first 24 hours after the procedure. You can return to all your usual activities such as work and driving, as soon as you feel well enough after that.

Can I have a shower after lumbar puncture?

You will have a small dressing over your puncture site. Please take care not to get this wet for the next 24 hours. After 24 hours, you can remove the dressing and can have a shower or bath.

How long after a lumbar puncture can I go swimming?

For 24 hours: Drink extra fluids such as juices, water, or a sports drink. For 2 days: Do not take a bath, sit in a hot tub, or go swimming. Soaking your body in water increases the risk of infection. It is OK to shower.

How long after a lumbar puncture can you get a headache?

This leakage decreases the pressure exerted by the spinal fluid on the brain and spinal cord, which leads to a headache. Spinal headaches typically appear within 48 hours after a spinal tap or spinal anesthesia.

Do you have to lay flat after a lumbar puncture?

You may be asked to lie flat to rest after the lumbar puncture is completed. You will be asked to drink extra fluids to rehydrate after the procedure. This replaces the CSF that was withdrawn during the spinal tap and reduces the chance of developing a headache.

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