Lumbar Puncture inPediatrics
• Indications, Technique, and Considerations
• Your Name
• Date
2.
Introduction
• • Definitionof Lumbar Puncture (LP)
• • Purpose in pediatric practice
• • Overview of presentation structure
3.
Indications
• • Suspectedmeningitis or encephalitis
• • Subarachnoid hemorrhage
• • Diagnosis of demyelinating diseases
• • Therapeutic use (e.g., intrathecal
chemotherapy)
• • Measurement of intracranial pressure
4.
Contraindications
• • Raisedintracranial pressure with mass effect
• • Coagulopathy or thrombocytopenia
• • Skin infection at puncture site
• • Unstable patient or signs of herniation
Positioning
• • Lateraldecubitus (preferred for pressure
measurement)
• • Sitting position (easier landmarks in infants)
• • Head flexed, knees to chest
• • Importance of proper alignment
8.
Technique
• • IdentifyL3–L4 or L4–L5 interspace
• • Aseptic technique
• • Needle insertion with bevel parallel to fibers
• • "Pop" felt as dura is punctured
• • Collect CSF in numbered tubes
9.
Post-Procedure Care
• •Monitor vitals and neurological status
• • Lie flat (older practice—current evidence
mixed)
• • Pain control if needed
• • Observe for complications
10.
Complications
• • Headache(less common in young children)
• • Bleeding or hematoma
• • Infection (rare)
• • Traumatic tap
• • Cerebral herniation (if done improperly)
11.
Special Considerations inNeonates
• • Anatomical differences (lower spinal cord
termination)
• • Use of smaller needles
• • Greater risk of traumatic taps
• • More likely to require sedation
12.
CSF Interpretation
• •Normal values vary by age
• • WBC, glucose, protein, opening pressure
• • Differentiating bacterial vs viral meningitis
13.
Summary
• • Essentialdiagnostic and therapeutic tool
• • Requires careful technique and patient
selection
• • Recognize and manage complications early
