The document outlines the procedure and indications for performing a lumbar puncture, which involves inserting a needle into the lumbar subarachnoid space to withdraw cerebrospinal fluid. It details the necessary materials, patient preparation, and monitoring, as well as contraindications and potential complications such as CSF leakage and infection. The document also emphasizes the importance of post-procedure care, including keeping the patient flat for a specified time and monitoring for any adverse effects.

1. ASSISTING WITH
LUMBAR PUNCTURE
Prepared By,
Silla Elsa Soji
Msc Nursing 1st Year

2. DEFINITION
Lumbar puncture is the insertion of a needle
into the lumbar subarachnoid space to
withdraw cerebrospinal fluid.

3. PURPOSES
• To administer spinal anesthesia before
surgery
• To administer medication into the spinal
canal in case of meningitis
• To reduce intracranial pressure
• To perform diagnostic studies
• To detect subarachanoid block

4. INDICATIONS
• Suspicion of meningitisCNS
• Suspicion of subarachnoid hemmorrhage
• Suspicion of CNS diseases such as GBS
• Therapeutic relief of pseudomotor cerebri

5. CONTRA INDICATIONS
• Suspected epidural infection
• Severe psychiatric or neuro problems
• Chronic Backache
• Intracranial Bleeding

6. ARTICLES
A sterile containing
• LP needle with stillete
• Sponge holding forceps
• Small bowls
• Specimen bottles
• Cotton balls , Gauze pieces , Cotton pads
• Dressing articles

7. A clean tray containing
• Mackintosh and towel
• Kidney tray
• Spirit / iodine/Tincture benzoin
• Lignocaine 2%
• Sterile Normal Saline
• Adhesive plaster and scissor
• Sterile gloves , gown, mask
• Syringe or needle

9. PROCEDURE
• Identify the patient and explain procedure
• Monitor vital signs
• Position the patient
• Keep a pillow under the head
• Encourage the patient to relax and breath
normally during procedures
• Expose and clean the site

10. • Spinal needle inserted into 3rd and 4TH
or 4TH and 5th lumbar intercostal
Space
• Remove stillete and connects three-way
with manometer
• Collect CSF specimen
• Sealing puncture site and apply sterile
dressing

11. • Instruct the patient to be flat for 12-24
hours
• Monitor for complications for LP and check
site frequently for CSF leakage
• Record the procedure and send specimen
to lab
• If no complications are observed give
upright position to the patient after 24
hours

12. COMPLICATIONS
• CSF leakage
• Infection
• Post procedure headache
• Paralysis
• Hematoma