Lumbar Puncture fact #4
Manometry is the measurement of CSF pressure using a 40cm long plastic gauge. The most common error is not to attemmpt to measure pressure! Measuring pressure is essential in patients presenting with acute headache, as a high or low opeinng pressure may be the only indication that there is a […]
Lumbar Puncture Guideline for You to Copy and Use
I’ve written my own guideline for doing Lumbar Puncture for my own hospital. This should reflect best practice. You can copy this for your own hospital, and adapt it where necessary. Please remember to quote your source - it is copyrighted, but available for free so long […]
You can use web feeds or RSS feeds to keep up to date. I’ve set up a feed here, which will search for articles from major journals on lumbar puncture. You can subscribe and you will pick up the latest journal articles on lumbar puncture.
Lumbar Puncture Fact #3
22 guage atraumatic needles are now recommended for diagnostic Lumbar Puncture (LP). An atraumatic needle has a rounded tip and is said to avoid cutting the fibres of the dura. If the fibres of the dura are separated without cutting, and the resulting hole is less likely to persist, […]
Lumbar Puncture Needle Selection
The issue of needle selection is almost resolved. The most up to date recommendation from the American Academy of Neurology is that 22 guage atraumatic needles should be used, as they are asociated with the lowest risk of an LPs most frequent complication - the post-LP headache.
The evidence for this comes mostly […]
Lumbar Puncture Fact #2
The distance from skin to the ligamentum flavum (the tough ligament just befire you reach the epidural space) is between 4 and 7cm in adults. Does anyone know an up-to-date study of this (i.e. if we are getting more obese, is this still true today?)
A calm environment
A trained nurse to assist
Careful explanation to patient of what to expect
Spend time on positioning the patient properly
Make sure you achieve cutaneous anaesthesia
Remember the 6 layers from skin to CSF
Loosen manometer tap and connect to manometer guage before you insert needle
Collect adequate specimens (2mls per bottle - 8mls is only 1.6% of total […]
The successful Lumbar Puncture……Key points
A calm environment
A trained nurse to assist
Careful explanation to patient of what to expect
Spend time on positioning the patient properly
Make sure you achieve cutaneous anaesthesia
Remember the 6 layers from skin to CSF
Loosen manometer tap and connect to manometer guage before you insert needle
Collect adequate specimens (2mls per bottle)
Be confident - if […]
Each year almost a million people worldwide will have to have a lumbar puncture (or spinal tap) test performed. A lumbar puncture (also called LP) is a test where a needle is put into the lower back to obtain a sample of fluid called cerebrospinal fluid (or CSF). The usual reason for the test is […]
To keep discomfort from an LP to a minimum, it is important to be fully aware of the range of experiences an LP may bring. Having performed many LPs in his career, he would vouch that many patients will have virtually no pain, except for the sting of local anaesthetic injection. “There is no doubt that […]