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Lumber Puncture LP Tapping

Assisting For Lumber Puncture of Child

Purpose

To perform diagnostic studies.

Scope

Diagnostic purpose.

Definition

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

Applicable Areas

NICU

Responsibility

Head Nurse, Staff Nurse, Auxillary Nurse Midwife, NICU Registrar, Housekeeping Attendant.

Procedure

  • Keep the following equipments ready –
  • Sterile gloves and disposable mask.
  • Antiseptic solution.
  • Lumber puncture tray with 22G needle 11/2”.
  • Sterile Cotton and Gauze.
  • Sterile Dressing.
  • Sterile Drape.
  • Benzoin Compound.
  • Specimen Containers as per the requirement.
  • Pulse Oxymeter.
  • Glucometer
  • Disinfectant for Hand Hygiene.
  • Kidney Tray.
  • Obtain written consent from the parents.
  • Keep required articles ready.
  • Monitor the infant, check O2
  • Assist doctors for gloving.
  • Position the child in such a way that the spine should be flexed forward to open the space between the vertebrae, posteriorly.
  • Take care that the breathing is not affected.
  • Do not flex the neck too much.
  • Assist for cleaning the site.
  • Collect the specimen for investigation in 1 culture bottle, 1 plain bulb, 1 fluoride bulb, 1 EDTA bulb.
  • After the procedure, apply tincture benzoin seal at the site.
  • Check the infant’s vitals.
  • Make the infant comfortable.
  • Check the blood glucose level (HGT).
  • Segregate generated Bio-Medical Waste as per the HIC policy.
  • Remove the articles and send to CSSD.
  • Label the sample, record in the pathology register and send the samples to the pathology laboratory with the attendant.

Monitoring

  • Vital Signs, HGT.
  • Oxygen
  • Observation of general condition of the infant throughout the procedure.
  • Quantity colour CSF collected.
  • The name of the doctor carrying out the procedure.
  • Feeding to be resumed after ½ hour.

Documentation

  • Nurse’s Observation Sheet