Purpose:

1. To remove cerebrospinal fluid by gravity flow in order to:
a. Secure specimen for diagnosis
b. Relieve intracranial pressure
c. Introduce drugs in therapy.
d. Introduce air or opaque liquid before taking X-ray for diagnosis
2. To determine the pressure within the cerebrospinal canal.

Point to Remember:

1. Observe strict asepsis.
2. See to it that the patient does not move during procedure.
3. To prevent the needle from breaking inside the spinal column.
4. Keep patient flat in bed without pillow for about 8 hours. May turn to sides

Equipment:

1. Skin disinfection tray with a bottle of colledion
2. Sterile tray with:
a. Two spinal needles with stylets g-19 or 20
b. Hypodermic needle no.24
c. Intramuscular needle no. 22
d. One 5-cc syringe
e. One 1.0 cc syringe
f. Medicine glass
g. Four 0.5
h. Specimen bottles or test tubes
i. Treatment sheet or operating towels
j. Rubber gloves 3 drugs ordered
3. local anesthetic
4. Sterile manometer, three-way stop cock
5. bed screen
6. bed protector
7. fracture board

Procedure:

1. Assemble equipment and bring to bedside.
2. Explain the procedure to the patient. Gain his cooperation. Get consent for puncture.
3. Screen the bed, replace top sheet with blanket.
4. Assist to assume the desired position for lumber puncture either.
a. Recumbent position—if mattress is soft bed hoards should be placed under the mattress to make the surface less flexible. Place the patient on his side on he edge of the bed. Ask patient to assume the “Fatal position”.
b. Sitting position—place the patient on sitting position in hood or on the chair with the back arched.
5. Uncover the lower hack.
6. Disinfect the area about the site of puncture.
7. Physician put the gloves. He drapes the area
8. Assist in the procedure as needed—The doctor gives the anesthetic, inserts the needle.
9. Receive the specimen as it drops from the hub of the needle, not the rate of drops per minute
10. Physician inserts the stylets then removes the needles
11. Press the site of puncture with alcohol sponge, apply collodion
12. Place patient in dorsal recumbent without pillow
13. Make patient comfortable
14. Clean and keep equipment.

Charting:

Record treatment performed, amount of fluid color character, rate of flow, drugs instilled if any, amount of drugs, person who did the procedure reaction of the patient.