Counseling for Lumbar Puncture

Def:
A medical procedure, carried out to obtain cerebrospinal fluid(CSF), CSF is the fluid that covers brain and
spinal cord.

Indication:
- Detect the infection in CSF.
- Measure CSF pressure.
- Measure levels of chemicals in CSF.
- Suspect any bleeding in the brain.

How?
- Need to NBM.
- Sedate the child, may feel uncomfortable, important to lie still, curl up into a ball.
- Locate the space between the vertebrae (bones of spine).
- Wash the skin and cover with sterile towel.
- A needle goes through skin in the lower back, into the lower spine.
- Collect CSF into the special container, send to lab.

Concerns:
- Not dangerous if follow the correct procedures.
- Must be done if
(a) any infection in the brain
(b) before start the antibiotic therapy for the febrile fits.
(c) persistent lethargy and not fully interactive 6 hours after the fits.
- Make sure no contraindication.
(a) infection over the injection site.
(b) bleeding in the brain.
- Body replace the small amount of fluid that is removed very quickly (less than two day).

Complications:
- GA ( if too restless / upset)
- Blood mixed with CSF ( results inaccurate )
- Swelling in the lower back (need to lie flat)
- Headache ( d/t slight reduction in pressure around the brain, give PCM.)
- Vomit (bed rest, regular sips of fluid).

After discharged:
- Pain(give PCM)
- Observe lumbar puncture site (continue to swell/ clear fluid/ blood)
- Plaster covering stay in place for 24 hr and then can remove it.
- Not joining sports for a week.