‫َب‬ ‫ا‬‫ًت‬

‫ْم َو ْل‬ ‫ا‬ ‫َأ‬ ‫ِهَّللا‬ ‫ي‬

‫ِب ِل‬ ‫َس‬ ‫ي‬ ‫ِف‬ ‫ْا‬‫و‬‫ُل‬‫ِت‬‫ُق‬ ‫َو َال َتْح َسَبَّن اَّلِذ يَن‬
‫َأْح َياء ِع نَد َر ِّبِهْم ُيْر َز ُقوَن‬

‫عاشت فلسطين حرة‬

‫مستقلة‬
LUMBAR PUNCTURE, ASSISTING
Introduction:
 Lumbar puncture involves the
insertion of a sterile needle into the
subarachnoid space of the spinal
 canal,
Performed by between
usually a practitioner withand
the third a
nurse assisting
fourth lumbar vertebrae.
 Lumbar puncture requires sterile
technique and careful patient
Definition:
A lumbar puncture, also called a
spinal tap or a spinal puncture, is the
introduction of a needle into the
subarachnoid space of the spinal
column. A lumbar puncture is a useful
procedure in the diagnosis of meningitis,
encephalitis, brain or spinal cord
Indications & Purpose of
lumbar puncture:
This procedure is used to determine:
1. The presence of blood in cerebrospinal
fluid (CSF).
2. Obtain CSF specimens for laboratory
analysis.
3. Inject dyes for contrast in radiologic
studies.
Contraindications of lumbar
puncture:
This procedure is contraindicated in:
1. Patients with increased intracranial
pressure (ICP) with mass effect
2. Lumbar deformity
3. Platelet count of less than 50,000/mm, or
an International Normalized Ratio (INR)
greater than 1.5
lumbar puncture
complications
1. Headache is the most common
adverse effect of lumbar puncture.
2. Reaction to the anesthetic agent.
3. Meningitis.
4. Epidural or subdural abscess.
5. Bleeding into the spinal canal
6. CSF leakage through the dural defect
remaining after needle withdrawal.
7. Local pain caused by nerve root
irritation
8. Edema or hematoma at the puncture
site
9. Transient difficulty voiding, and
fever.
Positioning for
lumbar puncture
For a side-lying position, have the patient lie
on the side at the edge of the bed, with the chin
tucked to the chest and the knees drawn up to
the abdomen. Make sure the head of the bed is
flat and the patient has no more than a small
pillow under the head. Make sure the patient’s
spine is curved and the back is at the edge of
the bed (as shown below). This position widens
the spaces between the vertebrae, easing
insertion of the needle. To help the patient
 For a
sitting
position,
have the
patient sit
on the edge
of the bed,
leaning
over the
Needle
insertion:
Typically,
the
practitioner
inserts the
needle
between the
Procedure of lumper
puncture
DOCUMENTATION
Record the date and time the lumbar
puncture was performed.
• Record the name of the physician or
qualified practitioner.
• Describe how the client tolerated the
procedure.
• Record the opening pressure.
• Note the color of CSF.
• Document the specimens sent for