Procedure for lumbar puncture

Puncture point selection

The intersection of the line connecting the posterior superior iliac spine and the posterior median line is the puncture point. Here, it is equivalent to the 3rd to 4th lumbar spinous process space, and sometimes it can also be performed in the upper or lower lumbar intervertebral space.

02

Routine disinfection

Use a sterile cotton ball to sterilize 2 to 3 times from the inside to the outside with the puncture point as the center, with a diameter of not less than 15cm. Wear sterile gloves, drape a hole towel, and anesthetize.

03

puncture

First check whether the puncture needle is unobstructed and insert the needle core. The surgeon fixes the skin at the puncture point with the left hand, and holds the puncture needle with the right hand to slowly pierce in the direction perpendicular to the back, the needle tip is slightly inclined to the head, and the needle body is inclined to the buttocks. The depth of needle insertion is about 4 to 6 cm for adults and 2 to 4 cm for children. When the needle passes through the ligament and dura mater, there is a sense of frustration that the resistance suddenly disappears.

04

Pressure measurement and pumping

Pull out the needle core before the liquid is discharged, and then connect the pressure measuring tube to measure the pressure. The normal cerebrospinal fluid pressure in the lateral decubitus position is 70 to 180 mmH2O or 40 to 50 drops/min. Remove the manometer tube and collect 2-5ml of cerebrospinal fluid for examination.

05

Needle withdrawal, dressing

After collecting cerebrospinal fluid, insert the needle core, slowly pull out the puncture needle, press and disinfect the puncture point, cover it with sterile gauze, fix it with tape, and ask the patient to lie down on the pillow for 4 to 6 hours.

06

pack up things

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