Technical specifications and operating procedures of lumbar puncture

Apr 02, 2022

1. Indication

①Check the properties of cerebrospinal fluid to assist in the diagnosis of inflammatory or hemorrhagic diseases of the central nervous system.

② Determination of intracranial pressure to understand whether the subarachnoid space is blocked.

③ Do other auxiliary examinations, such as pneumoencephalography, spinal cord air angiography, radionuclide scanning of ventricles and cisterns, etc.

④ After intracranial hemorrhage, inflammation or craniocerebral surgery, the drainage of irritating cerebrospinal fluid can reduce clinical symptoms.

⑤ Perform lumbar anesthesia or intrathecal drug treatment

2. Contraindications

1. Patients with obvious papilledema or with signs of brain herniation

2. Patients in shock, exhaustion or endangered state

3. There is an infected person at or near the puncture site

3. Preoperative preparation:

①1 set of conventional disinfection treatment tray. There are 1 sterile tweezers (soaked in disinfectant) 2.5% iodine, 70% iodine, sterile cotton swabs, 1 dressing tank (with gauze, cotton balls) tape, 1 curved plate, 1 treatment towel and 1 rubber towel, grinding wheel, hemostatic forceps, and tourniquet.

② Sterile lumbar puncture package. There are lumbar puncture needle, pressure measuring tube and three-way tube, 5ml syringe, 7-gauge needle, 1 vascular forceps, hole towel, gauze, cotton ball, and 2 test tubes.

③Other items. Sterile gloves, 2% procaine, curved disc, intrathecal drug injection, alcohol lamp, matches, and 1-2 culture tubes as needed.

Fourth, the operation process: ① Explain the purpose and precautions of the puncture to the patient, eliminate tension and fear, obtain cooperation, and ask to urinate.

② Do a procaine skin test before surgery, prepare all the supplies, bring it to the patient's bed, and cover it with a screen

③ The patient lies on the side of the hard board bed, removes the pillow, puts the back on the edge of the bed, spreads rubber towels and therapeutic towels, bends the head to the chest, tucks the knees with both hands, bends the knees to the abdomen, and arches the back as far as possible. The intervertebral space is widened, which is favorable for puncture. ⑧ During the puncture process, pay attention to observe the changes in the patient's consciousness, pupils, pulse, and respiration.

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