What is the process of doing a lumbar puncture needle?

Patients should take the lateral decubitus or sitting position. In order to obtain accurate open pressure and reduce the risk of headache after puncture, lateral decubitus position is preferable. Not all patients can undergo lumbar puncture in any position, so the physician should learn to perform this procedure when the patient is lying on the left, right, and upright. Once the patient's basic posture is established, the physician should instruct the patient to take the fetal position or arch the waist "like a cat" to increase the space between the spines. The lumbar spine should be perpendicular to the table top when the patient is in the sitting position and parallel to the table top when the patient is lying on his side. The boundary marker draws a line between the upper margin of the iliac ridge on both sides, intersecting the midline passing through the L4 spinous process. The needle is inserted in the gap between L3 and L4 or L4 and L5, as these points are located below the end of the spinal cord. Physicians should feel out boundary marks before disinfecting the skin and injecting local anesthetics, as these procedures may make them ambiguous. Use a skin marker to mark the correct position. After the physician has put on disinfecting gloves, disinfect the skin with an appropriate disinfectant (povidone-iodine or chlorhexidine solution), starting from the center and expanding outward in circles. Then cover with an antiseptic towel. Pain relief and sedation Lumbar puncture can cause pain and discomfort to the patient and is suitable for minimal doses of local anesthetics. If time permits, the physician may apply a topical anesthetic cream to the patient before disinfecting the skin. After the skin is disinfected and coated with a disinfecting towel, a local anesthetic may be administered subcutaneously, as well as a general sedative and painkiller. After the lumbar piercer has once again felt the boundary marker, a needle with a needle core is inserted in the midline position, at the upper edge of the next spinous process, with the needle facing the head at about 15 degrees, seemingly toward the patient's umbilical cord. CSF leakage can cause postpuncture headache, and recent data suggest that the use of a "pencil tip" needle may REDUCE the risk of headache because it disperses the fibers of the dural sac without cutting them. If a more commonly used bevel needle is used, the bevel of the needle should be located in the sagittal plane. This also allows the fibers parallel to the spinal axis to spread out without cutting them. If the needle is correctly placed, the needle should pass through the skin, subcutaneous tissue, supraspinous ligament, interspinous ligament between the spinous process, ligamentum flavum, epidural space (which includes the internal vertebral venous plexus, dura mater, and arachnoid), into the subarachnoid space, and between the cauda equina nerve roots. As the needle passes through the ligamentum flavum, the physician feels a sense of penetration. At this point, the needle core should be pulled out 2 mm to observe whether there is cerebrospinal fluid outflow. If the puncture is unsuccessful and the bone is touched, retreat the needle into the subcutaneous tissue, but not out of the skin, and re-enter the needle after adjusting the direction. Once the needle enters the subarachnoid space, CSF flows out. If the puncture was traumatic, the CSF may be slightly bloody. When collecting CSF, the CSF should be clear and free of blood unless subarachnoid haemorrhage is present. If cerebrospinal fluid is not flowing smoothly, the needle can be rotated 90 degrees because the opening of the needle may be blocked by nerve roots. Open pressure Open pressure can be measured only in the lateral decubitus position. Use a hose to connect the manometer to the base of the piercing needle. This should be done before any samples are collected. When the liquid column no longer rises, the measurement is read out. You may see a pulsatile fluid level caused by cardiac or respiratory movements. CSF should be dripped into the collecting tube for sample collection and should not be aspirated because even a small negative pressure can easily lead to bleeding. The amount of fluid collected should be limited to the minimum requirement, usually 3 to 4 ml. If the patient is undergoing an open manometry, the physician should turn the rotary valve to the patient to allow CSF from the manometer to flow into the collecting tube for CSF sample collection. After collecting sufficient samples, insert the needle core and pull out the puncture needle.

If you have any questions, please contact us. Our company can produce various customized needles, medical needles, puncture needles, hypodermic needles, biopsy needles, vaccine needles, injection needles, syringe needles, veterinary needles, pencil point needle, ovum pick up needles, spinal needles, etc. If you need customized needle products, please contact us. We look forward to your inquiry! The quality of the products manufactured in our factory will surely satisfy you!

Please contact us if you need: zhang@sz-manners.com