5/8/2023 0 Comments Spinal tap procedureOften times you’ll have a lumbar puncture kit that will contain necessary supplies: If you have someone to help they can then help the patient into position while you’re in sterile gloves.This can keep the procedure time to a minimum. Set everything up before positioning the patient and cleaning.You’re often doing this procedure with a patient that’s already feeling unwell.Tintinalli’s Emergency Medicine: A Comprehensive Study Guide Equipment/Skills/Setup Setup Sagittal plane, which shows a needle trajectory that would get access to the epidural or intrathecal space (in this picture the tip is in the intrathecal space): Moving posteriorly/superficially through the layers you have the:.Immediately surrounding the cauda equina is the intrathecal space (subarachnoid space) which contains the CSF (cerebrospinal fluid).Hence, below L1-L2 is a good place to stick a needle as it’s below the cord and less likely to cause injury.The cord itself ends around L1-L2 and only the cauda equina continues. The spinal cord runs down the middle of the spinal canal.See references below for detailed reviews of contraindications Anatomy Overview Blood thinners – See ASRA based guidelines (and an abbreviated protocol) for managing various blood thinners pre and post procedure.This may exclude pseudo–tumor cerebri (idiopathic intracranial hypertension) Intracranial lesion with mass effect (or other intracranial hypertension).IndicationsĬollect CSF fluid for diagnostic purposes, therapeutic purposes or to deliver medications. Lumbar puncture (spinal tap) Sample Opnote GoalĪccess the subarachnoid space (without image guidance) in the lumbar spine to sample CSF fluid.
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