Lumbar Puncture: Golden Rules

We feel it is extremely important to highlight some golden rules and additional pearls after our recent lumbar puncture series. (Read the first two articles about positioning and technique at http://bit.ly/1zRSOdC and http://bit.ly/1wY8MiJ.) These tips will help you ensure the best outcome for your patients.   Be Prepared §  Be aware that patients will be anxious. □   Spend dedicated time reviewing the procedure and informed consent. □   Make sure that they feel only the lidocaine injection. □   Most patients will do better with Versed as long as there are no contraindications. §  Be prepared for patients to vagal! It happens. □   Keep the patient on the monitor at all times. §  Bring an extra kit, sterile gloves, 1% lidocaine, and a partner to help you. □   PA student, anyone? §  Walk the sample to the lab. □   Do not send it in the tube system, and take it to the lab immediately. □   Do not refrigerate it if possible, and test the sample immediately. §  Know what goes in each tube. □   Collect 1.5-2 mL of fluid in each tube. No more. □   Know which label goes on which tube! □   Replace the stylet before withdrawing the needle.   Let’s remind ourselves how and why we label CSF tubes 1-4:     The color of the CSF:   Martha weighs in: Versed is a helpful adjunct for the right patient (all of them). Don’t forget to monitor your patient and then, of course, chart your vital signs and procedure ...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs