Ventricualr Septal Defect

LUMBAR PUNCTURE

CONTENTS

What is a lumbar puncture

Why is it done

Are there complications

What can a parent do

WHAT IS A LUMBAR PUNCTURE

1.  A lumbar puncture is also called a spinal tap.

2.  Cerebral spinal fluid is the fluid that bathes your baby’s brain and spinal cord.

3.  A lumbar puncture is a puncture or a stick into a space around the spinal cord to remove (draw out) some of the cerebral spinal fluid.

a.  The body replaces the cerebral spinal fluid each day.

4.  Sometimes a baby will need more than one (1) lumbar puncture during their hospitalization but the body replaces the amount we remove.

a.  Your baby will not run out of cerebral spinal fluid.

5.  A special long thin 2-part needle is used.

a.  The inner portion of the needle is known as the Stylet

b.  The outer portion is the needle itself.

6.  The stylet helps with insertion (stick) of the needle and prevents leakage of cerebral spinal fluid during the insertion.

a.  The stylet is removed after the needle is in place.

WHY IS IT DONE

1.  Lumbar punctures may be done for several reasons:

a.  To measure the amount of pressure in the baby’s brain and spinal canal

b.  To remove a small amount of cerebral spinal fluid to document (confirm) or rule out infection of the central nervous system

c.  To remove excess amounts of cerebral spinal fluid associated with hydrocephalus

d.  To exclude or support other diagnoses of the Central Nervous System, such as:

●  Intracranial/Intraventricular bleeding

●  Hydrocephalus.

HOW IS IT DONE

1.  A lumbar puncture is a sterile procedure.

2.  The Neonatologist or Neonatal Nurse Practitioner (NNP) does this procedure.

3.  The Neonatologist or NNP doing the procedure wears a sterile gown & gloves as well as a mask and hat.

4.  You will be asked to sign a consent giving us permission to do the procedure.

5.  Your baby is placed on an open bed warmer—the warmer your baby was on when he/she was 1st admitted to the NICU—either lying on their side or in a sitting position.

6.  A nurse holds your baby curled up in a tight ball during the procedure.

a.  This “opens” the spaces between the bones of your baby’s spine and makes the procedure easier to do.

7.  The Neonatologist or NNP feels the lower part of your baby’s back for a space between the bones of your baby’s spine.

8.  He/She cleanses this area of your baby’s back with an antiseptic.

9.  Next, he/she inserts (sticks) the special needle through the skin and into the space where the cerebral spinal fluid is found.

a.  The stylet is removed.

10.  The cerebral spinal fluid begins to drip out of the needle and a small amount is collected in 3 sterile test tubes.

a.  The specimens (cerebral spinal fluid) in the 3 test tubes are sent to the laboratory.

11.  The Neonatologist or NNP removes the needle, cleans off the baby’s back and applies a small bandage over the insertion site.

12.  The Neonatologist or NNP will talk with you about the results of the lab tests and what treatment is planned for your baby and to answer any questions you may have.

a.  Some of the test results will come back the same day; other tests may take several days to be completed.

ARE THERE COMPLICATIONS

1.  The lumbar puncture does not injure your baby’s spinal cord.

2.  We may ask you to allow your baby 30 minutes to 1 hour of quiet time after the procedure.

a.  You may sit quietly with your baby during this time.

WHAT CAN A PARENT DO

  1. Keep up with your baby’s progress each time you visit or call.
  2. An important part of the baby getting better is the parents’ love and concern.
  3. We encourage you to ask questions you may have.
  4. Your love and attention will go a long way in helping your little one on the road to recovery.

Reviewed/Revised: 03/07…..01/10

Lumbar Puncture 3