When should a lumbar puncture be done in a neonate?

When should a lumbar puncture be done in a neonate?

A lumbar puncture is needed to test the fluid around the brain and spinal cord. This test may be done to find out if a child has meningitis (a serious infection around the brain). Meningitis may be suspected in a baby with a fever, especially in babies less than one month old.

Why would they do a lumbar puncture on a newborn baby?

Why does my baby need it? The lumbar puncture is done to check if your baby has a serious infection called meningitis. It can also be done to check for bleeding around the brain and spine.

HOW DO YOU DO LP in pediatrics?

Lumbar puncture

1. Position needle in midline, with bevel pointing towards ceiling (if child lying) or to the side (if child sitting)
2. Pierce skin with needle and pause to ensure child is still.
3. Check child’s position and adjust if necessary.
4. Angle needle aiming for umbilicus.

Which position is given to a child after lumbar puncture?

In the lateral recumbent position, neck flexion does not increase the interspinous space and may increase morbidity; therefore, it is recommended to hold patients at the level of the shoulders as to avoid neck flexion.

What are the contraindications of lumbar puncture?

Absolute contraindications for performing a LP include infected skin over the puncture site, increased intracranial pressure (ICP) from any space-occupying lesion (mass, abscess), and trauma or mass to lumbar vertebrae.

How do you prepare a child for a lumbar puncture?

Usually, no special home preparation is needed before a lumbar puncture. Occasionally, however, the lumbar puncture may be done while your child is under sedation, meaning that your child will be given medication to make him or her very drowsy and relaxed during the test.

Are lumbar punctures safe for newborns?

Infants may not tolerate lumbar puncture well. This is usually because of excessive flexion of the infant. In term infants the seated position has been shown to be the best tolerated and to also have the best chance of obtaining CSF. Consider pain relief for the procedure.

What is the normal CSF pressure?

Results: The normal range of ICP measured by LP in adults in a typical clinical setting should now be regarded as 6 to 25 cmH2O (95% confidence intervals), with a population mean of about 18 cmH2O.

Which nursing intervention is most appropriate after the lumbar puncture has been performed?

The nurse should note of the following nursing interventions post-lumbar puncture: Apply brief pressure to the puncture site. Pressure will be applied to avoid bleeding, and the site is covered by a small occlusive dressing or band-aid. Place the patient flat on bed.

Which is the best way to position a patient for lumbar puncture?

Positioning — An LP can be performed with the patient in the lateral recumbent or prone positions or sitting upright. The lateral recumbent or prone positions are preferred over the upright position because they allow more accurate measurement of the opening pressure.

Why LP is contraindicated in increased ICP?

As the space-occupying lesion grows, ICP rises. When lumbar puncture is performed in these patients, a low-pressure shunt is formed at the site of LP where CSF can escape. As the CSF pressure drops in the spinal column, CSF and brain mass may then shift towards the low-pressure outlet (the LP site).

What is Xanthochromia CSF?

Xanthochromia is the presence of bilirubin in the CSF. This finding can be the only positive marker that a patient is suffering from an acute SAH. It is an important finding in distinguishing between traumatic tap and a SAH. Visual inspection of the CSF is the most common method of detection.