Spinal tap is the process of extracting cerebrospinal fluid through a puncture needle.
1. The spinal cord puncture patient lies on the side on a hardboard bed, with the back perpendicular to the edge of the bed, the head bent toward the chest, the waist arched backward, and the knees flexed toward the abdomen.
2. The 3rd and 4th lumbar vertebral interspace is often chosen as the puncture point (the intersection of the highest point of the iliac crest on both sides of the line and the spinal cord line is the 3rd lumbar vertebral interspace), in order to routinely disinfect the local skin, lay aseptic cavity towel, local anesthesia, and deepen the ligaments.
3. Fix the skin of the puncture point with the left hand, hold the needle with the right hand, and the spinal space and spine in a perpendicular direction, and slowly pierce the needle with the beveled surface upward, avoiding left and right skewing.
4. If the bone is touched in the middle of the procedure, the needle can be withdrawn slightly, and then slightly inclined to the side of the head to move forward, through the ligamentum flavum and the dura mater, there is often a sense of emptiness, and at this time the needle core is withdrawn, that is to say, the cerebrospinal fluid can be seen to flow out.
5. Immediately connect the manometer tube, relax the patient’s body, the cerebrospinal fluid can be seen in the manometer tube gradually rise to a certain level after the fluid surface fluctuates slightly with breathing, record the hydrostatic pressure of the cerebrospinal fluid at this time, i.e., the initial pressure, the normal pressure is 80～180mmH.
6. Remove the manometer tube and collect 2~5ml of cerebrospinal fluid for routine, biochemical and immunological tests, and send it to bacterial culture, fungal test and cytological examination if necessary.
7. After collecting cerebrospinal fluid, connect the manometry tube to test the final pressure of cerebrospinal fluid, then insert the core of the needle, pull out the puncture needle, sterilize it and cover it with sterile gauze.
Spinal puncture should be performed by a specialized doctor and should not be done or imitated by oneself.