Lumbar Puncture In Children

What you should know

• Lumbar puncture, also called LP, is a procedure where a needle is inserted in your child's back and into his spinal canal. This may be done to collect cerebrospinal fluid (CSF) or treat certain medical conditions. The spinal canal contains the spinal cord, which carries messages between your brain and your body, and CSF. CSF is a clear fluid that flows around the brain and inside the spinal canal. This fluid contains information about body functions and disease processes. It also acts as a cushion to protect the brain and spinal cord from injury. LP may be used to check for an infection, inflammation (swelling), or other conditions affecting the brain. Your child cannot have an LP if he has increased pressure in his brain. The increased pressure may be caused by a tumor or blockage. If your child bleeds easily or an infection is present in the area where the needle will be inserted, a LP is not done.
  
  
• During a lumbar puncture, CSF may be collected and sent to a lab for tests. The tests check for changes in the CSF, including the presence of blood, protein, glucose (sugar), and germs. The sample may also be used to do certain tests that check for an infection. Sometimes, medicine may be put through the LP into your child's back to treat a disease. CSF pressure may also be measured during LP.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Risks

Having a lumbar puncture may put your child at risk of having other problems. He may have a headache that gets worse when he sits or stands. He may have neck or back pain, feel sick to his stomach or vomit (throw up). He may have problems with his eyesight and hearing, such as blurred or double vision, dizziness, and ringing in his ears. There may be bleeding, infection, injury to a disk in his spine, or spinal fluid may leak from the site. Your child's nerves or spinal cord may be damaged. Medicines, including anesthesia, that are used during the procedure may cause an allergy. Patients who have blood disorders or who are taking certain medicines are at a higher risk of problems. LP may not be advised for those who are vomiting or have a bad headache. Talk with your child's caregiver if you are worried or have questions about your child's procedure, medicine, or care.

Getting Ready

Before your child's procedure:

• Procedure date and location: Ask a family member or friend to drive you home after your child's procedure. Do not drive yourself home.
  
  
• Write down the correct date, time, and location of your child's procedure.
  
  
• Tell caregivers if your child is taking any medicine that may make him more likely to bleed. These medicines may include aspirin, clot busters, or blood thinners. If your child is taking any of these medicines, he should not have a lumbar puncture.
  
  
• Tell caregivers if your child has any allergies. This includes an allergy to a cleansing solution, such as iodine, or any numbing medicine.
  
  
• Tell caregivers if your child has a blood disorder or has had a bleeding problem in the past.
  
  
• Your child may need to have blood tests, x-rays, or other tests. Brain imaging tests, such as computerized tomography (CT) scan or magnetic resonance imaging (MRI) may also be done. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your child's caregiver permission to do the procedure. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Treatment

What will happen:

• If your child is an infant or young child, he may be held by a caregiver during the LP. This is to make sure that he is in the correct position. If your child is older, he will be asked to change into a hospital gown and to lie on his side. His knees will need to be bent and slightly drawn close to his chest. His neck should also be slightly tucked toward his chest. He may be given medicine to help him relax or make him drowsy. The caregiver will find the best place to do the LP, and mark the place using a marker. Your child's lower back will be cleaned, and he may be given one or more shots of numbing medicine. A needle will be inserted between the vertebrae (spine) of the lower back. Your child may feel some pushing or discomfort as the needle enters his back. If your child is old enough, he should tell his caregiver if he has pain that does not stop within a few seconds. His caregiver may need to pull out, reinsert, or change the position of the needle to find the spinal canal.
  
  
• Your child's caregiver may take readings of your child's CSF pressure. This will be done by connecting a measuring device to the needle. After the pressure is measured, the device will be removed and CSF will be allowed to flow out of the needle. Samples of your child's CSF may be taken. The needle will then be taken out and a bandage secured over the area.

After your child's procedure:

Your child will need to lie flat in bed for a time that may be between 1 and 24 hours. When caregivers see that your child is OK, he may be allowed to go home. If caregivers want your child to stay in the hospital, he will be taken back to his hospital room. Your child may need to drink more liquids than usual after the LP, or he may need fluids through the vein (IV).

Waiting area:

This is an area where family and friends can wait until your child is able to have visitors. Leave a phone number or other means of contact where you can be reached if you leave the area.

Contact a caregiver if

• You or your child cannot make it to his procedure appointment on time.
  
  
• Your child is irritable and crying more than usual.
  
  
• Your child has a skin infection or a wound near the area where the LP will be done.
  
  
• Your child's skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your child's LP.

Seek Care Immediately if

• Your child has a fever.
  
  
• Your child has trouble breathing or his heart is beating faster than normal.
  
  
• Your child's signs and symptoms are getting worse.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.