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Lumbar Puncture In Children
WHAT YOU NEED TO KNOW:
Lumbar puncture (LP) is a procedure in which a needle is inserted in your child's back and into his spinal canal. This may be done to collect cerebrospinal fluid (CSF) to check for an infection, inflammation, bleeding, or other conditions that affect the brain. CSF is a clear, protective fluid that flows around the brain and inside the spinal canal. LP may also be done to remove CSF and reduce pressure in the brain.
WHILE YOU ARE HERE:
Before your child's procedure:
- Informed consent is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.
- Emotional support: Stay with your child for comfort and support as often as possible while he is in the hospital. Ask another family member or someone close to the family to stay with your child when you cannot be there. Bring items from home that will comfort your child, such as a favorite blanket or toy.
During your child's procedure:
- 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 lie on his side. His knees will be bent and drawn toward his chest. His neck will be tucked toward his chest and he may be given a pillow. He may be given medicine to help him relax or make him drowsy.
- The caregiver will feel your child's spine to look for the best place to do the LP. He will mark this position using a marker. Your child's lower back is cleaned. Your child is then given one or more shots of numbing medicine under the skin. A needle is inserted between the vertebrae (spine) in your child's 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. The caregiver may need to pull out, reinsert, or change the position of the needle.
- 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 and placed in sterile bottles. The needle is then taken out and the area will be covered with a bandage.
After your child's procedure:
Your child will need to lie flat in bed until his caregiver says it is okay for him to get up. When caregivers see that your child is okay, your child may be able to go home. If caregivers want your child to stay in the hospital, he will be taken back to his hospital room. Tell a caregiver if your child says he has a headache, back pain, or tingling, numbness, or weakness below the waist.
- Ibuprofen or acetaminophen: These medicines are given to decrease your child's pain and fever.
- Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.
- Antinausea medicine: This medicine may be given to calm your child's stomach and control vomiting.
- Post-lumbar puncture headache: Your child may develop a headache during the first few hours after his LP that may last for several days. The headache may be mild to severe and may get worse when he sits or stands. The following may help ease or prevent a post-lumbar puncture headache:
- Liquids: Your child may be asked to drink more liquid than usual after his LP. Ask your child's caregiver how much liquid is right for him.
- Caffeine: Caffeine may be used to treat a LP headache. Your child may be given caffeinated drinks every 4 to 6 hours. He may also be given caffeine through an IV.
- Vital signs: Caregivers will check your child's blood pressure, heart rate, breathing rate, and temperature. They will also ask you or your child about his pain. These vital signs give caregivers information about your child's current health.
- Neurologic signs: Neurologic signs are also called neuro signs, neuro checks, or neuro status. Caregivers check your child's eyes, memory, and how easily he wakes up. Your child's hand grasp and balance may also be tested. This helps tell caregivers how your child's brain is working after a procedure. Your child may need to have his neuro signs checked often. Your child's caregiver may even have to wake him up to check his neuro signs.
Your child 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. He may have blurred or double vision, dizziness, and ringing in his ears. There may be bleeding, infection, or injury to a disk in his spine. Spinal fluid may leak from the puncture site. Your child's nerves or spinal cord may be damaged. Patients who have blood disorders or who are taking certain medicines are at a higher risk of problems.
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.
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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.