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The first 25 slides, exactly as they appear. The full deck has 43 content slides.
Neuro Critical Care
3 Lumbar Puncture
Built from Jallo — Neurocritical Care Procedure Atlas
What’s inside
9 sections · 43 slides
Overview
- What this teaches you
The relevant anatomy
What the needle is aiming for, and why the lower back is safe
- Cerebrospinal fluid: the brain's water cushion
- CSF by the numbers
- Circulation of cerebrospinal fluid
- Why the lower back is the safe target
- Lumbar spinal anatomy
When to do an LP
Four reasons to enter the CSF space
- The four broad indications
- Indication 1 - sampling the fluid for diagnosis
- Indication 2 - measuring pressure
- Indications 3 and 4 - drainage and medication
When NOT to do an LP
Relative contraindications - weigh risk against benefit
- The danger: pulling the stopper from below
- Mass lesion vs obstructive hydrocephalus
- Bleeding risk and infection at the site
The equipment
Mostly contained in a pre-packaged LP kit
- What you gather before starting
- Lumbar puncture kit contents
The technique
From positioning to closure, step by step
- Before you start
- Patient positioning
- Sitting and lateral decubitus positions
- Preparation and finding the landmark
- Inserting the needle
- Atraumatic and cutting spinal needles
- Feeling your way in: the layers of resistance
- Needle trajectory into the lumbar cistern
- Measuring the opening pressure
- Measuring CSF pressure with a manometer
- Collecting the CSF
- Cerebrospinal fluid samples
- Closing up
Complications
What can go wrong, and why
- Recognizing the complications
Expert tips and troubleshooting
Getting out of trouble at the bedside
- Reading the needle's feedback
- Difficult patients and difficult anatomy
Bringing it together
The essentials to carry away
- Three ideas to remember
- References
- Neuro ICU Procedure Atlas