Procedural Steps
Patient Positioning
Site Preparation
Local Anesthesia
Needle Insertion
Collection of CSF
Removal of Needle
Post-procedural Care
Interpretation of Results
CSF Pressure

LP Pressure Quick Guide

Once CSF return is obtained, the stylet can be replaced half way into the needle while the test tubes are obtained from the tray. Collect 1.5-2 cc. of fluid in each of 4 to 5 tubes (except when the pressure is elevated). More CSF should be collected if a special study such as globulin immunoelectrophoresis is required.

The following would be a typical grouping of tests ordered in the emergency department:

Tube 1

Cell count

Tube 2

Stat gram stain and culture (C+S) (2 cc.)

Tube 3

Glucose and protein

Tube 4

Cell count (for comparison to Tube 1)

Tube 5 (optional)

Virology, mycology, cytology,etc.

A serum glucose analysis should be done simultaneously.

Remember the order in which the tubes are collected or prelabel them. Be sure to tighten the test tube tops well to prevent CSF loss during transport to the lab.


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