Skill 16[1] Assisting with Collection of Cerebrospinal

EQUIPMENT
Spinal tap (lumbar puncture) tray:

Antiseptic solution
Sterile drape
3-way stopcock
Spinal fluid pressure manometer
Lumbar puncture needle (various sizes)
Fluid collection tubes (3 or 4)

Gloves, sterile (physician)
Gloves, nonsterile (nurse)
Local anesthetic
Band-Aid or 2

× 2 gauze

Adhesive bandage
Gauze sponges

GENERAL GUIDELINES FOR DIAGNOSTIC
TESTS

1. Explain procedure to child and family. Enhances cooper-

ation and participation and reduces anxiety and fear.

2. Obtain signed consent.
3. Gather equipment. Promotes organization and effi-

ciency.

4. If possible, have child void before procedure. Promotes

comfort and avoids interruption of procedure.

5. Wash hands. Reduces transmission of microorganisms.

PROCEDURE

1. Steps 1–5 of General Guidelines.
2. Put on nonsterile gloves. Reduces transmission of

microorganisms and protects careprovider from contact
with body fluids.

3. Properly label tubes with client information and name

of test desired. Ensure tubes are numbered in sequence
of collection. Place tubes in appropriate bag or con-
tainer. Avoids errors in testing and reporting.

4. Assist with placement of direct pressure and placement

of Band-Aid or gauze dressing over site. Pressure helps
minimize bleeding and cerebrospinal fluid (CSF) loss.

5. Dispose of equipment in appropriate container.

Consistent with body fluid precautions.

6. Remove gloves. Wash hands. Reduces transmission of

microorganisms.

7. Send specimens to laboratory.

NOTE: Two individuals are needed: one to restrain the
child and one to assist the physician.

DOCUMENTATION

1. Procedure performed, time, physician’s name.
2. How procedure tolerated, including opening pressure,

color of CSF, drainage on dressing, headache, leg tin-
gling, changes in vital signs, nausea, vomiting, changes
in level of consciousness.

3. Laboratory specimens sent.

SKILL 16

Assisting with Collection of Cerebrospinal
Fluid