neurologic disorders
How To Do Lumbar Puncture
Equipment
In many centers, prepackaged lumbar puncture kits are available. If not, necessary equipment includes the following: Sterile gloves, gown, face mask, and cap Sterile drapes and/or towels Antiseptic solution (eg,chlorhexidine,povidone-iodine, alcohol wipes) Sterile gauze (eg, 10 cm × 10 cm [4" × 4"] squares) Local anesthetic (eg, 1%lidocainewithoutepinephrine, 25- and 20-gauge needles, 10-mL syringe) Topical anesthetic (standard for children): Needle-freelidocainegas-injection device,lidocaine-epinephrine-tetracaine(LET) gel orlidocaine-prilocainecream Spinal needle with stylet: Cutting needle (beveled tip) or noncutting (atraumatic) needle* (pencil-point tip); 20 or 22* gauge; 9-cm-long for adults, 6 cm for children, 4 cm for infants 4 CSF collection tubes (labeled 1 through 4) for laboratory studies; additional tubes if large-volume CSF collection is needed (eg, 30 to 40 mL) or additional special tests are needed. Large volumes of 30 to 40 mL of CSF may need to be collected where Subacute and Chronic Meningitis (eg, Manometer and stopcock; optionally, short extension tubing Adhesive bandage * Use of noncutting needles and smaller caliber (ie, 22-gauge) needle reduces risk of post-lumbar puncture headache. For ultrasonographic guidance: Bedside ultrasound device with a high-frequency linear array probe 