Lumbar Puncture
05/23/2016
As of 12/17/15, Chattanooga Neurology Associates prefer their samples to go to Memorial Lab. The following is the list of physicians in that group:
Sharon N. Farber, M.D.
Tareck A. Kadrie, M.D.
Howard Kraft, M.D.
Gabe Tallent, M.D.
Nathan B. Wyatt, M.D.
If there is any question as to whether blood work should be drawn, call the referring to make sure.
(If they order CSF, Oligoclonal Banding blood needs to be drawn into a tiger top[red and grey] tube. If they also need a BNP you do not have to draw a separate tube, one tiger top will do for both.)
Patient Prep: Dress patient with pants and shirt off, gown open in the back. Take history. Make sure patient has signed all/any consents. Check order to see if they want samples sent to the lab or just opening pressures.
If study is for Alzheimer’s(sometimes ordered as Admark), use polypropylene tube.
Refer to Lab Work Procedure on Page 16 to determine which drugs need to be discontinued and for how long.
Myelogram Tray Set Up:
10cc syringe (9ml lidocaine, 1ml sodium bicarb)
Keep the tubes on tray
Place manometer(ref#4330) on tray
Have a 20ga x 5cm spinal needle ready in case the Radiologist requests one.
Tube labeling:
Patient name, date of birth
Social security number, study date, and time
Patient Positioning:
Patient will be in prone position with pillow under abdomen
USE LEAD MARKER ON UNDERSIDE OF TUBE
Set Up:
Open Myelogram tray using sterile technique. Draw up 9ml of Lidocaine and 1ml of Sodium Bicarb in to 10ml syringe. Attach 25G, 1 ½” needle. Assemble Manometer and set on tray.
Procedure:
After Rad gains access and attaches manometer, document opening pressure. Usually, 3 vials will be drawn and sent to the lab. Label the vials in the order they are drawn. Note the amount for each vial, a total amount must be noted in the report. Make sure the patient info is also on each vial. Note the size of the needle used. Give pt. discharge sheet. Make sure to log the exam in the invasive procedure log on the RA’s desk.
PATIENT WILL NEED TO REMAIN FLAT FOR AT LEAST 1 HOUR AFTER EXAM.
Please refer to the memo for Dr. Kundu’s diagnosis specific protocols when performing studies for him.