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Interventional procedures for neonates

- Lumbar Puncture Policy


Policy Name: Lumbar Puncture

Department: Neonatology

Definition:
A lumbar puncture is an invasive procedure performed to obtain a cerebrospinal fluid (CSF) sample.

Required Equipment:

  • 70% ethyl alcohol
  • Povidone-iodine (Betadine)
  • Sterile gloves
  • Kidney tray
  • Scissors
  • Face mask
  • Autoclaved sterile pack containing:
    • Cup
    • Sterile cotton
    • Gauze
    • Square drape
    • Square fenestrated drape
  • Sterile needles (sizes 21, 22)
  • Butterfly needle (size 23)
  • Three sample collection tubes
  • Adhesive tape

Procedure Steps:

  • Ensure all steps are performed under strict aseptic conditions.
  • Perform routine handwashing and prepare the necessary equipment.
  • Connect the newborn to a vital signs monitor (monitoring device) throughout the procedure.
  • Perform surgical handwashing.
  • Wear sterile gloves.
  • Position the newborn on the incubator edge or warming bed in a straight posture without upward bending.
  • Hold the newborn in a lateral or sitting position, ensuring the knees touch the chest.
  • Avoid bending the newborn's head to prevent respiratory distress.
  • Disinfect the puncture site on the newborn’s back with Betadine, followed by alcohol, alternating three times.
  • Collect 1 mL of cerebrospinal fluid in each sample tube.
  • Continuously monitor the newborn’s vital signs throughout the procedure.

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After the Procedure:

  • The newborn is returned to the incubator.
  • The newborn is placed in a supine position and should not be moved for at least one hour.
  • Samples are sent immediately to the laboratory for analysis, with a label containing the newborn’s name on each tube.
  • Used equipment is safely disposed of in designated areas.
  • Instruments are cleaned and prepared for sterilization.
  • Hands are routinely washed.
  • The newborn’s vital signs and general condition are monitored.
  • Vital signs are recorded in the newborn’s file.
  • The physician is informed of any deviation from normal parameters.

Responsible Personnel:

  • Nursing staff.