1. Obtaining Spinal Fluid Samples
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Collect a total of 2 mL of CSF in the premature or full-term neonate. In older children 3 to 6 mL can be safely removed.
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Note the character of the CSF and, if bloody fluid flows originally, observe the fluid for clearing with subsequent collection.
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If the fluid does not clear this may indicate the presence of a subarachnoid hemorrhage.
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After collecting CSF fluid obtain a closing pressure reading as previously indicated.
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Replace the stylet and remove the needle.
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Place a bandage over the site and encourage the patient, if able, to lie prone for 3-4 hours to prevent leakage.
2. CSF Analysis
Send CSF for analysis of:
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Cell count and differential.
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Protein and glucose determinations.
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Gram stain.
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Routine culture.
To prevent misinterpretation caused by RBC contamination, send the last tube collected for cell count evaluation.
Obtain a peripheral serum glucose level immediately before the LP to determine the CSF serum ratio of glucose.