Injection site pain, infection, bleeding, neurological damage, death and headache after a lumbar puncture are possible complications. Of these, postural headaches caused by chronic leakage of the injection site are the complication most often brought to the attention of medical professionals. It can be treated epidural with the injection of a small amount of the patient`s blood to form a blood stain. See: CSF cerebrospinalis A puncture wound is usually caused by a sharp object such as a fingernail, animal teeth or a hook. This type of sore usually does not bleed excessively and may appear to close. Puncture wounds are also susceptible to infection and must be treated appropriately. The procedure and expected sensations are explained, and the patient is asked to remain calm when positioned and breathe normally. The patient is usually placed on the left side on the right edge of the bed or examination table with knees to abdomen and chin to chest or sitting with legs on one side of the table and buttocks on the other side, bending head and chest towards the knees. Each of these positions exposes the operator`s back and provides vertebral flexion that allows easy access to the lumbar subarachnoid space. The LPN holds the patient appropriately to secure this position (one arm around the neck, the other around the knees, or both shoulders bent forward). The draping brings warmth and intimacy. Next, the patient`s skin is prepared with an antiseptic solution and a sterile fenestrated barrier is placed at the proposed injection site. A local anesthetic is injected, and then the spinal needle with its stiletto is slowly advanced between the vertebrae into and through the dura mater and arachnoid membranes.
The style that fills the needle is removed and the first measurements of the intracranial opening pressure (ICP) are made with a manometer. When the diagnostic procedure is performed, about 8-10 ml of fluid is collected and immediately sent to the clinical laboratory for analysis of cell count, glucose, protein content, culture spots and special studies. The closing pressure should then be read, the needle removed, and a small waterproof adhesive bandage applied, sometimes with collodion, to prevent cerebrospinal fluid from escaping. See: Figure Informed consent for the procedure is obtained, except in cases of urgency where clinical judgment prevails. Suitable equipment is collected: sterile gloves and mask for the operator, skin antiseptic (povidin-iodine solution), local anesthetic (1% lidocaine) and lumbar puncture box with sterile gauze sponges, windowed curtains and towel, needles and syringe for anesthesia, vertebral needles, 4 collection tubes, 3-way shut-off valve and pressure gauge; and a small adhesive bandage. Lammers RL, Aldy KN. Principles of wound management. In: Roberts JR, Custalow CB, Thomsen TW, eds.
Roberts and Hedges` clinical procedures in emergency medicine and acute care. 7th edition. Philadelphia, Pennsylvania: Elsevier; 2019: Chapter 34. Open wound; Laceration; Perforating wound medtermes medical dictionary a-z list / puncture Definition of wound Infection can occur with certain cuts and puncture wounds. The following people are more likely to be infected: If the wound is bleeding heavily, call your local emergency number, such as 911. Minor cuts and puncture wounds can be treated at home. Quick first aid can help prevent infections, speeding healing and reducing scarring. Puncture wound: A wound caused by a sharp object that pierces or penetrates the skin. Puncture wounds carry a risk of tetanus.
A laceration is a wound caused by tearing the soft tissues of the body. This type of wound is often irregular and serrate. A laceration is often contaminated with bacteria and debris from the object that caused the cut. After the procedure, the nurse assesses vital signs and neurological status, especially signs of paralysis, weakness or loss of sensation in the lower limbs. If cerebrospinal fluid pressure is elevated, the patient`s neurological condition should be assessed every 15 minutes for 4 hours, if normal, every hour for 2 hours, and then every 4 hours or as directed. The puncture site should be checked every hour for 4 hours and then every 4 hours for 24 hours to assess redness, swelling and drainage. To reduce the risk of headaches, oral intake (to replace cerebrospinal fluid and equalize pressure) is recommended, and the patient should not stay in bed in a supine position or with his head raised for more than 30 ° for 4 to 24 hours (by operator or institutional protocol). The patient should not raise his head, but can move it (and himself) from side to side.
Non-invasive pain relief measures and prescribed analgesia are provided in case of headaches. A puncture is an injury caused by a sharp object such as a fingernail, knife or sharp tooth. Puncture wounds often appear to be on the surface, but can extend into the deeper layers of the tissue. Make sure you and your child are up to date on vaccines. A tetanus vaccine is usually recommended every 10 years. The nurse assists the operator throughout the procedure by numbering and sealing the sample tubes for laboratory tests and applying jugular vein pressure as directed. The patient is calmed and guided throughout the procedure, and the patient is examined for side effects (increased pulse, pain radiating into the limbs, pallor, wet skin or shortness of breath). A.D.A.M., Inc. is accredited by URAC for Health Content Providers (www.urac.org). FCAC`s accreditation program is an independent audit to ensure that A.D.A.M. adheres to strict standards of quality and responsibility. A.D.A.M.
was among the first to receive this important award for eHealth information and services. Learn more about A.D.A.M.`s editorial process and privacy policy. a.d.a.m. is also a founding member of Hi-Ethics. This website complies with the HONcode standard for reliable health information: click here. Ball JW, Dains JE, Flynn JA, Solomom BS, Stewart RW. Skin, hair and nails. In: Ball JW, Dains JE, Flynn JA, Solomom BS, Stewart RW, eds. Seidel`s Guide to Physical Examination. 9th edition. St. Louis, MO: Elsevier; 2019: Chapter 9.
A cut is a fracture or opening in the skin. It is also known as laceration. A cut can be deep, smooth or serrated. It can be near the surface of the skin or deeper. A deep incision can affect tendons, muscles, ligaments, nerves, blood vessels or bones. Keep knives, scissors, sharps, firearms and fragile objects out of reach of children. When children are old enough, teach them how to use knives, scissors and other tools safely. Simon BC, M. HG. Principles of wound management. In: Walls RM, Hockberger RS, Gausche-Hill M, eds, eds. Rosen`s Emergency Medicine: Concepts and Clinical Practice.
9th edition. Philadelphia, Pennsylvania: Elsevier; 2018: Chapter 52.
