Cerebral ventricular tap
This procedure is done for
drainage of CSF in non-communicating hy-drocephalus, to obtain CSF for
microbiological testing, e.g. to diagnose ventriculitis, and to administer intraventricular
antibiotics.
As for lumbar puncture.
•
Before
the procedure is undertaken, cerebral lateral ventriculomegaly must be
confirmed by cranial US.
•
Place
the baby supine, with an assistant firmly holding the baby’s head.
•
Measure
the necessary depth required for needle insertion.
•
Palpate
and locate the lateral corner of the anterior fontanelle on the intended side
to drain.
•
Shave
a small area of the scalp at the needle insertion point if required.
•
Set
out sample containers +/– CSF pressure manometer if needed.
•
Full
aseptic technique should be used.
•
Wash
hands and put on sterile gloves, gown, +/– surgical mask.
•
Clean
area with antiseptic solution and create a sterile field with sterile drapes.
•
Insert
needle into the lateral corner of the fontanelle in a direction slightly
forward and inward, aiming toward the inner canthus of the ipsilateral eye.
•
After
the needle is inserted to the predetermined distance, remove stylet and CSF
should drip out.
•
If CSF
pressure measurement is required, attach manometer and allow it to fill until
measurement is complete.
•
If CSF
drainage or sample is required, then allow fluid to drip out spontaneously into
containers until required amount is drained.
•
Once
required CSF has been drained, remove the needle and then cover with adhesive
plaster or spray with plastic dressing to seal.
•
The
child should lie flat for the next 6hr and have hourly neurological
observations and BP measurement.
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