Lumbar Puncture question

Have a child with SM/Chiari? Share issues unique to children and their caregivers.

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Lumbar Puncture question

Postby lttutrow » Fri Sep 11, 2009 3:47 pm

Can anyone tell me what the procedure involved for your children when these have been done? Specifically, how awake are they for it? I am trying to get as much information as I can so that I can prepare Keegan. He wants to know if he'll be awake, if it will be painful and if so, how painful? Do they have to lay flat after and for how long?
After consulting with another nsg., he is thinking it's possible he is having a reaction or rejection to his patch, but he doesn't really take on patients that have had a surgery elsewhere. Our local nsg. is willing to investigate this via an LP, but said she's never had anyone have a reaction to the patch, it is a durepair patch. I wish there was a less invasive test to see if this is the possible cause, and I don't understand yet how looking at the csf tells them if there is an issue with the patch or not. If he's going to have an LP, are there other things we should ask them to do as a part of it, is an opening pressure reading important?

Thank you!
Lori
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Re: Lumbar Puncture question

Postby razzle » Fri Sep 11, 2009 4:11 pm

What happens after a lumbar puncture?

Caregivers will check the LP site to make sure it is not bleeding too much, leaking fluid, or swelling. If your child is older, he may be asked to wiggle his toes.


Your child will need to lie flat or nearly flat for 30 minutes to several hours after the LP. If your child is sent home after the LP, have him lie flat or recline as much as possible on the way home. For 24 hours after the LP, have him rest as much as possible. This helps to decrease the chance of a "spinal headache". Have your child avoid hard activity (such as sports) for 48 hours after the LP.
Care for a spinal headache: A spinal headache can happen during the first few hours to several days after the LP. The discomfort of a spinal headache can range from mild to severe (very bad). The headache may get worse when your child sits or stands. He may have neck or back pain as well. Things that may decrease the pain of a spinal headache include the following.

If your child gets a headache, have him lie down until the headache is better. Tell your child's caregiver if his headache is very bad and it does not get better after lying down for a while.


Over-the-counter medicines, such as acetaminophen (a-seet-a-MIN-oh-fen), may decrease your child's pain. Ask your caregiver which over-the-counter pain reliever is right for your child. Always follow the directions on the bottle. Never give aspirin to your child without first asking your child's caregiver. Giving aspirin to your child when he is ill may cause a very serious illness called Reye's syndrome. This could cause brain and liver damage. Read medicine labels to see if your child's medicine has aspirin in it.


Offer your child plenty of liquids to drink during the first 12 to 24 hours following the LP. This may help decrease the chance of a spinal headache. Good liquids to drink include water and milk. Children over the age of six months can drink juices as well. For some older children, caregivers may suggest allowing your child to drink caffeine. This may help to decrease the pain of a spinal headache. Things that have caffeine include some sodas, some tea, and some energy drinks. Ask your child's caregiver before giving your child caffeine.
What is a blood patch? A blood patch may be used to help a spinal headache that is very bad or does not go away. This is also called an epidural (ep-i-DU-ral) blood patch. A blood patch may be done in the days or weeks following an LP. To place a blood patch, caregivers first draw blood from your child. This blood is injected with a needle into your child's back over the LP site. Your child will need to lay flat for about an hour after this is done. Your child may need IV fluids also.

Risks: There is a risk of an allergic reaction if a numbing medicine is used during the LP. Other problems are rare, such as bleeding, infection, or injury to a disk in the spine. There is also a small risk of leakage of the spinal fluid. There is a very small chance that the brain or spinal cord could be injured. The risk of problems is increased if your child moves during the LP test. If your child does not have an LP test, caregivers may not be able to find or treat his illness. Call your caregiver if you are worried or have questions about your child's medicine or care.
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Re: Lumbar Puncture question

Postby lttutrow » Fri Sep 11, 2009 4:49 pm

WOW, that is great information, thank you!!
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Re: Lumbar Puncture question

Postby Sara » Fri Sep 11, 2009 6:12 pm

Holly has had 13 spinal taps. She has always been awake because anesthesia can alter the pressure. I hope they are checking his opening pressure to rule out raised ICP if they are also doing an analysis. In Holly's case, LP's were always done under flouroscope, with a radiologist looking under xray to ensure they entered the right area. She has had prior back surgery, tethered cord, so this was important. They would put EMLA cream over her back an hour prior, then they would give a shot of lidocaine to numb the area. (after about 3 taps she told them not to use the Emla anymore, she didn't think it helped!) The radiologist would try to keep her as entertained as possible. She would have to roll to her side to check the pressure and stay in that position to get an accurate reading. After wards they would have her lay flat for about 30 minutes. She did not get low pressure headaches because she had high pressure and taking fluid out made her feel better. Her back was sore for a few days. After the spinal tap was worse than during for her, but like I said, she does have serious back issues to begin with so her response might not be typical.

I hope it gives you some answers and they can come up with an idea to help him!
Sara
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Re: Lumbar Puncture question

Postby jupes » Fri Sep 11, 2009 8:24 pm

Hope all goes well with the lumbar puncture and pray they find answers.
Keep us updated.
Julie
14 yr old DD with CM 0/SM and mild scoliosis.
"Trust in the Lord with all your heart and lean not on your own understanding" Proverbs 3:5
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