This block we started real clinical medicine procedures, so my next posts will highlight these areas. So, let’s start by talking about the lumbar puncture or spinal tap. For a little background information about this procedure, I will give you a brief overview and talk about some of the reasons why a physician would order this procedure.
The lumbar puncture is a standard medical procedure that can be used as a diagnostic tool as well as therapeutic for pharmaceutical reasons, such as spinal injections. Lumbar punctures are basically used for the collection of CSF (cerebrospinal fluid), which acts as a “cushion” fluid for the brain. Usually this procedure is done in the case of meningitis to sample the CSF and look for bacterial and other pathogens that cause this infection.
Meningitis is a life-threatening infection, usually bacterial of the membranes covering the brain and spinal cord. If caught in time, it can be treated through the use of antibiotics with little or no long term consequences. Headache and neck stiffness are usually accompanied by fever and sometimes confusion. The lumbar puncture, or spinal tap, is where a spinal needle is placed between your lumbar (lower back) vertebral space. This is where the CSF can be collected, and it must be done below where the spinal cord ends.
As a class, we were able to practice this technique on simulators. The simulators were basically a lower torso similar to human skin. When it was my turn to do the procedure, I was a little nervous since we were in a group of 5 to 6 students and didn’t want to mess up too bad in front of my classmates.
I got up to the simulator and palpated, or felt the space where I was supposed to place the needle. As a D.O., palpitation skills are very important to the profession, because this is something that separates us from our M.D. counterparts, which gives the D.O.s an advantage in this type of procedure.
I placed the needle in the proper area but, on first try, I just missed, , as the doctor showed me on the simulator. The second time around was much better. It was great because the doctor told us that we should feel a pop right before we get into the space. On my second try, I went into the area fairly deep, where I seemed to reach a barrier. I pushed the needle a little farther in and felt the pop. The liquid that they place in the simulator started flowing, and it was pretty cool that I just performed my first spinal tap, or lumbar puncture.
This was the first actual “clinical” skill I have learned, and there are many more to come, which is very exciting.
Latest posts by Mike DeWall (see all)
- Mr. DeWall (Future Dr.) Goes to Washington - April 24, 2012
- Starting Clinical Procedures: My Experience with a Lumbar Puncture - March 13, 2012
- New Experiences – Lab Work & Patient Interaction - February 9, 2012