Human Specimen Model - Pediatric Lumbar Puncture Model

Human Specimen Model - Pediatric Lumbar Puncture Model

The model is 1:1 human body ratio, the skin is soft and elastic, and the human anatomical structure is accurate. Accurate simulation of the posterior lower spine, with vertebral column and spinal cord. Can be filled with liquid to simulate cerebrospinal fluid. The simulated baby must be in the correct position (in the arcuate lateral position) before lumbar puncture training can be performed. Accurate touch positioning of each puncture point can be performed. There should be a sense of impedance during puncture. Lumbar puncture, epidural block, coccygeal nerve block, sacral nerve block and lumbar sympathetic nerve block can be practiced. Has a real sense of block and frustration and can draw cerebrospinal fluid.

Pediatric lumbar puncture:

Usually take the bent side lying position, since the lumbar 3-4 or lumbar 4-5 intervertebral space puncture. After routine local disinfection and anesthesia, wear rubber gloves, and use a puncture needle (or pediatric scalp needle) to slowly pierce in the direction of the spinous process. When the needle is inserted about 1.5-3 cm, after two breakthrough sensations are felt, the needle core is pulled out to flow out the cerebrospinal fluid, and the cerebrospinal fluid is measured. After pressing and slowly discharging the liquid (not more than 2-3ml), put the needle core and pull out the puncture needle. The puncture point was slightly pressurized to stop bleeding, and sterile gauze was applied and fixed with adhesive tape. Lie down for 4-6 hours after surgery. If the initial pressure exceeds 2.94kPa (300mm water column), it is not suitable to discharge the liquid, and only the cerebrospinal fluid in the manometry tube is sent for cell counting and protein quantification.

1. Instruct the patient to lie on the side on the hard board bed, with the back perpendicular to the bed surface, flex the head forward and the chest, and hold the knees with both hands close to the abdomen, so that the trunk is arched; or the assistant should hold the patient's head with one hand opposite the surgeon. , the other hand grabs the lower extremities at the fossa and holds them tightly, so that the vertebral column is kyphotic in order to widen the intervertebral space and facilitate needle insertion.

2. Determine the puncture point, take the intersection of the line connecting the posterior superior spine of the iliac and the posterior median line as the puncture point, generally take the 3-4 or 4-5 lumbar spinous process space, and the position of the baby is not easy to be too high.

3. After routine disinfection of the skin, wear sterile gloves and cover holes, and use 2% lidocaine for local anesthesia from the skin to the intervertebral ligament.

4. The surgeon fixes the skin of the puncture point with the left hand, and holds the puncture needle with the right hand to slowly pierce in the direction of the vertical north, and the needle is inserted about 1.5-3cm. When the needle passes through the ligament and dura, you can feel the sudden loss of resistance and a sense of loss. At this time, the needle core can be slowly withdrawn (to prevent the rapid outflow of cerebrospinal fluid and cause brain herniation), and the outflow of cerebrospinal fluid can be seen.

5. Connect the pressure measuring tube to measure the pressure before discharging the liquid. CSF pressure in normal lateral position is 0.69-1.96 kPa (0.29-0.78 kPa in neonates). If you know whether the subarachnoid space is blocked, you can do the Queckenstedt test. That is, after measuring the initial pressure, the assistant first compresses one side of the jugular vein for about 10s, then presses the other side, and then simultaneously presses both sides of the jugular vein; under normal circumstances, after the jugular vein is compressed, the pressure of the cerebrospinal fluid immediately doubles rapidly. , 10-20s after the release of the oppression, it quickly drops to the original level, which is called a negative obstruction test, showing that the subarachnoid space is unobstructed. If the pressure of the cerebrospinal fluid cannot be increased after the jugular vein is compressed, the infarction-yin test is positive, indicating complete subarachnoid obstruction; if the pressure rises slowly after pressure is applied, and then slowly decreases after relaxation, it indicates incomplete obstruction. All patients with increased intracranial pressure should not perform this test.

6. Remove the pressure measuring tube and collect 2-5ml of cerebrospinal fluid for inspection; if it is necessary for culture, use aseptic operation to keep the specimen.

7. After the operation, insert the needle core and pull out the puncture needle together, cover it with sterile gauze, and fix it with tape.

6. Warranty card: 1;

7. Certificate of Qualification: 1.