lumbar puncture

lumbar puncture (or LP, and colloquially known as a spinal tap) is a diagnostic and at times therapeutic medical procedure. Diagnostically it is used to collect cerebrospinal fluid (CSF) to confirm or exclude conditions such asmeningitis and subarachnoid hemorrhage and it may be used in diagnosis of other conditions. Therapeutically it may be used to reduce increased intracranial pressure. Under some circumstances, lumbar puncture cannot be performed safely (e.g. a severe bleeding tendency). It is regarded as a safe procedure, but post-dural-puncture headache is common.

The procedure is typically performed under local anesthesia and aseptic technique. A needle is used to access thesubarachnoid space and fluid collected. Fluid may be sent for biochemical, microbiological, and cytological analysis.

Lumbar puncture was first introduced in 1891 by the German physician Heinrich Quincke.


Abdominal paracentesis

Abdominal paracentesis


An abdominal tap is a procedure used to remove fluid from the area between the belly wall and the spine. This space is called the abdominal cavity.

How the Test is Performed

This test may be done in an office setting, treatment room, or hospital.

The puncture site will be cleaned and shaved, if necessary. You then receive a local numbing medicine. The tap needle is inserted 1 – 2 inches into the abdomen. Sometimes a small cut is made to help insert the needle. The fluid is pulled out into a syringe.

The needle is removed. A dressing is placed on the puncture site. If a cut was made, one or two stitches may be used to close it.

There are two kinds of abdominal taps:

  • Diagnostic tap — a small amount of fluid is taken and sent to the laboratory for testing
  • Large volume tap — several liters may be removed to relieve abdominal pain and fluid buildup

How to Prepare for the Test

Let your health care provider know if you:

  • Have any allergies to medications or numbing medicine
  • Are taking any medications (including herbal remedies)
  • Have any bleeding problems
  • Might be pregnant

How the Test Will Feel

You may feel a stinging sensation from the numbing medicine, or pressure as the needle is inserted.

If a large amount of fluid is taken out, you may feel dizzy or light-headed. Tell the health care provider if you feel dizzy.

Why the Test is Performed

Normally, the abdominal cavity contains only a small amount of fluid. In certain conditions, large amounts of fluid can build up in this space.

An abdominal tap can help diagnose the cause of fluid buildup. It may also be done to diagnose infected abdominal fluid, or to remove a large amount of fluid to reduce belly pain.

Normal Results

Normally, there should be little or no fluid in the abdominal space.

What Abnormal Results Mean

An examination of abdominal fluid may show:


There is a slight chance of the needle puncturing the bowel, bladder, or a blood vessel in the abdomen. If a large quantity of fluid is removed, there is a slight risk of lowered blood pressure and kidney failure. There is also a slight chance of infection.

Alternative Names

Peritoneal tap; Paracentesis


Types of Nursing Careers

 – Agency Nursing is essentially where a nurse will register or sign up with an agency or similar group and tell them what hours they are available to work. The nurses are then contacted and offered work on a shift to shift basis.

Agency Nurses are now in high demand, particularly, in the case of nurses with specialized training or experience. See also: travel nursing

Ambulatory Care – Ambulatory Care Nurses care for patients whose stay in the hospital or other facility will last for less than 24 hours. ambulatory care nursing covers a broad range of specialties in the out-patient setting.

American Academy of Ambulatory Care Nursing

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10 Things Nurses Can Be Thankful For

I’ve never made a secret of the fact that I’m a sentimental sort, and never more than at this time of the year. So now that I’ve been doing this blog thing for awhile and my readers are probably expecting the annual essay on gratitude, far be it from me to disappoint…..even as I give you something a little new and different. 
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How to Survive in Nursing School

beginning at the beginning: tips for pre-nursing students

#1 get a job! the very first tip that i give to anyone who is even considering nursing school is to get a job in the healthcare field. you can be a cna, a patient care assistant, a unit clerk, or even a patient transporter with little to no experience needed. be sure to mention on your job application that you are considering going to nursing school, hr people love that.
there are many reasons that this is the first thing i tell people who ask me about becoming a nurse. first and foremost is that no matter what you may think you know about being a nurse, there is nothing like observing what nurses do from day-to-day in the real world rather than on tv to help you decide if it’s really for you. consider it an anthropological study. every different field from banking to food service has it’s own culture, it’s own set of unspoken rules. the sooner you learn what they are, the more likely you are to be successful down the road as a nursing student and as a nurse.

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Recommended General Surgery Books for medical students

I. Good reference and reading book, recommended for junior students:

1) Essentials of General Surgery, by Peter Lawrence: This book provides a synopsis for junior medical students on surgical clerkship. It covers all major topics in surgery and, overall, it is considered a good book to read from cover to cover (approximately 400 pages). It includes a glossary and some chapters discuss major advances in the field. $39.00. 

2) Current Surgical Diagnosis and Treatment, by Lawrence W. Way: This is an excellent book, currently on its 11th edition (1996). It was originated at the University of California, San Francisco, with more than 85 contributors. It focuses on all diseases managed by surgeons and it is an outstanding reference for junior & senior medical students, residents, and practitioners. It is more difficult to read from cover to cover (approx. 700 pages) but it provides a more in depth review of subjects, covering many aspects frequently asked on board part I & II exams. Highly recommended. $42.00.

3) General Surgery, by Ritchie P. Wallace: From Temple University, this is a book that concentrates on the clinical presentation, diagnostic studies, and common surgical procedures. It is concise, two-color textbook for medical students that addresses the essential clinical conditions treated by general surgeons. Approx. 970 pages. $154.00.

4) The Student’s Textbook of Surgery, by William M. Rambo From the Medical University of South Carolina, this book was written with the junior medical student in mind. With only 350 pages, it covers all the essentials of general surgery, easy to read and understand. Highly recommended as an introduction to surgery. $40.00.

5) Essential Surgery: Problems, Diagnosis, and Management, by George H Burkitt: Concise surgery synopsis for medical students. Approx. 740 pages. Uses a problem-based approach. Includes outlines of major procedures, discussion of minimally invasive surgery. $49.95.

6) Basic Surgery, by Hiram C Polk, Jr.: From the Univ. of Louisville. An introductory text for medical students on the assessment, diagnosis, treatment, and postoperative care of the surgical patient. New topics include managed care and indications for referral. 89 contributors. Approx. 1,000 pages. $48.00.

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Internal Med Residency 1

Medical Student’s Guide to Surgery


Welcome to your Surgery Clerkship! This rotation can be one of the most memorable experiences of your third year. This may be the only chance you will ever have to see such things as a liver transplant, open-heart surgery, a laparoscopic gastric bypass, a trauma, or even an appendectomy. It can be an unbelievable experience, but we also recognize that it can be quite intimidating. With this guide, we hope to unlock the mystery of surgery and give you some tips on how to excel on this rotation. Continue reading

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