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2016, Number 4

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Rev Cubana Pediatr 2016; 88 (4)

Use of lumbar puncture in the teaching-educational process in Pediatrics

Valdivia ÁI, Melo PJL

Language: Spanish
References: 19
Page: 454-462
PDF size: 122.67 Kb.


ABSTRACT

Introduction: diagnostic lumbar puncture is a common procedure at the infant emergency services and is essential for the diagnosis of infectious, inflammatory, oncologic and metabolic diseases.
Objectives: to characterize some technical and teaching aspects in the performance of lumbar puncture as well as identifying the use of informed consent as an ethical tool for its application by the staff working in the emergency department.
Methods: cross-sectional and descriptive study of 45 patients which included the whole health staff that woks either part-time or full time at the emergency service of "Juan Manuel Marquez" pediatric hospital and participated in performing lumbar punctures in children from February to May 2015, according to the performing variables, the child´s age, the position of the patient, the participants, the technique used and the results obtained.
Results: lumbar puncture was more frequently performed by specialists, mainly in under one-year old children (56.2 %), the predominant position for this procedure was seated (82.3 %). Lumbar puncture is useful for diagnosis in 89.9 % of patients. In one-third of the cases, no previous consent was required from relatives or tutors and just 33 % of undergraduate students were involved in the procedure.
Conclusions: the lumbar puncture technique is often performed by specialists in nursing infants and by residents when infant is over one year of age, in sitting position, with adequate use of TROCAR and good immobilization in most of cases. The request of consent to perform the lumbar puncture and the participation of undergraduate students as a form of education at work are unsatisfactory.


REFERENCES

  1. Cortes MC, Herrera P, Retamal JM, Molina JC. Incidencia y factores relacionados a punción lumbar traumática en un hospital pediátrico docente asistencial. Rev Ped Electrónica [serie en Internet]. 2007 [citado 22 de abril 2016];4(3). Disponible en: http://www.revistapediatria.cl/vol4num3/3.html

  2. Mazor SS, McNulty JE, Roosevelt GE. Interpretation of traumatic lumbar punctures: Who can go home? Pediatrics. 2003;111(3):525-7.

  3. Hon-Ping M, Yun-Fei H, Shin-Han T, Ju-chi O. Predictions of the length of lumbar puncture needles. Computational and Mathematical Methods in Medicine [serie en Internet]. 2014(2014): Article ID 732694 [citado 13 de octubre de 2015]. Disponible en: http://www.hindawi.com/journals/cmmm/2014/732694/

  4. Ghasemi A, Gharavi Fard M, Sabzevari AR. General Anesthesia for Lumbar Puncture and Bone Marrow Aspiration/Biopsy in Children with Cancer. Iranian Journal of Pediatric Hematology Oncology. 2013;3(2):54-8.

  5. Patel PB, Anderson HE, Keenly LD, Vinson DR. Informed Consent Documentation for Lumbar Puncture in the Emergency Department. Western Journal of Emergency Medicine. 2014;15(3):318-24.

  6. Nigrovic L, Kuppermann N, Neuman M. Risk factors for traumatic or unsuccessful lumbar punctures in children. Ann Emerg Med. 2007;49:762-71.

  7. Lammers RL, Temple KJ, Wagner MJ, Ray D. Competence of new emergency medicine residents in the performance of lumbar punctures. Academic Emergency Medicine. 2005;12:622-8.

  8. In-Ho J, Jung-Kil L, Kyung-Sub M, Hyoung-Jun K, Sung-Pil J, Tae-Sun K, et al. Iatrogenic intraspinalepidermoid tumor: Case Report. Pediatr Neurosurg. 2006;42:395-8.

  9. Hatzipantelis E, Kyriakidis I, Pavlou E, Pavlidou E, Stamou M, Foroglou N, et al. Lumbar puncture complicated by spinal epidural hematoma in a child with leukemia. Clinical Case Reports. 2015;3(6):388-91.

  10. Apiliogullari S, Duman A, Gok F, Akillioglu I. Spinal needle design and size affect the incidence of postdural puncture headache in children. Pediatric Anesthesia. 2010;20:177-82.

  11. Calthorpe N. The history of spinal needles: getting to the point. Anaesthesia. 2004;59:1231-41.

  12. Sempere AP, Berenguer-Ruiz L, Lezcano-Rodas M, Mira-Berenguer F, Waez M. Punción lumbar: indicaciones, contraindicaciones, complicaciones y técnica de realización. Rev Neurol. 2007;45(7):433-6.

  13. Farley A, McLafferty E. Lumbar puncture. Nursing Standard. 2008;22:46-8.

  14. Claro MC, Podestá MC, Rosales A, Fernández Barbieri MA, Méndez T, Gómez A. Sedación y analgesia en los procedimientos diagnósticos y terapéuticos en el paciente pediátrico. Arch Argent Pediatr. 2006;104(6):512-9.

  15. Birnie KA, Noel M, Parker JA, Chambers CT, Uman LS, Kisely SR, et al. Systematic Review and Meta-Analysis of Distraction and Hypnosis for Needle-Related Pain and Distress in Children and Adolescents. Journal of Pediatric Psychology. 2014;39(8):783-808.

  16. Bradford K, Kost S, Selbst SM, Renwick AE, Pratt A. Family member presence for p rocedures: The resident's perspective. Ambulatory Pediatrics. 2005;5:294-7.

  17. Bernadá M, Más M, Vázquez M. Presencia de los padres en procedimientos médicos invasivos realizados a sus hijos. Opinión de profesionales uruguayos de la salud. Arch Pediatr Urug. 2013;84(3):193-204.

  18. Martínez Moreno C, Cordro Castro M, Palacios Cuesta A, Blázquez Gamero D, Marín Ferrer MM. Presencia de los familiares durante la realización de procedimientos invasivos. Anales de Pediatría. 2012;77(1):28-36.

  19. Gamell Fulla A, Corniero Alonso P, Parra Cotanda C, Trenchs Sainz De La Maza V, Luaces Cubells C. ¿Están presentes los padres durante los procedimientos invasivos? Estudio en 32 hospitales de España. Anales de Pediatría. 2010;72(4):243-9.




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