Page 202 - pathology_services_handbook_5th_edition_2018

2.2 Cerebrospinal Fluid (CSF)

HTAA, KUANTAN A. Lumbar puncture

1. Position the patient.
2. Procedure should be done under aseptic technique.
3. Disinfect site with 2% chlorhexidine in 70% alcohol.
4. Insert needle with a stylet at L3-L4, L4-L5 or L5-S1 interspace. Upon reaching
the subarachnoid space, remove the stylet and collect 1-2 mls of fluid into each
sterile containers for examination of:
• CSF C&S
• FEME
• Latex Bacterial Antigen /India ink
• AFB
• TB culture
5. The specimen should be sent immediately within 1 hour and handed personally
to bacteriology staff (office hours) and staff counter (after office hours/weekend/
public holidays). Do not store in refrigerator.
6. The request form must be attached with QAP/CSF-1 (TURNAROUND TIME (TAT)
MOTION STUDY OF CEREBROSPINAL FLUID-BACTERIAL MENINGITIS).
7. Always send the most turbid specimen for microbiology analysis.

Note: Before starting procedure, it is compulsory to make appointment with
laboratory staff ( Call ext: 2074 (during office hours), ext: 2069 (after office hours /
weekend/public holidays).

B. Ommaya reservoir fluid or ventricular shunt fluid

1. Clean the reservoir site with antiseptic solution and alcohol prior to removal of
fluid to prevent introduction of infection.
2. Remove 1-2 ml of the Ommaya fluid via the Ommaya reservoir unit or by
collection from the ventricular drain or shunt and place into sterile container
for examination of:
• Culture and sensitivitiy.
• FEME.

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