VENTRICULAR TAPPING

INTRODUCTION:
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the
brain and the spine from injury.

the fluid is normally clear

the test is also used to measure pressure in the spinal fluid.

Neurological diagnostic procedures are performed in a variety of settings

including the radiology department, special procedure areas and patient care
unit

VENTRICULAR TAPPING is mainly to diagnose the infection of ventricles.

VENTRICULAR TAPPING- is the insertion of the needle into tha lateral ventricle. In
infants no. 22 needle with a stylet is introduced through the sclap into the
anterior fontanelle.
INDICATIONS: Ventricular tapping is indicated to:

Drain CSF in Non-communicating Hydrocephalus

Diagnose Ventriculitis

Administer intraventricular drugs

A VENT. TAP is performed by medical staff deemed competent in the

procedure and is a sterile aseptic procedure.
PRIOR to Vent. Tap., an Ultrasound should be performed to confirm
"VENTRICULOMEGALLY" and measurements taken to confirm the depth and
direction of needle insertion.

PROCEDURE:
1. PRE PROCEDURE CARE

a. UTZ or CAT Scan study before the procedure.

b. Obtain informed written consent
c. Preparation of the area shave at least 5cm lateral and posterior to the
anterior fontanel and anteriorly up to the forehead.

d. Monitor the baseline vitals signs and record it.

e. sedation if necessary.
f. Assemble all the articles.
A.

A sterile tray containing:

1. Specimen bottle
2. Needle (g.22 or 23)
3. Syringe 5 ml
4. Kidney tray
5. Slit towel
6. Sponge holding forcep
7. thumb forcep
8. 2 bowl

B.

A clean tray containing

1. bottle with transfer forcep
2. Bottle with betadine
3. bottle with spirit
4. bottle with tincture benzoine
5. shaving set

C.

A sterile pack containing

1. gown
2. glove
3. towel

TECHNIQUE:
1. Position the infant supine with the top of the infants head facing
toward the operator
2. insert the spinal needle into the lateral ventricle of the fontanelle
and advance it toward the inner angle of the IPSILATERAL eye.
The needle should be inserted smoothly without change of direction to
minimize trauma to the brain.

3. once the ventricle has been penetrated, the stylet is removed and
the CSF should drip out rather than be aspirated.
4. once the required amount of CSF is obtained, the needle should be
removed and pressure applied to the area.
5. Wash off CHLORHEXIDINE when the procedure is completed.
6. Apply tincture benzoine seal over the punctured site.
7. Apply pressure dressing
8. The infants tolerance of the procedure should be noted in the infants
progress notes.

2. POST PROCEDURE CARE:

a. Watch the child closely

b. monitor the signs of collapse
c. monitor the vital signs
d. Place the child with head end elevated or can allow the child to
sit for sometime

COMPLICATIONS:
1. Fever
2. Haemmorhage
3. Infection
4. Leaking of CSF

CONCLUSION:
Patient who is undergoing ventricular tapping need a general
explanation of the procedure with special emphasis on what to
expect.
The patient or caregiver support is needed on conducting the
procedure.

BIBLIOGRAPHY:

1. Prajapathi B. Essential procedures on Pediatrics. Jaypee

bbrothers; NewDelhi:2003
2.
http://www.wnhs.health.wa.gov.au/services/nccu/guidelines/docume
nts/7380
3. http://www.nlm.nih.gov/medlineplus/article/003428.htm
Prepared by:
MARIA VICTORIA C. SANGGOY, RN
RN 3- STAFF NURSE