Page 38 - Radiology Book

myelogram / lumbar Puncture Protocol continued
head down 10 degrees while the patient is still prone. Roll the patient into a lateral decubitus position for 20 seconds to allow the contrast to run out of the sacral area.
VI. Myelogram Images
1. AP prone table at. This gets the upper lumbar canal and sometimes the conus medullaris.
2. Right AND left obliques. If the patient has surgical hardware you should also obtain steep obliques.
3. Lateral prone overhead views.
You may now move the patient to the stretcher to go to CT or recovery (for LP). Have the patient sit up with the HEAD OF BED UP 30-40 degrees to minimize the intracranial concentration of contrast.
FINISHING UP
Write a Procedure Note and Post-Myelogram orders.
Orders:
1. Bed rest 4 hrs (Discretion of Attending) with head of bed up 30 degrees.
2. Bathroom privileges with attendant.
3. Encourage p.o. uids and regular diet.
4. Pain reliever of choice PRN headache.
5. Discharge after 3-4 hrs (If outpatient).
6. No Phenothiazines.
7. You must read both the myelogram and CT portion of the
examination with an attending.
Southfield16
LP ProtocoL