What is an SA drain?

Closed subarachnoid drainage, when properly performed and monitored, is a reasonably effective and safe method for treating dural-cutaneous cerebrospinal-fluid leaks after a spinal operation. It may be considered as a non-operative alternative to the standard procedure of reoperation and direct repair of the dura.

How do you manage a lumbar drain?

Be sure to maintain the drain at the proper level, keeping the patient’s head, neck, and back in a neutral position. Keep the drain insertion site clean and dry; cover it with an occlusive dressing. A transparent dressing allows better assessment of the insertion site.

How long do lumbar drains stay in?

The drain remains in place for 2 to 3 days. Even if you did not respond to a single large volume tap, this extended drainage may indicate that you could respond to a shunt.

Can you lay on your back with a lumbar drain?

The drain often remains in place for up to 7 days. A healthcare provider checks on you often while your drain is unclamped to be sure there are no problems. While the drain is in place and open, you lie on your back or side. Let your nurse know if you’re uncomfortable and need to change positions.

Is a lumbar drain painful?

When the drain is taken out, it should not cause any discomfort. A dressing will be placed over the site. Your nurse will check it for drainage and infection. What are the risks of a lumbar drain?

Where do you zero a lumbar drain?

Figure 1.01: Lumbar ICP/CSF pressure is zeroed to the iliac crest. The panel (left) must be positioned in an upright position, with the “0” reference point (E) at the level of the patient’s catheter.

Where should a lumbar drain be leveled?

The catheter is placed below the level of the termination of the cord (L2-L3 or below) and within the CSF. The catheter is taped securely to the skin to prevent dislodgement, and connected to a manometer, which should be set at 10cm/H20, measured from the lumbar drain insertion site.

What are two biggest risks of lumbar drains?

Major complications included spinal hematoma with paraplegia in 1 patient, intracranial hemorrhage in 2, meningitis in 2, arachnoiditis in 3, CSF leak requiring a blood patch in 3, bloody tap delaying the operation in 1, and a retained catheter tip in 1 patient.

When is a lumbar drain needed?

A lumbar drain is often needed to collect CSF from the spine after surgery or to reduce pressure in the spinal cord or brain. Too much pressure in the spinal cord can slow blood flow to the area and can lead to confusion and trouble thinking, pain, weakness, and even paralysis.

How do you remove fluid from your spine?

A lumbar puncture (spinal tap) is performed in your lower back, in the lumbar region. During a lumbar puncture, a needle is inserted between two lumbar bones (vertebrae) to remove a sample of cerebrospinal fluid. This is the fluid that surrounds your brain and spinal cord to protect them from injury.