Ventricular Tapping

: Admin : 2022-05-21

Ventricular tapping

Ventricular Tapping is a surgical procedure used to drain CSF (cerebrospinal fluid) in patients suffering from noncommunicating hydrocephalus. It is also used to diagnose ventriculitis and to provide intraventricular medications. Ventricular tapping entails inserting a tube (shunt) into one of the brain's ventricles or into the CSF space in the spine. CSF is transferred from the brain to the peritoneal cavity in the abdomen (Ventriculo-peritoneal tapping), the pleural cavity in the lungs (Ventriculo-pleural tapping), or the right atrium in the heart (Ventriculo-pleural tapping) (Ventriculo-atrial tapping).

A ventricular tap is recommended when:

In noncommunicating hydrocephalus, drain cerebrospinal fluid. Recognize ventriculitis. Administer intraventricular medications. A ventricular tap is a surgical aseptic operation done by medical experts considered competent in the practice. Neurosurgeons are typically the ones that do it. If a newborn needs a ventricular tap, please consult with the neurosurgeons.

An ultrasound should be conducted prior to a ventricular tap to check ventriculomegaly, and measurements should be recorded to validate the depth and direction of needle entry. 

Equipment

• Shave pack / Skin prep as per gestation
• Sterile drapes / Dressing pack
• Lumbar puncture needle (size 22G or 23G)
• Specimen bottles - appropriate bottles for specific tests 

Procedure

Continuous monitoring and resuscitation equipment must be available for the baby. Shave the scalp overlying the lateral angle of the anterior fontanelle with caution to avoid injuring the skin. Using the right solution, clean a large region of the head. Place the newborn on its back, with the top of its head facing the operator. Using the index and thumb of your left hand, Move the skin over the place of entrance so that after the tap is completed and the needle is withdrawn, the skin returns to its original position and the needle track is broken. Insert the spinal needle via the lateral angle of the fontanelle and toward the inner angle of the ipsilateral eye. To avoid brain damage, the needle should be placed smoothly and without changing direction. The stylet is withdrawn after the ventricle has been punctured, and the CSF should trickle out rather than be sucked. After obtaining the requisite volume of CSF, the needle should be withdrawn and pressure given to the region to prevent CSF leaking.

After obtaining the requisite volume of CSF, the needle should be withdrawn and pressure given to the region to prevent CSF leaking. Neonatal Recommendations Allow the area to dry after cleaning it with chlorhexidine.