Lumbar puncture

You undertake the lumbar puncture in the intensive care unit. He is now fully ventilated and sedated.

You prepare with full aseptic precautions and site the needle in the CSF space. Clear fluid begins to flow rapidly from the spinal needle.

While this is happening, his nurse notes that he is becoming bradycardic. You complete the procedure and remove the needle.

When re-examining him shortly after, the intensive care team note that both of his pupils are fixed and dilated. He is rescanned and this shows that he has coned.

Later he his brainstem function is tested, but none is seen. He is removed from the ventilator and dies peacefully.