Revised national guidelines for analysis of cerebrospinal. This guide gives the correlation between 49 of the nist csf subcategories, and applicable policy and standard templates. Guide to laboratory services laboratory procedure collection and handling of cerebrospinal fluid csf specimens document number. Upon reaching the subarachnoid space, remove the stylet and collect 12 ml of fluid into each of 3 sterile csf. Results a total of 79 patients underwent csf analysis. Cerebrospinal fluid analysis in the dog and cat veterinary.
Csf from the plastic tubing connected to the needle can be retained in the last tube. Cerebrospinal fluid csf analysis procedure, test, blood, tube. Glucose estimation in csf csf is a fluid that flows through and protects the subarachnoid space of the brain and spinal cord. If 34 ml csf is available, use 3 separate tubes and place approximately 1ml into each tube.
Analysis of the cerebrospinal fluid generally includes a cell count and determination of the glucose and protein concentrations. Csf protein electrophoresis separates different types of protein. In the published literature, great variability exists in the rate of csfrelated complications and morbidity. We now propose revised guidelines for the specimen requirements, transport, handling and analysis of csf and interpretation in suspected sah with a negative. For this reason, analysis of csf should include a differential cell count if the total wbc count is elevated 520 wbcl in children and adults or 30 wbcl in infants aged less than 1 year. Peripheral blood in the csf after a traumatic tap will result in an artificial increase in wbcs by one wbc for every 500 to 1,000 rbcs in the csf. Your cerebrospinal fluid will be collected through a procedure called a spinal tap, also known as a lumbar puncture.
Lumbar puncture is frequently performed in primary care. It supplies nutrients to the tissues of the central nervous system and helps to protect the brain and spinal cord from injury. Cerebrospinal fluid analysis in infectious diseases of the. Cerebrospinal fluid results csf interpretation other. Lumbar puncture lp, also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid csf for diagnostic testing. You can asses this ppt for your routine laboratory work. The cerebrospinal fluid csf is a dynamic, metabolically active substance that has many important functions. A 22 or 20gauge larger patients spinal needle is used to collect csf by allowing it to drip from a needle into a sterile tube without anticoagulant.
Csf analysis includes tests in clinical chemistry, hematology, immunology, and microbiology. Analytical phase, csf analysis, and acceptance criteria csf and controls calibrators in phosphatebuffered solution were analyzed in duplicate in one. Procedures represent an established way of doing something, such as a series of actions conducted in a specified order or manner. Jan 31, 2018 the examination of cerebrospinal fluid csf is crucial for the diagnosis of bacterial meningitis, which causes significant morbidity and mortality in infants. Measuring the opening pressure of csf in idiopathic intracranial hypertension and at spinal tap in normal pressure hydrocephalus constitute diagnostic examination procedures with therapeutic benefits.
Cerebrospinal fluid csf is a clear, watery liquid that flows around the brain and spinal cord, surrounding and protecting them. You can watch how to process a csf sample in microbiological laboratory. Csf examination with quantification of leukocytes and differential count of cellular subsets in the cerebrospinal fluid is a standard procedure in cases of suspected infectious conditions. Csf is withdrawn by spinal tap lumbar puncture which is a process involving. Moreover, the differential cell count should be performed on a concentrated, stained specimen rather than. A sample of cerebrospinal fluid csf is collected by a doctor from the lower back using a procedure called a lumbar puncture or spinal tap see common questions. Procedure documentation is meant to provide evidence of due diligence that standards are complied with.
The main reason for a lumbar puncture is to help diagnose diseases of the central nervous system, including the brain and spine. Procedure one drop of csf sample collected from the patient by lumbar puncture technique, is added to about 1ml of pandys solution. Pdf cerebrospinal fluid csf is a clear fluid circulating in the intracranial and spinal compartments. Laboratory name standard operating procedure sop version. Cerebrospinal fluid csf analysis very frequently makes the difference to the diagnosis, not only in relation to infections but also in other diseases of the nervous system such as inflammatory, demyelinating, neoplastic and degenerative diseases. May 01, 2008 evidence clearly indicates that visual inspection is not a reliable method. Framework for improving critical infrastructure cybersecurity. Results of the csf analyses were compared after calibration against a nondetergent or detergentcontaining calibrator series.
Properly interpreted tests can make cerebrospinal fluid csf a key tool in the diagnosis of a variety of diseases. Ios press optimized standard operating procedures for the. Often, three or more separate tubes of csf are collected and multiple tests may be run on the different samples. In this video you can watch the csf culture technique in microbiology. Pdf cerebrospinal fluid composition modifications after. Collection and transport of csf the collection of csf is an invasive procedure and should only be performed by experienced personnel under aseptic conditions. Cerebrospinal fluid csf interpretation geeky medics. Recommendations most important 35 recommendations on a glimpse. S1 guidelines lumbar puncture and cerebrospinal fluid. Analysis is the investigation of consequences of the internal processes of the association. Cerebrospinal fluid analysis american family physician.
Csf glucose is little lower than that of plasma and is usually 6070% of plasma relative comparison has to be done with blood glucose low csf glucose can be of considerable diagnostics value in determining the causative agents in meningitis. Resuspend the csf to a final volume of 2 ml with xpert mtbrif sample reagent. The common practice is to put 3 ml of csf in each of the first three tubes and to put 5 ml of csf in the last tube. Discuss techniques used to concentrate cerebrospinal fluid csf specimens for a differential cell count.
Policies and procedures prior assessment reports auditing and monitoring records and logs observable practices management system owners key stakeholders detailed configuration settings vulnerability scans penetration tests noncompliant csf controls analysis of results step 8. Cerebrospinal fluid csf is the fluid that is produced in the choroid plexuses of the ventricles of the brain. Provides introductory information on risk management frameworks rmfs and the hitrust rmf, briefly describes csf assessments and the csf control structure, presents the hitrust maturity model used to evaluate control effectiveness along with several explanatory examples. Properly interpreted tests can make cerebrospinal fluid csf a key tool in the diagnosis. Cerebrospinal fluid csf analysis is a classic tool for diagnosing infectious diseases of the nervous system ns. Csf analysis the purpose of csf analysis is to investigate certain conditions such as. Csf is collected by lumbar puncture between third, fourth, fifth. Any suspected case with macroscopic aspect of cerebrospinal fluid csf. Csf is withdrawn from the subarachnoid space through a needle by a procedure called a lumbar puncture or spinal tap. Insert needle with stylet at l3l4, l4l5, or l5s1 interspace. It is a routine practice to collect three 3 sterile tubes of csf 15 ml per tube for analysis. If bacterial meningitis is suspected, csf is the best clinical specimen to use for isolation, identification, and. There sometimes is discussion about compliance with the framework, and the framework has utility as a. With a standard diagnostic lp, csf is collected in four tubes, for a total volume of 815 ml.
Pdf cerebrospinal fluid csf analysis and interpretation in. Via the collaboration, planners ensure that key managers and users upkeep the procedure and. This correction factor is accurate as long as the peripheral wbc count is not extremely high or low. Csf is withdrawn from the subarachnoid space through a needle by a procedure called a. Accurate reference ranges are required to facilitate the interpretation of csf laboratory values, including white blood cell wbc counts and protein and glucose concentrations. Haematology cerebrospinal fluid analysis laboratory. A csf analysis is a group of tests that evaluate substances in csf in order to diagnose conditions affecting the brain and spinal cord central nervous system. While csf analysis sometimes identifies specific etiologic agents or neoplastic cells, csf analysis alone often does not provide a definitive diagnosis of neurologic disease. Mar 01, 2018 nearly every section of the laboratory can be involved in the evaluation of cerebrospinal. With the cybersecurity standardized operating procedures csop, it is important to understand a few key terms. The threetube method, commonly used to rule out a central nervous system hemorrhage after a traumatic tap, is not completely reliable. Cerebrospinal fluid examination lab tests online au. A nist subcategory is represented by text, such as id. Indications for csf analysis bacterial, viral, fungal cns infections sah demyelinating degenerative disorders primary and metastatic tumors of cns and meningitis carcinomatosa pressure recordings pseudotumor cerebri, nph, head injury suspected cerebral abscess, hemorrhagic infarctions access for neuroradiologic procedures.
This risk analysis guide for hitrust organizations and assessors. It is invaluable as a diagnostic aid in the evaluation of inflammatory conditions, infectious or non. Only l of csf sample per test tnc and rbc reagents stain total nucleated and red blood cells assay sample preparation tray organizes the csf analysis workflow to help operators work more efficiently low and high level controls ensure optimal system. Sep 15, 2003 lumbar puncture is frequently performed in primary care. Lumbar puncture procedure and csf analysis medcrine. Nov 03, 2020 cerebrospinal fluid csf is a clear, colorless body fluid found in the brain and spinal cord. Cerebrospinal fluid csf is collected in aliquots of 1 ml to 4 ml in 3 or sometimes 4 sterile tubes which are labeled 1, 2, 3, and 4 in the order they are collected. To access memberexclusive content on our website, you must login.
Examples of these conditions include meningitis and subarachnoid. Sep 23, 2018 cerebrospinal fluid csf processing in medical laboratory 11 12. Cerebrospinal fluid csf analysis is a common procedure in the diagnosis of central nervous system cns disease. Lumbar puncture lp is one of the wellknown ancillary procedures in clinical neurology. Cerebrospinal fluid volume in adults 120180 ml volume in small babies 4060 ml daily production 430580 ml hypooncotic, isoosmolarfluid. Laboratory tests that may be performed on csf include, but are not limited to, macroscopic evaluation, microscopic evaluation of cell count and type, chemical analysis, microbiology cultures, and immunologic and molecular analyses. It assists planners to attain a better understanding of the organizations present processes and procedures. Infections such as meningitis or other bacterial, viral or parasitic infections. Upon reaching the subarachnoid space, remove the stylet and collect 12 ml of fluid into each of 3 sterile csf tubes. Cerebrospinal fluid csf analysis procedure, test, blood. Standard operating procedure sop specimen processing of csf, lymph nodes code. Once all of the csf is collected, the stylet is then reinserted before removal of the needle. Cerebrospinal fluid csf csf is a dynamic, metabolically active body fluid. The other analytical studies of cerebrospinal fluid are conducted according to the diagnostic suspicion.
Critical success factors csfs in strategic planning for. The turbid appearance signifies the presence of elevated levels of globulin protein in the csf and is regarded as positive pandys reaction. The main diseases that can be diagnosed among ns infectious diseases are acute meningitis, acute meningoencephali tis and chronic meningitis. Cerebrospinalfluid csf drainage is recommended by current guidelines for spinal protection during open and endovascular repairs of thoracic and thoracoabdominal aortic aneurysms. Standard operating procedures for surveillance of meningitis. Cerebrospinal fluid reference values for young infants. Inflammation or autoimmune disorders such as multiple sclerosis.
Csf is withdrawn by spinal tap lumbar puncture which is a process involving aseptic insertion of a long. One millilitre of csf per 5 kg body weight can be safely removed at once in most patients, but the sample of 11,5 ml is enough for a complete analysis. Outer most membrane dura mater center membrane arachnoid mater spiderweb like inner membrane pia mater csf between pia and arachnoid maters subarachnoid space. Add 2ml of the sample mixture directly to the xpert mtbrif cartridge 3. Discard the needle in a punctureresistant, autoclavable discard container. Its obtained by lumbar puncture, l 3l 4 in csf, glucose is estimation by god pod method. Compared to plasma, csf has a lower concentration of glucose, protein, and. Guidelines on routine cerebrospinal fluid analysis. Frameworks five functions to analyze its entire risk management portfolio. Proper evaluation of csf depends on knowing which tests to order, normal ranges for the patients age, and the tests limitatio. Csf produced by ventricular capillary blood vessels choroid plexuses csf absorbed by arachnoid villi csf is a selective ultrafiltrate.
Lumbar puncture procedure and csf analysis lumbar puncture is a procedure that is often performed to obtain information about the cerebrospinal fluid. Pdf lumbar puncture is frequently performed in primary care. Automated cerebrospinal fluid cell counts using the sysmex xe. Jan 16, 2019 cerebrospinal fluid csf is a clear and colorless fluid that surrounds the brain and spinal cord with a density ranging from 1. Csf analysis chemical examination glucose glucose enters csf by active transport across blood brain barrier. Withdraw the needle and cover the insertion site with an adhesive bandage. Pdf cerebrospinal fluid csf analysis and interpretation. Define criticality analysis procedure s where the organization develops or adopts a set of procedures for performing a criticality analysis. This represents the nist function of identify and the category of asset management.
1034 223 1020 1268 1841 1330 1643 1146 153 1040 1828 403 1692 3 840 442 893 254 1106 1194 128 352 549 410 1861 1219 1709 1761 1464 1140 1331 40 1825 1144 1708