This is known as a spinal tap correct okay so a spinal tap is done you said any baby who shows a blood culture should be getting us finally a positive blood culture is an indication to do a lumbar puncture now in late-onset sepsis we also part of the workup is to get a lumbar puncture and yes just like you see there in the graph we do with under sterile conditions so that we don’t introduce any infection into the spinal fluid so we clean very well with betadine to not introduce any of the bacteria from the skin into the spinal fluid but I have to ask I mean it must be difficult to do this to a child a newborn well in a trained hand it’s it’s probably not it’s a pretty simple procedure because we’re specialized in doing procedures on newborns so we have a very high success rate of getting those samples and we’re trained to do it so it’s it’s it’s not more difficult than adults I would think and then good trained hand okay now do you position the baby a certain way – okay there are two ways just position the babies you could either have the baby sit up or have the baby on this side I personally prefer to have the babies on the side and why is that it’s just it’s easier okay just a preference oh yeah and your we just put the baby’s in the fetal position so that would open up the spaces between the spine bones and then we would feel for the space and introduce a needle there and collect some of the spinal fluid so okay so now we now we’ve got in the fluid now we’ve done the spinal tap what are you determining from what you put in the samples that you got so the most important thing is through a lot meningitis so meningitis is an inflammation of the meninges which are the membranes surrounding the brain so this is a very serious condition and could lead to detrimental serious complications if it is present so whenever we have a positive culture or sick enough baby we have to make sure that there is no meningitis so when we check the sample we send it for different tests and we also send it for a culture okay so if the culture and he’s already on antibiotics okay if the culture is negative then we know that there’s no meningitis you