The Lumbar Puncture

E.g. chlorhexidine or povidone-iodine

E.g. large dressing pack

With stylet

Use an atraumatic needle where possible

3-way tap, spinal manometer

1% Lignocaine in a 5mL syringe with long needle

Sterile impermeable adhesive dressing

Sharps container

Test request form, patient labels

L3/L4, L4/L5, L5/S1

Using the marking pen

Place everything in the order it will be used

Decontaminate with chlorhexidine or povidone-iodine

To ensure maximum flexion of the lumbar spine

Maintaining sterile conditions

Make a small wheal over the insertion site

Slowly, with bevel up and facing slightly superiorly

A ‘pop' may be felt on entry to the dura

Look for CSF drainage

Drain three 2mL  samples into specimen containers

Dispose of sharps and other waste

Label the collection tubes and send to the lab

Check local guidelines for bed rest post LP

Blood-stained, insufficient volume

Around site or into the subarachnoid space

Meningitis, abscess