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
Sitting or lateral foetal position
In the midline between iliac crests
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
Attach the three-way tap and manometer
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