How to do a lumbar puncture

Master the lumbar puncture to help you diagnose a brain bleed or infection in an emergency situation.

Siamak Moayedi, MD
Siamak Moayedi, MD
7th Nov 2018 • 2m read

In this video, from our Emergency Procedures Masterclass (Part I) course, we'll simplify the lumbar puncture procedure and explain it in full. Master this procedure to help you diagnose a brain bleed or infection in an emergency situation!

Join our Emergency Procedures Masterclass (Part 1) course today!

Perform emergency procedures like a pro! With our Emergency Procedures Masterclass (Part I) course, you'll get the lowdown on the tools involved in each treatment or diagnostic procedure, when and how to perform them, and how to anticipate and minimize complications.

Become a great clinician with our video courses and workshops

Video Transcript

[00:00:00] Here's a video demonstrating the lumbar puncture procedure, starting from the point where the skin has already been anesthetized. We're going to indent the skin with the back of a needle cap and use the small needle to anesthetize the skin. Now, this is a mannequin so you won't be able to see the blood and you can't see the weal. We're going to change the needle to the longer needle

[00:00:30] to anesthetize the deeper tissues. Spinal needle is introduced with a slight angle aimed towards the patient's belly button. And once you feel a little pop right there, you're going to take out the stylet and see if there's flow of CSF, it sure is. So, we're going to put the stylet back in

[00:01:00] and get the manometer ready. The dial of the manometer is closed towards you so that the fluid will come through the needle and go up, up, up. At this point, I have seen what the opening pressure is so I'm going to turn the dial towards the patient and the CSF will flow down into the tube.

[00:01:30] Now, I've chosen to just take the whole manometer off and collect 1 cc in each of the tubes. There's a total of four tubes, 1 cc for each tube. What you see is,

[00:02:00] with one hand, I fill the tube and with the other, I close the cap. It's okay if some of it drips, like I drip there. Before taking the LP needle out, we're going to put the stylet back in to decrease the chances of a post-LP headache. I'm going to take the needle out and put our bandage on. Here, we have completed

[00:02:30] our lumbar puncture.