Lumbar Puncture Step by Step

Abstract This video tutorial presents all aspects of performing the lumbar puncture procedure. Topics covered in the video include: indications and contraindications; risks and complications; preparing, positioning, and interacting with the patient; necessary equipment and supplies; review of relevant anatomy; identifying and finding injection points; proper injection point preparation and injection technique; measuring cerebrospinal fluid (CSF) pressure; proper collecting, handling, sequencing and labeling of CSF samples; administering intrathecal chemotherapy; causes of possible problems; how to prevent problems and deal with those which occur; laboratory tests run on CSF; interpreting test results; and summary and review. The authors are unaware of any other noncommercial video tutorial that reviews the pertinent anatomy by schematic and cadaver demonstration and by step-by-step demonstration of the procedure on a patient. The video is part of the training received by fourth-year medical students and is used for review by interns and residents. Incoming residents to Wake Forest School of Medicine of Wake Forest Baptist Medical Center have completed an anonymous survey that identifies deficiencies in their training. Twenty percent reported they had never attempted the procedure.