Preparation of a Lumbar Puncture

Patient Position

Lateral recumbent position

A lumbar puncture (LP) can be performed with the patient in the lateral recumbent position or sitting upright. The lateral recumbent position is preferred because it allows accurate measurement of the opening pressure. The patient shown in the photo here is in the left lateral recumbent position.

Positioning of the patient is crucial to the success in performing a LP. The patient is instructed to adopt a “fetal position” where the back, limbs and neck are in flexion. The back should be perfectly perpendicular to the edge of the bed.

Equipment Required

The photo shown above demonstrates the equipment which are required for performing a LP. These include: a sterile biopsy and tapping set, sterile gloves, disinfectant (such as ethanol 70% and betadine solution), spinal needles and syringes, sterile specimen container specific for cerebrospinal fluid (CSF), a manometer for measuring the CSF opening pressure and dressing materials.

In this photo, the sterile biopsy and tapping kit is laid out and the contents within displayed. Other items required to perform the LP are also displayed.