Lumbar puncture

  1. Provide initial anesthesia/analgesia (e.g., lidocaine cream), anxiolysis or sedation as needed
  2. Appropriately position the patient
  3. Identify anatomic landmarks
  4. Inject local anesthetic at correct site
  5. Prepare area and place sterile drape
  6. Insert spinal needle with stylet at an appropriate location and angle
  7. Advance spinal needle until CSF noted in hub of needle
  8. Attach opening pressure device if desired, demonstrate familiarity with equipment
  9. Collect an appropriate amount of CSF
  10. Replace stylet and remove needle
  11. Maintain sterility through procedure