Lumbar Puncture

Question 1

Lines to aid with LP placement

Answer 1

Draw a straight line between the iliac crests. This will give you roughly L3-L4

Aim for the umbilicus, with the bevel vertically to avoid cutting as many fibers ( l as opposed to - )

You can go slightly higher, but not too much – the conus medullaris sits around ~L1-L2

Question 2

Does lying flat after LP prevent a spinal headache?

Answer 2

No.

This is a medical myth that has been repeatedly disproven.

Question 3

Risk factors for spinal headache after LP

Answer 3

Age (younger are more likely, < age 50)

Needle type

Needle size

Question 4

Things that help with pain in a post-LP headache

Answer 4

• Lying down
• Caffeine
• IV fluid bolus (1 liter)
• NSAIDs and tylenol
• Bloodpatch