![Page 1: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/1.jpg)
Lumbar Puncture Steps on Scientific
Trainer
Dr Sanjoy Sanyal MBBS, MS (Surgery), MSc (Royal College of Surgeons of Edinburgh),
ADPHAProfessor and Course Director of Neuroscience – FCM-III Neurology
Watch video here: http://www.slideshare.net/sanyalsanjoy8/demonstrating-lumbar-puncture-steps-on-gaumard-trainer-sanjoy-sanyal
![Page 2: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/2.jpg)
L4 Spinous Process (Sitting
Position)Palpate L4 Spinous Process with both Thumbs while feeling both Iliac Crests with Other Fingers of both Hands
![Page 3: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/3.jpg)
L4 Spinous Process (Left
Lateral Position)
L4 Spinous Process is on the Supracristal Plane (Line joining highest points of both Iliac Crests)
Head End
![Page 4: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/4.jpg)
Skin PrepChorohexidin
e Gluconate
with Alcohol
or Povidone-
Iodine 10%
and / or
Alcohol
(Isopropyl or
Ethanol)
Povidone-
Iodine is not
used in this
trainer
because it
will stain the
trainerHead End
![Page 5: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/5.jpg)
Sterile
Drape
Sterile drape with an opening centered
over L3-L4 Interspinous Space is placed
over patient
Head End
![Page 6: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/6.jpg)
Local Anesthesi
a0.5 or 1% Lignocaine is
infiltrated subcutaneously at
the LP site
Head End
![Page 7: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/7.jpg)
Manometer Assembly
Manometer (Vertical Tube) is attached to the 3-way Stop-cock, for use after inserting the LP Needle
Head End
![Page 8: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/8.jpg)
LP Needle
Placement
26-Gauge Tuohy LP Needle with Stylet inside is advanced through L3-4 Inter-spinous Space
Head End
![Page 9: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/9.jpg)
Assess Placement
Periodically remove Stylet to
assess placement (CSF should
drip out)
Head End
![Page 10: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/10.jpg)
Confirm Placement
CSF dripping out confirms Needle Placement in Lumbar Cistern Subarachnoid Space
Head End
![Page 11: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/11.jpg)
Manometer
Attachment
Manometer Assembly (with 3-way Stop-cock) is attached to Hub of Tuohy LP Needle
Head End
![Page 12: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/12.jpg)
ICP Measuring
Intracranial Pressure can be read off from the level of CSF on the vertical tube (in Millimeters of Water)
Head End
![Page 13: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/13.jpg)
CSF Collection
Turn the lever of 3-way Stop-cock
to collect CSF in a Test Tube for
analysis
Head End
![Page 14: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/14.jpg)
Needle Removal
Remove Tuohy LP Needle by applying a counter-pressure on skin with left hand, using a Gauze
Head End
![Page 15: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/15.jpg)
Sterile Dressing
Apply a dressing over LP site using
a sterile gauze or Tincture-Benzoin
seal
Head End
![Page 16: Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal](https://reader033.vdocuments.mx/reader033/viewer/2022061201/547a382bb37959652b8b4925/html5/thumbnails/16.jpg)
Acknowledgement The Gaumard Scientific trainer is in routine use in our medical institution
Special thanks are being extended to Gaumard Scientific and its Vice President John Eggert for permission to use the pictures in this presentation.