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Dr Sanjoy Sanyal MBBS, MS (Surgery), MSc
(Royal College of Surgeons of Edinburgh),
ADPHA
Professor 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
Palpate L4
Spinous Process
with both
Thumbs while
feeling both Iliac
Crests with Other
Fingers of both
Hands
L4 Spinous Process is on
the Supracristal Plane (Line
joining highest points of
both Iliac Crests)
Head End
Chorohexidine
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 trainer
Head End
Sterile drape with an opening centered over L3-
L4 Interspinous Space is placed over patient
Head
End
0.5 or 1% Lignocaine is infiltrated
subcutaneously at the LP site
Head
End
Manometer (Vertical Tube) is
attached to the 3-way Stop-cock, for
use after inserting the LP Needle
Head
End
26-Gauge Tuohy LP Needle with Stylet
inside is advanced through L3-4 Inter-
spinous Space
Head
End
Periodically remove Stylet to assess
placement (CSF should drip out)
Head
End
CSF dripping out confirms Needle
Placement in Lumbar Cistern
Subarachnoid Space
Head
End
Manometer Assembly (with 3-
way Stop-cock) is attached to
Hub of Tuohy LP Needle
Head
End
Intracranial Pressure can be read off
from the level of CSF on the vertical
tube (in Millimeters of Water)
Head
End
Turn the lever of 3-way Stop-cock to
collect CSF in a Test Tube for analysis
Head
End
Remove Tuohy LP Needle by applying a
counter-pressure on skin with left hand,
using a Gauze
Head
End
Apply a dressing over LP site using a
sterile gauze or Tincture-Benzoin seal
Head
End
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.

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Demonstrating Lumbar Puncture Steps On Gaumard Trainer - Sanjoy Sanyal

  • 1. Dr Sanjoy Sanyal MBBS, MS (Surgery), MSc (Royal College of Surgeons of Edinburgh), ADPHA Professor 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
  • 2. Palpate L4 Spinous Process with both Thumbs while feeling both Iliac Crests with Other Fingers of both Hands
  • 3. L4 Spinous Process is on the Supracristal Plane (Line joining highest points of both Iliac Crests) Head End
  • 4. Chorohexidine 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 trainer Head End
  • 5. Sterile drape with an opening centered over L3- L4 Interspinous Space is placed over patient Head End
  • 6. 0.5 or 1% Lignocaine is infiltrated subcutaneously at the LP site Head End
  • 7. Manometer (Vertical Tube) is attached to the 3-way Stop-cock, for use after inserting the LP Needle Head End
  • 8. 26-Gauge Tuohy LP Needle with Stylet inside is advanced through L3-4 Inter- spinous Space Head End
  • 9. Periodically remove Stylet to assess placement (CSF should drip out) Head End
  • 10. CSF dripping out confirms Needle Placement in Lumbar Cistern Subarachnoid Space Head End
  • 11. Manometer Assembly (with 3- way Stop-cock) is attached to Hub of Tuohy LP Needle Head End
  • 12. Intracranial Pressure can be read off from the level of CSF on the vertical tube (in Millimeters of Water) Head End
  • 13. Turn the lever of 3-way Stop-cock to collect CSF in a Test Tube for analysis Head End
  • 14. Remove Tuohy LP Needle by applying a counter-pressure on skin with left hand, using a Gauze Head End
  • 15. Apply a dressing over LP site using a sterile gauze or Tincture-Benzoin seal Head End
  • 16. 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.