Title: US Guided LP Site Marking<br/>
Author: Alexis Salerno<br/>
<a href='mailto:alexis.salerno@som.umaryland.edu'>[Click to email author]</a><hr/>
Link: <a href='https://umem.org/educational_pearls/4476/'>https://umem.org/educational_pearls/4476/</a><hr/><p>Simple tool to help improve your next lumbar puncture: Use ultrasound for site marking.</p>
<p>This can be done in a patient sitting up or laying on their side.</p>
<p>-First start with the probe marker midline towards the patient's head and use the ultrasound to identify the L4/L5 and L3/L4 space.</p>
<p>-Use a surgical pen away from the gel to mark midline on both sides of the probe, using the midline marker on the ultrasound probe. You can use m mode to help you identify the middle of the image when using a curvilinear probe. </p>
<p>-Then rotate the probe towards the patient's left and use the ultrasound to identify the midline point (spinous process)</p>
<p>-Use a surgical pen away from the gel to mark midline on both sides of the probe, using the midline marker on the ultrasound probe.</p>
<p>-Clean off the gel, connect the skin markings and use a 3 cc syringe to mark the center of the crosshair. </p>
<p>-Sterilize and start your LP!</p>
<p><img src="https://umem.org/files/uploads/content/pearls/LP_points-661d75070be6e.jpg" alt="" /></p>