Lumbar Puncture Procedure Module

Abstract

Abstract This module outlines an approach to teaching the hands-on skills of lumbar puncture using a task-trainer, or simulation model. Lumbar puncture is commonly performed by trainees in internal medicine, family medicine, pediatrics, neurology, and anesthesia. Risks of the procedure include spinal hematoma, radicular pain, and (rarely) compromise of motor function in the lower extremities. Systematic training in the proper lumbar puncture technique may decrease the risk of complications and increase the success rate for trainees performing this procedure. The module is designed as a 1–1.5 hour hands-on session, and includes a role-play component and a template for obtaining informed consent for lumbar puncture. It is appropriate for third- and fourth-year medical students; first-year residents in medicine, neurology, family medicine, emergency medicine and anesthesia; and physician assistant students. The optimal number of learners per each training model is three to four. Ideally, a supervising faculty or upper level resident should be stationed at each model to observe and give feedback to the learners. Common problems encountered during the use of a lumbar puncture task trainer are described. The module includes training in obtaining informed consent, with a templated discussion that provides specific information on the frequency of complications and highlights the use of the teachback method (asking the patient to repeat key information to ensure comprehension). Numerous organizations have called for procedural training using simulation, including the Institute of Medicine, the ACGME, and various specialty societies, making this ideal for medical schools and residencies looking to implement simulation training for lumbar puncture.

Keywords

• Lumbar Puncture
• Spinal Tap
• Procedure
• Methods
• Task Trainer
• LP