U/S can be used to ID interspaces in obese patients increasing your accuracy as much as 2.3 times
Aim lower than L4-L5 and no higher in pediatric patients as the conus medullaris ends at L3 at birth
Tuffier's line, L5/S1 at iliac crests in the pediatric patient
Patient on side: able to measure opening pressure
Patient sitting: helpful for difficult habitus, but must move patient to measure opening pressure
3.5 in atraumatic 22ga needle is ideal
A 2018 meta analysis showed atraumatic needles had a lower incidence of post-LP headache and need for blood patch when compared to sharp needles
Needle >20ga almost doubles incidence of post-LP headache
Lumbar puncture
Ventriculoperitoneal shunt drainage
CT brain interpretation
NIH Stroke Scale
Therapeutic hypothermia
Modified Rankin Scale
Brain MRI
Awake intubation