Positioning for Lumbar Puncture in Infants
Experience obtained from continuous blood gas monitoring indicates that hypoxemia in sick newborn infants frequently occurs as a result of handling. Such activities range from seemingly harmless maneuvers such as changing diapers or excessive noise in the nursery, to invasive procedures such as injections, chest physiotherapy, airway suctioning, and lumbar puncture (LP). Obviously, a "hands-off" policy that might seem prudent to avoid repeated hypoxemia in such patients is not consistent with their intensive care needs. When a lumbar puncture is needed, it should be done in the least compromising way.
The optimal position for this procedure was investigated. Three positions were studied: (1) lateral recumbent with full flexion of the neck (flexed position), (2) lateral recumbent with partial extension of the neck (extended position), (3) sitting position.
