Practical Procedural Ultrasound Training by Kung Medics

Develop the anatomical, ultrasound and procedural skills required to perform ultrasound-assisted and ultrasound-guided lumbar puncture more confidently, particularly in patients with difficult or poorly palpable anatomical landmarks.

The Ultrasound-Guided Lumbar Puncture Course by Kung Medics is a focused, hands-on training programme for doctors and healthcare professionals who want to improve their ability to identify spinal landmarks, estimate depth and plan a safer lumbar puncture using bedside ultrasound.

The course combines relevant anatomy, ultrasound image acquisition, procedural planning, sterile technique and simulation-based lumbar puncture practice.

Who Is This Course For?

This course is particularly suitable for:

• Foundation doctors

• Internal Medicine trainees

• Emergency Medicine doctors

• Acute Medicine doctors

• Anaesthetic trainees

• Critical Care doctors

• Neurology trainees

• Paediatric or other clinicians undertaking lumbar puncture within their scope of practice

• International Medical Graduates entering UK clinical practice

• Clinicians who have difficulty identifying landmarks using palpation alone

• Doctors who want more confidence with technically difficult lumbar punctures

• Candidates preparing for procedural competency assessments

Previous basic lumbar puncture experience is helpful but not essential.

What You Will Learn

During the course, candidates develop a structured approach to:

• Understanding the indications for lumbar puncture

• Recognising contraindications and precautions

• Performing appropriate pre-procedure assessment

• Understanding lumbar spinal anatomy

• Selecting and optimising the ultrasound probe

• Identifying spinal landmarks using ultrasound

• Locating the midline

• Identifying intervertebral spaces

• Estimating needle insertion depth

• Selecting an appropriate puncture site

• Planning needle trajectory

• Maintaining aseptic technique

• Performing lumbar puncture on simulation models

• Measuring opening pressure where appropriate

• Collecting cerebrospinal fluid correctly

• Recognising complications

• Providing appropriate post-procedure care

Relevant Spinal Anatomy

Candidates review the anatomy required for safe lumbar puncture, including:

• Lumbar vertebrae

• Spinous processes

• Laminae

• Interspinous spaces

• Ligamentum flavum

• Epidural space

• Dura

• Thecal sac

• Relevant nerve structures

The course aims to improve three-dimensional understanding of the lumbar spine rather than relying solely on surface landmarks.

Ultrasound Assessment

Candidates learn how bedside ultrasound can assist lumbar puncture by helping to identify:

• The spinal midline

• Spinous processes

• Intervertebral spaces

• Suitable needle-entry points

• Depth from skin to the relevant deeper structures

• Abnormal or difficult anatomy

Ultrasound may be particularly useful in patients where landmarks are difficult to palpate.

Ultrasound Techniques

Candidates practise commonly used scanning approaches, including:

• Transverse scanning

• Longitudinal or paramedian scanning

• Identification of the sacrum as an anatomical reference

• Counting lumbar interspaces

• Marking an appropriate puncture level

• Estimating the required needle depth

• Optimising image quality in technically difficult patients

The course explains the distinction between ultrasound-assisted lumbar puncture, where ultrasound is used to identify and mark the site before needle insertion, and real-time ultrasound-guided approaches where clinically appropriate.

Patient Positioning

Candidates review positioning options such as:

• Lateral decubitus positioning

• Sitting positioning

• Optimising spinal flexion

• Maintaining patient comfort

• Avoiding excessive or unsafe positioning

The effect of positioning on both ultrasound imaging and lumbar puncture technique is discussed.

Preparing for the Procedure

Candidates learn a structured preparation process including:

• Confirming the indication

• Reviewing relevant investigations

• Assessing bleeding risk and anticoagulation

• Checking for contraindications

• Obtaining appropriate consent

• Preparing monitoring where required

• Selecting appropriate equipment

• Choosing the needle type and length

• Performing an ultrasound assessment before starting

• Ensuring appropriate assistance is available

Lumbar Puncture Technique

Candidates practise a systematic lumbar puncture technique using procedural simulators.

Training includes:

1. Confirming the indication and patient identity

2. Positioning the patient

3. Performing ultrasound assessment

4. Marking or selecting the insertion site

5. Preparing a sterile field

6. Administering local anaesthetic

7. Introducing the spinal needle safely

8. Recognising tissue resistance and loss of resistance appropriately

9. Confirming cerebrospinal fluid return

10. Measuring opening pressure where indicated

11. Collecting samples in the correct sequence

12. Removing the needle safely

13. Applying a dressing

14. Labelling and handling samples correctly

15. Documenting the procedure

Cerebrospinal Fluid Sampling

Candidates review practical considerations including:

• Appropriate specimen tubes

• Sample order

• Avoiding contamination

• Correct labelling

• Sending samples promptly

• Recording opening pressure when clinically required

• Communicating with the laboratory where urgent testing is needed

Difficult Lumbar Puncture

The course is particularly useful for patients with:

• Obesity

• Poorly palpable landmarks

• Previous spinal procedures

• Limited spinal mobility

• Difficult positioning

• Multiple previous failed attempts

• Anatomical uncertainty

Candidates learn when ultrasound may improve procedural planning and when senior, anaesthetic, radiology or other specialist support may be appropriate.

Complications and Safety

Candidates learn to recognise and reduce the risk of complications such as:

• Post-dural puncture headache

• Back discomfort

• Traumatic tap

• Bleeding

• Infection

• Nerve irritation

• Failed procedure

• Persistent CSF leak

• Rare neurological complications

The course also emphasises appropriate patient selection and recognising when lumbar puncture should be deferred or escalated.

Post-Procedure Management

Candidates learn the importance of:

• Reassessing the patient

• Monitoring for complications

• Providing appropriate patient advice

• Ensuring samples are processed correctly

• Documenting the procedure and findings

• Escalating unexpected symptoms or results appropriately

Hands-On Simulation Training

This is a practical course with a strong emphasis on repeated procedural practice.

Candidates have opportunities to:

• Use ultrasound machines

• Identify spinal anatomy

• Practise probe positioning

• Mark lumbar puncture sites

• Estimate needle depth

• Perform lumbar puncture on simulation models

• Practise sample collection

• Troubleshoot unsuccessful attempts

• Repeat difficult procedural steps

• Receive immediate instructor feedback

The aim is to build a reproducible technique in a safe simulated environment before progressing to supervised clinical practice.

Preparing for Clinical Competency

Completion of the course supports procedural development but does not replace formal workplace competency assessment.

Candidates should continue their training through:

• Supervised clinical lumbar punctures

• Procedure logbooks

• Direct observation

• Workplace-based assessments

• Local competency frameworks

• Ongoing ultrasound practice

Candidates must follow local policies and work within their individual professional scope of practice.

Why Train With Kung Medics?

Candidates benefit from:

• Experienced clinical instructors

• Hands-on procedural ultrasound teaching

• Lumbar puncture simulation models

• Repeated practical attempts

• Small-group instruction

• Immediate technique correction

• Structured step-by-step teaching

• A supportive environment for clinicians lacking confidence

• Training focused on real clinical application

Our aim is to help candidates move from relying solely on surface landmarks to developing a more systematic ultrasound-assisted approach to difficult lumbar puncture.

Learning Outcomes

By the end of the course, candidates should have a better understanding of how to:

• Select appropriate patients for lumbar puncture

• Recognise contraindications and precautions

• Identify relevant spinal anatomy using ultrasound

• Locate the midline and suitable intervertebral spaces

• Estimate needle depth

• Plan an appropriate puncture site

• Demonstrate lumbar puncture in simulation

• Collect and handle CSF samples correctly

• Recognise important complications

• Document and monitor the patient appropriately

• Continue toward supervised clinical competency

Important Course Status

The Ultrasound-Guided Lumbar Puncture Course is an independent practical training programme delivered by Kung Medics.

Completion of this course:

• Does not by itself certify independent procedural competence

• Does not replace supervised clinical training

• Does not constitute employer credentialing

• Does not replace local competency assessment or sign-off

• Does not authorise independent lumbar puncture where local approval is required

Candidates must practise within their competence and comply with local clinical governance, supervision and credentialing requirements.

Book Your Ultrasound-Guided Lumbar Puncture Course

If you find lumbar puncture challenging in patients with difficult landmarks or want more confidence using ultrasound to plan the procedure, this course provides focused, practical training in a supportive environment.

Book your Ultrasound-Guided Lumbar Puncture Course with Kung Medics and develop the procedural foundations needed to progress toward safe, supervised clinical practice.