The Royal Children’s Hospital of Melbourne has a great clinical guideline for pediatric lumbar puncture
22 gauge spinal needle can be used in all age groups. Use 1.5 inch length in < 2-3 year olds, 3.5 inch length in older (can use 2.5 inch length in 2-12 year olds if available)
20 drops of CSF = ~ 1 mL
| Age | Weight (kg) | MSCD (cm) | Needle length cm | Needle length in |
|---|---|---|---|---|
| Neonate / Infant | 1-5 | 0.9-1.7cm | 2 | 0.8 |
| Toddler 12-18mo | 10 | 2.4cm | 3 | 1.2 |
| 4yo | 15 | 2.6cm | 3-4 | 1.2-1.6 |
| 6yo | 20 | 2.8cm | 4 | 1.6 |
| 9yo | 30 | 3.2cm | 4 | 1.6 |
| 12yo | 40 | 3.6cm | 5 | 2 |
| 14yo | 50 | 4cm | 5-6 | 2-2.4 |
Formulas to estimate median spinal cord depth (MCSD, mm):
Neonates and infants: 2 (wt in kg) + 7 mm
Children: 0.4 (wt in kg) + 20 mm
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