Real-Time Ultrasound Guided Paramedian Lumbar Puncture in the Pediatric Emergency Department

Pediatric lumbar puncture is often performed using the traditional landmark approach. The ultrasound-assisted approach has demonstrated benefit, but its efficacy is limited by the lack of real-time ultrasound needle guidance. The ultrasound-guided paramedian technique is a novel approach that allows for active ultrasound guidance of the needle into the spinal canal. We describe 2 cases of successful ultrasound-guided paramedian lumbar puncture in the pediatric emergency department.