Consecutive Practice | Medical | Lumbar Puncture 
 
 
Doctor:  Good morning, sir​1​. Today we’re going to talk about ​consent​2​ for a  
procedure. 
  
Patient:  Good morning, Doctor. 
  
Doctor:  We are concerned that your ​dizziness​3​ may be caused by ​bleeding​4​. 
  
Patient:  Okay 
  
Doctor:  We are also concerned that it may be due to i​ ncreased pressure​5​ within  
your brain, so the procedure we would like to do today is called a ​lumbar  
puncture​6 
  
Patient:  And what is that? 
  
Doctor:  We  are  going  to  take  a  ​needle​7  and  we’ll  try  to  put  it  in  your  back  to 
collect​8 
as​ ample​9​ ​of c
​ erebrospinal fluid​10​. This way we can also measure the  
pressure within your brain and make sure that you are not bleeding. 
  
Patient:  Okay 
  
Doctor:  We think this ​spinal tap​11​ is important because it can tell us a lot about  
what might be causing your ​symptoms​12 
 
Patient: Yes 
  
Doctor:  Now, with every procedure, there are ​risks involved​13​. The first risk is  
bleeding​14​ but we will try to ​minimize​15​ that and we’ll make sure we don’t  
hit any of the ​surrounding structures​16 
 
 The ​second concern​17​ is introducing i​ nfection​18​, but we minimize this by  
​ terile techniques​19​ and we make sure to clean your back  
practicing s
before we do the procedure 
  
Patient:  Yes 
  
Doctor:  There’s a​ lways​20​ a possibility of d
​ amaging surrounding structures​21​, like  
​ pinal cord​23​, but we minimize this risk by using ​landmarks​24​ in your  
the s
body to make sure we’re going in the right spot 
 
Another very rare risk is that this procedure can cause you to have  
orthostatic hypotension​25​ which is a drop in blood pressure that can  
occur when you stand up quickly, but we will monitor you for that 
  
Patient:  Okay 
  
Doctor:  The ​last​26​ risk that we always discuss is that there’s a possibility that this  
procedure could ​fail​27​ and it’s possible that someone else will want to  
repeat the procedure ​at a later time​28  
 
Patient:  ​ ery​29​ painful?  
Is it v
  
Doctor:  It can be painful, but we give you some ​numbing​30​ medication  
beforehand​31​ to minimize the pain. That means we will be injecting a  
medicine called ​Lidocaine​32​ into your skin. Any other questions?  
 
Patient: No 
 
Doctor: Even though the possibility of you requiring this is low, we need to know if  
in the event of an emergency if you require ​blood products​33​, would you  
accept them? 
  
Patient:  Yes, but ​only​34​ if I really need them 
  
Doctor:  Ok. If you don’t have any more questions and you consent to this  
​ lease​35​ sign here and put  
procedure, we are going to sign these papers. P
your initials​ ​over here. 
  
Patient:  Thank you, Doctor.  
 
Doctor:  I will let you know when we’re ready to do the procedure. Thank you.  
 
 
 
How did you do? 
 
Grade  your  performance  comparing  your  recording  to  the  script.  You  get  one  (1)  point 
for  each  scoring  unit  you  hit,  one-half  of  a  point  (0.5)  if  the  rendition  was  ballpark,  and 
zero  (0)  if  you  missed  it  completely.  Drill  it  until  you  master  a  score  of  at  least  90% 
(31.5/35).  Don’t  forget  to  analyze  other  aspects  of  your  renditions  such  as  grammar, 
syntax, tonality, etc.