Bone marrow aspiration

bone marrow aspiration

1. UNIT : 5 PAEDIATRIC PROCEDURES: BONE MARROW ASPIRATION Deepa shrestha B.Sc. Nursing 2 nd year

2. DEFINITION Removal of small amount of bone marrow fluid through a needle put into bone.

3. INDICATIONS Investigation of unexplained anemia , abnormal red cell indices, cytopenias or cytoses , Investigation of abnormal peripheral blood smear suggestive of bone marrow pathology, Diagnosis , staging and follow up of maligant haematological disorders ,

4. CONTD… Investigation of suspected bone marrow metastases, Unexplained focal bony lesions on radiological imaging, Unexplained organomegaly or presence of mass lesions unavailable for biopsy,

5. CONTD…. Microbiological culture for pyrexia of unknown origin or specific infections , eg . Miliary tuberculosis , leishmaniasis , malaria, Evaluation of iron stores, Investigation of lipid/glycogen storage disorders,,

6. CONTD… Exclusion of hematological disease in potential allogenic stem cell transplant donors,

7. COMMON SITES Iliac Crest ( posterial and superior part, client lie on lateral or prone position) Sternum (2 nd space of sternum) Tibia Crest ( babies below 1 year)

8. ILIAC CREST STERNUM

9. EQUIPMENTS Sterile gloves Sterile drape Povidone iodine Bone marrow aspiration needle or 11 or 13 gauze Jamshidi needle 22 and 25 gauge needles

10. TYPES OF NEEDLES KLIMA NEEDLE JAMSHIDI NEEDLE

11. CONTD…. No. 11 scalpel blade Heparinized 10 cc syringe 1 % lignocaine Glasss slides (10) Specimen bottle with formalin

12. EQUIPMENTS

13. CONTD….. 4” 4” Gauze Pressure dressing and tape

14. SITE AND POSITION

15. PROCEDURE Physical preparation Make sure the doctor have obtain consent from client Provide clear explanation Make sure the puncture site has been cleaned check vital sign.

16. BEFORE Prepare equipments Prepare trolley aseptically Make sure equipments are complete

17. During procedure Help client to remain in the right position Assist the doctor in the procedure. ( Prepare the equipments and hold the client) Monitor vital signs during procedure to dectect complication.

18. AFTER PROCEDURE Place the client in supine position and apply sandbag at the puncture site at least for 6 hours to prevent bleeding complication. Observe the pressure dressing is tight, clean and no signs of bleeding to prevent infection.

19. CONTD… Observe the client until their condition stable and recover. Monitor vital signs after the procedure.

20. POSSIBLE COMPLICATION Infection bleeding