Today our topic of discussion is Procedure of Bone Marrow Biopsy and Aspiration.
Procedure of Bone Marrow Biopsy and Aspiration
Procedure
- Transfer the patient from bed to treatment room
- Position the patient and assess the doctor to locate and mark the site
- Open small dressing pack and slides, syringes, needles and scalpel blade into pack
- Assist the doctor to clean site with antiseptic solution and drape with sterile towels
- A small incision may be made with scalpel blade.
- Bone marrow needle with stillete is introduced through incision and marrow is aspirated
- Inform patient that a brief episode of sharp pain during aspiration will be experienced
- Syringe with aspirated marrow is handed over to technician and collect into various containers as indicated
- Collect bone marrow tissue in small bottle containing FAA solution
- Apply pressure over punctured site until bleeding ceases
- Assist doctor to seal punctured site with tincture benzoin and apply small from dressing.
Post-procedure Care
- Keep the patient in supine or lateral position
- Allow the patient to rest for few hours after the procedure
- Check the vital signs and observe for signs and symptoms of complications
- The puncture site should be treated as a surgical wound.
- The dressing should be done under strict aseptic techniques
- Give mild analgesics if needed
- Label specimen and send to laboratory
- Replace the articles after cleaning
- Wash hands
- Record the procedure in the nurse’s record sheet.
Complications
- According to the site
- Sternal puncture: Injury to the pericardium, myocardium, lungs and to the large blood vessels of the mediastinum
- Iliac site: Injury to the sacroiliac ligament, dural sac and cauda equina
- Vertebral site: Injury to the dural sac and the spinal cord
- Tibial site: Damage to the tibial collateral ligament of the knee.
Other Complications
- Bleeding from puncture site.
- The causes are thrombo- cytopenia and bleeding diathesis.
- Bleeding can be prevented by local pressure
- Perforation of aorta, due to penetration of posterior side of sternum if too much force is applied Infection (osteomyelitis).
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