Showing posts with label bone test. Show all posts
Showing posts with label bone test. Show all posts

Tuesday, April 9, 2013

A guide to performing a bone marrow aspiration


1. Decide on the most appropriate site for aspiration;
  • The usual site for puncture in adults is the posterior superior iliac spine (PSIS).
  • This may be technically difficult in obese or immobile subjects.
  • The main advantage of this site is that a trephine biopsy can also be performed. Alternatively the sternum ( manubrium or 1st or 2nd parts of the body) can be used with care as there is a danger of  perforating the inner cortical layer and damaging the underlying large blood vessels and right atrium with serious consequences.
2. Obtain informed written consent;
  • The procedure (in brief) and its main adverse effects (although rare) should be explained to the patient prior to obtaining consent.
  • Pain, bleeding/haematoma formation and infection at aspiration site are the most commonly seen adverse effects, however, very rarely cause major concern.
3. Positioning the patient;
  • Either left or right lateral decubitous on a bed/couch, with the dorsal surface of the patient facing the operator.
  • Hold the hips and knees flexed to a comfortable maximum – knees drawn up and tucked into chest.

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