College of Nursing

NURSING SKILLS OUTPUT (NSO)

Report No. 02
BIOPSY &BONE MARROW ASPIRATION

I.

DESCRIPTION:

A bone marrow aspiration is when a small amount of bonemarrow fluid is withdrawn

and put into tubes and spread onslides. It can then be looked at under the
microscope and furthertests can be done looking at the proteins on the cells and
thegenetic material inside them.
A bone marrow trephine biopsy is when a tiny core of the bonemarrow tissue is
removed. This is then processed and sliced verythinly. It can be looked at under the
microscope to see how thecells lie while they are actually in the bone marrow.This
gives more information than just looking at the cells inliquid (as in the bone marrow
aspirate).

II.

MATERIALS / EQUIPMENT NEEDED:

dressing pack
sterile gloves
alcohol-based antiseptic ChloraPrep, 2%
chlorhexidine in 70% isopropyl alcohol (see below for
alternative solutions for infants under 35 weeks and
where there is any skin reaction to the solution)*
20ml syringes
local anaesthetic if required
needles and syringes for local anaesthetic
bone marrow aspiration needle
trephine needle if required
glass slides
slide container
specimen bottles i.e. lithium heparin 5ml x1
(cytogentics), minimal residual disease (MRD and
immunophenotyping) bottles x 2 from haematology
plain sterile pot, 0.9% saline solution and sterile
gauze/formalin pot for trephine sample
pencil
Micropore/Transpore tape.

III.

PROCEDURE:
Bone marrow samples are usually taken from the bony ridge at the back of
the pelvic bone.
Asked the client to lie on a bed on your left side curled up in a ball as much
as is
comfortable.
The skin will be cleaned with antiseptic which can be cold but doesnt hurt.
A local anaesthetic is then injected into the area, usually with a couple of
injections. The anaesthetic stings at first, but then makes the skin numb.
Bone marrow aspiration: a thin needle will be passed through the numbed
skin into the pelvic bone.
Withdraw a small amount of liquid of bone marrow into a syringe. You may
feel an odd sensation for a few seconds, although many patients do not
feel anything at all.
Remove the needle and put samples into the appropriate tubes. Passing the
needle and taking the sample usually only takes a few minutes.
Bone marrow trephine biopsy: if required, this is done immediately after the
aspiration.
A different needle will be inserted into the site where the aspiration needle
was.
The needle will be passed a few centimetres into the bone and rotated to
obtain the sample. You may feel pushing and some pain at this
point but this part of the test is usually over very quickly.
After the needle is removed, the site will be checked to ensure
there is no bleeding and then a simple dressing will be applied.

IV. DIAGRAM /ILLUSTRATION:

IV.

NURSING RESPONSIBILITIES:
Before the test

If you are taking aspirin, warfarin, clopidogrel, or other

medication to thin the blood, your doctor will have given you
advice about whether you need to stop these prior to the
procedure.
If you are unsure whether you need to stop any medications,
please contact your clinical nurse specialist (key worker) or
consultant (please see contact details at the end of this leaflet).
You may need a blood test prior to the procedure to ensure the
risk of bleeding is low. If you have been asked to stop or reduce
your medication you may start to take it again on the evening of
the procedure.
Tell your doctor or nurse if you have previously had an allergic
reaction to any local anaesthetics (which you may have had
during dental procedures or prior to having stitches put in).

After the test

You will need to lie flat on your back (lying directly on the site of the
procedure) for
short while to ensure no bleeding occurs.
If you have had sedation you must not drive home or travel on your own.
Please bring someone with you who can take you home. If this is a problem
for you discuss it with your nurse before you come into hospital. If you have
had a sedative you will must not operate machinery, drive or sign any legal
papers for 24 hours.

You may have some discomfort and bruising over the test site for a few days
for which you can take normal painkillers such as paracetamol.
Following the procedure there will be a small wound in the skin (2-3
millimetres) which will heal without stitches. You should not soak the area for
48 hours after you return home. This means that you must avoid going
swimming or having a bath. You may have a shower during this time. The
dressing can be removed after 24 hours.
REFERENCE
https://www.google.com.ph/search?client=ms-androidsamsung&ei=GMeEV5u9LJaojwOG9qiQAw&q=bone+marrow+aspiration+and
+trephine+biopsy+procedure&oq=trephine+biopsy+and+bone+marrow+as
piration+pro&gs_l=mobile-gwsserp.1.0.0i22i30.9386.14933.0.15559.12.9.3.0.0.0.488.3770.32j7.9.0....0...1c.1j4.64.mobile-gws-serp..0.12.3921...41j33i21.ZB2AUc13K-w