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4. Local anesthetic: The skin, sub-cutanoons tissues ‘and perlosteursoverthe manubsium arwinfilteatod with 2% lignocaine, Aspiration: After 2-3 minutes when the local anesihotic effect is apparont, the bone-marrow ‘aspiration noedte, with guard half an inch from the lip is pushed vertically through tho sternal plate withaboringmotion. Whon theneodts hasentorvd the marrow, the stillet is withdrawn and 02-0: mlofbone-marrow is aspirated with a1 mi syringe. ‘The noodle iswithdrawn and smears are propared with the marrow. Hemostasis is assured by ‘ainitaining prossure aver thesito for3-5 minutes. ©. Seal: As for liver biopsy, 7. Post-procedure orders: 2 ‘ast-procedure ordi 2 a) T.P-T..B.P half hourly for4 hours row examination helpful but not il by m 0 Be dioganaie, pfu nol b) Nil by mouth for 4 hours ©) Analgesics for pain COMPLICATIONS 4. Bone pains 2 Homatoma A, Infection (Osteomyelitis) 4. Transfixation ofthe stern vessels (This is proventes ‘CAUSES OF DRY TAP “A Faultytechnique Pathological changes in the bone-marrow: ey Jofibrosis and myelosclerosis. espiration is aspiration of the b of the bone aeticalexemination ofwhichisuseful 5 ‘Various hematological conditions, jomatousinfiltrationof hebene-marrow. iyperplasia of the marrow-loukaemnia, poplasia of the marrow. |ON OF NORMAL BONE-MARROW Cells: Nucleated cells 20,000 -1,00,000 por 5, Nerves GOK FOR THE FOLLOWING IN A BONE: RROW SMEAR and mogakaryocytes. 2, Cellularity of the marrow |. Myolotd-Erythroid ratio (Normally 3:4 0° 4:1) 4 Presenco of tamor cells, plasma cells, ete, §. Presence of parasites: 1..D bodies, malarial ‘parasites, otc.