Bone marrow aspiration

Definition
Bone marrow aspiration is a procedure that involves
taking a sample from the soft tissue inside the bone. A
small amount of this tissue is removed by inserting a
needle or biopsy instrument into a bone usually the
posterior iliac crest or sternum. In bone marrow
aspiration; a thick, hollow needle is used to remove
samples of the bone marrow. In bone marrow biopsy; a
very thick, hollow needle is used to remove a small
piece of bone and bone marrow. It is used to diagnose
diseases like aplastic anemia, leukemia and other
cancers.
Nursing interventions before procedure
Obtain informed consent
Check the results of the patient’s coagulation studies to be sure
that they are within normal limits.
Restate the purposes and procedure of the test.
Record vital signs. Instruct the patient to void before procedure.
Place in supine position if sternum or anterior iliac crest is used
and prone or lateral decubitus position if posterior iliac crest is
used.
Help the patient to maintain position and encourage him/her to
take deep breath and use relaxation technique during procedure.
Assess for pallor, diaphoresis and other changes.
Assist the doctor as needed.
Cont’d
Provide teaching to the patient and family members.
- a local anesthesia will be used and the patient will
feel some pain during insertion. Take deep breaths to
help relieve pain during this time.
- remain still during the procedure.
- the site of aspiration may ache for several days.
- report if any abnormal symptoms develop after the
procedure such as fever, bleeding, discharge.
Post procedure intervention
Apply pressure to punctured site for 5-10 minutes, and
cover the site with sterile dressing.
Keep the patient in a comfortable position and assess
vital signs and report changes in baseline.
Properly label and promptly transfer the specimen to
the lab.
Assess the post procedure pain and provide pain
medication as prescribed.
Monitor for bleeding and infection.