To diagnosis/ staging of diseases
To monitor the development of hemolytic
disease and respond towards the treatment given.
To obtain more information on hematopoiesis.
Infection of the skin overlying the area from
which the biopsy is to be taken
Infection in the bloodstream
Check doctor’s order in progress note:
Selected site for procedure
Any pre-medication order
Check for consent form is sign by doctor and client.
Lever of consciousness or restless
Ability to assume position required for
Skin of procedure site
Notify for lab Technician on call
Second nurse as assistant
Lab technician with glass slide
Big tray with:
• Disposable dressing set
• Extra cotton balls and gauzes
• 1 pair of sterile gloves
• Face mask
• 1 Fenestrated towel
• Bone marrow aspiration needle with inner stylet
•Cleansing solution (surgiacal spirit 70% and
• Lignocaine 1% or 2%
• Syringes: 3ml×2, 5ml×2 and 20ml×2
• Needles: 18G×2 and 23G×2
• Heparin saline 5ml×2
• Medication tray with prepared pre-medication
Laboratory form according to type of test.
Greet client and check ID tag.
Second nurse position client according to
doctor’s chosen site for procedure.
Expose insertion site and place incopad
1st nurse assist the doctor throughout procedure:
• open dressing set follow by all sterile items as
per requirement needs.
• Pour solution
• Give assistant to doctor when necessary
2nd nurse observe client’s condition for difficulty
in breathing or unbearable pain throughout the
Maintain client in supine position and check
client’s vital sign hourly for 4 hours.
Make client comfort.
Put up both cot side and place call bell within
the client’s reach.
Cleat trolley and wash hands.
Document in nursing care plan.
• Make sure the doctor have obtain consent
• Provide clear explanation
• Make sure the puncture site has been cleaned
• check vital sign.
•Prepare trolley aseptically
•Make sure equipments are complete
Make sure laboratory technicians has been
inform more earlier.( Technician must be present
during procedure because aspirated bone marrow
is smeared immediately on a glass slide.)
Help client to remain in the right position
Assist the doctor in the procedure. ( Prepare
the equipments and hold the client)
Monitor vital signs during procedure to dectect
Place the client in supine position and apply
sandbag at the puncture site at least for 6 hours
to prevent bleeding complication.
Observe the pressure dressing is tight, clean
and no signs of bleeding to prevent infection.
Observe the client until their condition stable
Monitor vital signs after the procedure.
Tidy the equipment and make sure CSSD
instruments are complete before sending to