Bone marrow aspiration is a procedure to remove a small amount of bone marrow fluid through a needle inserted into the bone. It is indicated to investigate various hematological conditions like anemia, infections, and cancers. The common sites for aspiration are the posterior iliac crest, sternum, and tibia. The procedure involves preparing equipment like needles, sterile drapes and applying local anesthesia before inserting the needle and aspirating the bone marrow sample. Post procedure, pressure must be applied to prevent bleeding and vital signs must be monitored for any complications like infection.

1. UNIT : 5
PAEDIATRIC PROCEDURES:
BONE MARROW ASPIRATION
Deepa shrestha
B.Sc. Nursing 2nd year

2. DEFINITION
Removal of small amount of bone marrow fluid
through a needle put into bone.

3. INDICATIONS
• Investigation of unexplained anemia ,
abnormal red cell indices, cytopenias or
cytoses,
• Investigation of abnormal peripheral blood
smear suggestive of bone marrow pathology,
• Diagnosis , staging and follow up of maligant
haematological disorders ,

4. CONTD…
• Investigation of suspected bone marrow
metastases,
• Unexplained focal bony lesions on radiological
imaging,
• Unexplained organomegaly or presence of
mass lesions unavailable for biopsy,

5. CONTD….
• Microbiological culture for pyrexia of
unknown origin or specific infections , eg.
Miliary tuberculosis , leishmaniasis , malaria,
• Evaluation of iron stores,
• Investigation of lipid/glycogen storage
disorders,,

6. CONTD…
• Exclusion of hematological disease in potential
allogenic stem cell transplant donors,

7. COMMON SITES
Iliac Crest ( posterial and superior part,
client lie on lateral or prone position)
 Sternum (2nd space of sternum)
 Tibia Crest ( babies below 1 year)

8. ILIAC CREST STERNUM

9. EQUIPMENTS
1. Sterile gloves
2. Sterile drape
3. Povidone iodine
4. Bone marrow aspiration needle or 11 or 13
gauze Jamshidi needle
5. 22 and 25 gauge needles

10. TYPES OF NEEDLES
KLIMA NEEDLE JAMSHIDI NEEDLE

11. CONTD….
• No. 11 scalpel blade
• Heparinized 10 cc syringe
• 1 % lignocaine
• Glasss slides (10)
• Specimen bottle with formalin

12. EQUIPMENTS

13. CONTD…..
• 4” 4” Gauze
• Pressure dressing and tape

14. SITE AND POSITION

15. PROCEDURE
 Physical preparation
• Make sure the doctor have obtain consent
from client
• Provide clear explanation
• Make sure the puncture site has been cleaned
• check vital sign.

16. BEFORE
 Prepare equipments
• Prepare trolley aseptically
• Make sure equipments are complete

17. During procedure
 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 complication.

18. AFTER PROCEDURE
 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.

19. CONTD…
Observe the client until their condition
stable and recover.
Monitor vital signs after the procedure.

20. POSSIBLE COMPLICATION
• Infection
• bleeding