A bone marrow biopsy, defined as the removal of bone marrow through a large needle, is performed to diagnose various blood disorders, toxic states, metastatic neoplasms, deficiencies, and unknown fevers. The procedure involves careful preparation and equipment collection, with emphasis on patient safety and post-procedural care to monitor complications such as bleeding and infection. Special considerations include evaluating the patient's medical history and ensuring consent is obtained before proceeding.

1. BONE MARROW
BIOPSY
Presented by
Puja Sharma

2. DEFINITION
It is the removal of bone
marrow through a large
needle to obtain bone
marrow along with
bone fiber

3. PURPOSE
 To diagnose------
 Blood dyscrasia such as aplastic anemia, leukemia,
thrombocytopenia etc.
 Toxic states producing bone marrow depression or
destruction.
 Metastatic neoplasm
 Deficiency states of Vit B12 , folic acid , iron, etc.
 Unknown fever

4. 
To determine the number , size and
shape of red cells, white cells and
platelets .

5. CONTRAINDICATION
Coagulation defect
SPECIAL CONSIDERATION
 Aspirin containing analgesic should be
avoided

6. PREPROCEDURALEVALUATION
History
 travel history
 Immune compromise or immune deficiency status
 Risk of bone fragility
 Malignancy
 Allergies
Physical examination
Lab test

7. ARTICLES
ASTERILETRAYCONTAINING
Marrow puncture needle with obturator
Aspiration syringe
Syringe
Sponge holder forceps
Dissecting forceps

8.  Small bowls
 B.P handle with blade
 Dressing towel
 Cotton swabs , gauze piece
 Slides

9. A TRAY WITH
 Kidney tray with paper bag
 Spirit, iodine
 Mackintosh and towel
 Lignocaine 2 %
 Adhesive tape , scissors

11. PROCEDURE—NURSING ACTION
 Identify the client
 Check-
physician order
investigation report
 Consent
 Explain procedure
 Collect equipment
 Ensure privacy
 shave site

12. POSITION
Sternal punture

13. ILIAC PUNTURE

14. SPINOUS PROCESS

15. TIBIAL PUNTURE

16. STEPS

17. Apply pressure as needle removed
Seal the punture
Instruct not to wash or wet the site for
24hrs
Make the client comfortable
Remove & dispose waste
Send specimen to laboratory
Record

18. POSTPROCEDURAL CARE
Keep the client in supine or
lateral position
Administer analgesics, if
required
Monitor pulse and respiration
every 30min for 4-6hrs or untill
stable

19. COMPLICATION
Bleeding
Infection

20. NURSING DIAGNOSIS
Anxiety related to procedure
Acute pain related to surgical
procedure
Risk for infection related to invasive
procedure