Bone marrow aspiration is a medical procedure where bone marrow is removed to examine for diseases like leukemia or infections. It can be used diagnostically to detect conditions or therapeutically to administer medications. It should not be done if the patient has a skin infection, bone disorder, or bleeding disorder. Intra-osseous injection provides intravenous access by directly injecting into the bone marrow when standard IV access is not possible. It is indicated for conditions like collapse or when IV cannot be established, especially in young children or burns patients. Contraindications include osteoporosis, vascular injuries, infections or fractures near the injection site.

1. By:
Seragaldin M. Abdulqader
Clinical pharmacology for nurses
University of Raparin/school of nursing
The lecture for undergraduate students:
2015 -201618 December 2015 1

2. Introduction
Commonly bone marrow
aspiration performed by
a surgeon that is the medical
removal of tissue from a living
subject to determine the
presence or extent of a disease.
The tissue is generally examined
under a microscope by
a pathologist.
18 December 20152 2

3. Indications
 Diagnostic:
• Leukemia
• Myelofibrosis
• Aplastic Anemia
• Megaloblastic Anemia
• Infections (e.g.: Meningitis)
• Storage disorders (e.g.: Gaucher’s disease)
18 December 2015 3

4. Indications
 Therapeutic:
 Analgesia
 Anesthesia
 Anti-biotics
 Anti-neoplastics
18 December 2015 4

5. Contraindications
 Skin infection
 Bone disorders
(e.g.: Osteomyelitis)
 Haemorrhagic disorders
(e.g.: Hemophilia)
18 December 2015 5

6. Intra-osseous injection (IO)
A process of injecting directly
into the marrow of a bone to
provide a non-collapsible entry
point into the systemic venous
system.
This technique is used to
provide fluids and medication
when intravenous access is not
available.
18 December 2015 6

7. Indications
 Collapse
 Burns
 Obesity
 Edema
 Seizures
 Children aged 6 years or younger
 After failed attempting at IV access
18 December 2015 7

8. Contraindications
 Osteoporosis
 Vascular injury
 Burn at entry site
 Infection at entry site
 Fracture of the extremity
 Previous attempt at the same site
18 December 2015 8

9. 18 December 2015 9