Bone marrow puncture needle method

1. Selection of puncture site:

1) The puncture point of the anterior superior iliac spine was located 1-2cm behind the anterior superior iliac spine. The bone surface of this part was relatively flat, easy to fix, easy to operate and not dangerous;

2) The puncture point of the posterior upper iliac spine was located on both sides of the sacral vertebra, protruding above the hip;

3) Sternum puncture point: manubrium sternum or sternum body is equivalent to the position of the first and second intercostal Spaces. The sternum is relatively thin (about 1.0cm), and the atrium and great vessels are located behind it to prevent accidents through the sternum. However, due to the rich content of sternum bone marrow fluid, sternum puncture is still needed when other parts of puncture fail. 4) Puncture point of lumbar spinous process is located at the origin of lumbar spinous process.

2. Position: For sternum or anterior superior iliac spine puncture, client is supine. The sitting or lateral decubitus position was taken during spinous process puncture. The posterior upper iliac spine should be punctured in lateral position.

3. Routine disinfection of local skin, the operator with sterile gloves. Local skin, subcutaneous and periosteal anesthesia was performed with 2% lidocaine.

4. To fix bone marrow puncture needle holder on the appropriate length (sternum puncture is about 1.0 cm, skeletons of bone biopsy is about 1.5 cm), with left thumb and index finger puncture, pierced with the right hand holding needle to the bone surface vertical (for sternal puncture, should maintain the surface of the needle body and bone into 30-40 degree Angle), when after bone will rotate around puncture needle, needle point contact Slowly drill bone marrow, when the resistance disappears, and the needle has been fixed in the bone and flesh, said that has entered the bone marrow cavity. If the needle is not fixed, a little more should be drilled until it can be fixed.

5. Pull out the needle core, attach a dry 10ml or 20ml syringe, and aspirate with appropriate force. If the needle is in the marrow cavity, the patient will feel a slight sharp pain when aspirating, and a small amount of red marrow fluid will enter the syringe. The appropriate amount of bone marrow aspiration was 0.1-0.2ml. For bacterial culture of bone marrow fluid, 1-2ml should be extracted after bone marrow fluid counting and smear preparation.

6. The marrow droplet was placed on the slide, and the nucleated cell count and smear count were performed quickly for morphological and cytochemical staining.

7. If you fail to extract marrow fluid, it may be that the needle cavity is blocked by the skin or subcutaneous tissue block or dry extraction, at this time, you should insert the needle core, rotate slightly or drill into a little or withdraw a little, pull out the needle core, if you see the needle core with blood, then suction can get bone marrow fluid.

8. After suction, sterile gauze was taken from the left hand and placed at the pinhole, and the needle was pulled out with the right hand. Then the gauze was covered on the pinhole and pressed for 1-2 minutes, and then the gauze was pressurized and fixed with adhesive tape.

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