What are the precautions for bone marrow examination
May 05, 2022
Notes before inspection:
1. The doctor explains the purpose and process of the examination to the patient and their family members.
2. Complete the inspection consent form.
3. Medications such as pain relievers or sedatives are given before the exam.
4. There is no need to fast on the day of the examination, please wear loose-fitting clothes.
5. Go to the toilet before the examination.
Inspection process:
1. Examination location: inpatients are in the original ward, and outpatients are sent to the treatment room of the Department of Hematology and Oncology.
2. Posture preparation: For bone marrow puncture, the puncture site is at the sternum, and the specimen is lying flat; for bone marrow biopsy, the puncture site is at the iliac bone, and the specimen is to lie on the side, with the lower foot straight and the other foot bent.
3. Bone marrow puncture (slicing) procedure: Before bone marrow slicing, analgesics will be injected intramuscularly, but bone marrow puncture is not required. After sterilizing the skin, the doctor puts a hole towel on the puncture (slicing) site, injects local anesthetic first, and then inserts the puncture needle (or slicing needle) into the bone marrow cavity with aseptic technique, and then connects the empty needle to extract the bone marrow tissue. There will be a little soreness during the process. At this time, you can take deep breaths and relax the muscles of the whole body to relieve tension, but do not twist your body or reach out to touch the puncture site, so as to avoid wound contamination or puncture failure. After the puncture, the nursing staff will cover the puncture site with gauze and apply pressure with a sand bag to stop the bleeding. The whole process takes about 20 to 30 minutes.
Notes after inspection:
1. Pressurize the puncture site with a sand bag and lie down for 2 to 4 hours. Try not to get out of bed during the process until the medical staff confirms that there is no bleeding at the puncture site.
2. If there is continuous bleeding during the pressurization of the puncture site, for example: blood oozing from the gauze covering the wound, rapid heartbeat, difficulty breathing, cold limbs, etc. Immediately notify the medical staff in the above situations.
3. The gauze covering the puncture site should be removed after 24 hours by medical staff or by yourself, without changing the dressing; the dressing site should be changed depending on the wound condition. Do not do strenuous activities within 24 hours to avoid bleeding, and take a bath on the same day to avoid getting the gauze wet to reduce the occurrence of infection.
4. The medical staff should be informed in the following situations: (1) The puncture site still has severe pain or sudden bleeding more than 24 hours after the examination. (2) Redness, swelling, heat, pain or exudate at the puncture site. (3) Fever and chills.
5. One week after the examination, the doctor will inform the examination results. Non-inpatients, please register and return to the outpatient clinic to confirm the examination report.
Possible risks of bone marrow aspirate (sectioning):
1. Wound bleeding, hematoma.
2. Puncture or section site infection, osteomyelitis, cellulitis.
3. Allergies may be caused by physical constitution during local anesthesia.
4. When the puncture site is in the sternum, there may be sternum fracture, mediastinal emphysema, pneumothorax, and even the possibility of injuring large blood vessels and the heart.
If you still have any questions about the above instructions or if there is any abnormal change in the wound after returning home, please call the doctor and ask the relevant personnel.
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