Disposable Bone Marrow Puncture Needle Method

1. Selection of puncture site: anterior superior iliac spine: 1 ~ 2cm above the posterior superior iliac spine is usually chosen as the puncture point, where the bone surface is relatively flat, easy to fix, convenient and safe to operate; Posterior superior iliac spine: located on both sides of the sacral vertebra, above the hip bone protrusion; Sternal manubrium: The bone marrow content here is rich, when the above part of the puncture fails, can be used for sternal manubrium puncture, but the bone here is thin, there are atrium and large blood vessels behind, to prevent the risk of penetration, less selection. Lumbar spine process: Located in the source of lumbar spine protrusion, rarely used. 5.2 Infants under the age of 2 years should choose anterior and inferior tibial trochanter.
2. Position: supine position was adopted for puncture of sternum and anterior superior iliac spine. The posterior superior iliac spine should be punctured in the lateral position. The lumbar spinous process puncture was performed in the seated or lateral position.
3. Routine skin disinfection, wear sterile gloves, spread disinfection towel, use 2% lidocaine for local infiltration anesthesia to periosteum. Do "product" shape multiple anesthesia. Wait for about 2 minutes, so that the periosteum is fully infiltrated and anesthetized.
4. Fix the bone marrow puncture needle fixator on an appropriate length (iliac puncture is about 1.5cm; for obese patients, it can be extended appropriately; sternal stalk puncture is about 1.0cm), fix the skin of the puncture site with the thumb and index finger of the left hand, and Pierce vertically into the bone surface with the needle in the right hand (for sternal stalk puncture, puncture needle and bone surface at an Angle of 30-40 °). When the puncture needle comes into contact with bone, the needle will be removed Rotate left and right, slowly drill into the bone-piercing substance, when the resistance is felt to disappear, and the puncture needle has been fixed in the bone, it indicates that it has entered the marrow cavity.
5. With a dry 20ml syringe, withdraw the inner plug 1cm, pull out the needle core, attach the syringe, and slowly aspirate with appropriate force, a small amount of red bone marrow fluid can be seen into the syringe. The appropriate aspiration amount of bone marrow fluid should be 0.1-0.2 ml Study the staining test.
6. Bone marrow culture is required, then a syringe is attached, and 2 ~ 3ml of bone marrow fluid is pumped into the culture medium.
7. If marrow fluid is not extracted, the needle cavity may be filled with skin, subcutaneous tissue or bone pieces, or the needle may be too deep or too shallow, and the needle tip is not in the pulp cavity. At this time, the needle core should be re-inserted, slightly rotated or drilled into or out of a little, and the needle core should be pulled out.
8. After the suction is completed, insert the needle core and pull out the puncture needle by slightly turning it. Then cover the needle hole with the sterilized gauze, press it slightly, and fix it with adhesive cloth.