If smears will be made at the bedside, place two slides on a gauze at a slight (30 degree) angle and stack other slides nearby. Depending on specific needs, one can set up an unsterile tray with: vacutainer tubes (EDTA, heparin, yellow tube for extra studies), extra aspirate and Jamshidi needles (if not in the bone marrow biopsy kit, or if one wishes to use different needles than what is provided). Obtain informed consent, mentioning risks of: risk of infection, bleeding, pain, scar formation, and failure to obtain adequate specimen. Sometimes, when there is something wrong with these cells, the bone marrow biopsy procedure (medically known as bone marrow aspiration and biopsy) will be needed. Remove the syringe's plunger which has the residual clot from the aspirate. Initially, there may be a little sting followed by a burning sensation. This results in a deep ache at the time of the aspiration due to the suction applied. However, here is a general overview of bone marrow biopsy procedure. Hold the aspirate needle with the proximal end in the palm and index finger against the side of the needle's metal shaft near the tip. It’s home to blood vessels and stem cells that help produce:. Before the procedure, the patient will be asked to change into a patient gown. Speak to the patient about the indication for the procedure, and the potentials risks and benefits. The area to be biopsied was located using anatomic landmarks. Depending on the doctor, the patient may have an IV placed or have blood drawn. Rotate the needle with quick, full twists several times to the right and to the left to separate the bone marrow biopsy specimen. Label requisitions and complete paperwork with patient's identifying information, clinical history, and studies requested for bone marrow prior to the procedure to avoid delay in delivering the samples to the lab. Bone marrow biopsy protocol, Watchglass technique, and contents of bone marrow biopsy kit were adapted with permission from the Fellows' Handbook of the Division of Hematology/Oncology at Beth Israel Deaconess Medical Center, Boston, MA. It's also important to tell your physician if you have had any bleeding issues or any adverse reactions to drugs, and if you are pregnant. The sample is tested for disease or infection. If touch preps are desired, remove the specimen by gently inserting the probe through the distal cutting end and allow the sample to fall on a gauze pad. Open Jamshidi package and aspirate needles and drop onto sterile field. After withdrawing the needle, place a gauze over the incision site, and turn your attention to the biopsy. Copyright WWW.NEWHEALTHADVISOR.ORG © 2020, All rights Reserved. They make red blood cells that are needed for transporting oxygen from the lungs to the body tissues, white blood cells that are involved in the immune response to combat infections, and platelets that allow the blood to clot when you are injured. The Hematology Pathology lab will make the aspirate slides for you. If bleeding will not stop with direct pressure, If the patient sees thick, pus-like discharge from the wound. Place gauze pads over the incision and cover with a bandaid. The obturator may optionally be gently dropped back into the Jamshidi to assess the size/adequacy of the core (optional). If additional samples are taken, a clot section may be done by leaving 0.1 mL of marrow aspirate to clot in the syringe. Common diseases affecting the bone marrow include: Prior to undergoing a bone marrow biopsy procedure, you need speak to your doctor about any allergies you have, and any prescription, over-the-counter medications, or home remedies you are taking. Using a Pasteur pipette, pick out spicules from the aspirate in the watchglass and place them on a coverslip. Bone marrow biopsy was performed with adequate marrow specimen obtained. Remove the aspirate needle from the biopsy site. After the local anesthetic wears off over the next few hours, the patient may have some pain at the biopsy site. Locate the posterior iliac spine and mark with thumbnail pressure or a ballpoint pen. Repeat the procedure by putting other spicules on other coverslips and making as many coverslips as possible. The patient was given post-procedural instructions, including not to shower until tomorrow and, if possible, to lie down with pressure on the biopsy location. After breaking sterility by handling the tubes themselves, people performing the bone marrow biopsy will need to unglove and reglove with sterile gloves. The left/right posterior superior iliac crest was sterilely prepped and draped in the usual manner with Povidone-iodine (Betadine) swabs. If samples are to be collected for culture, chromosomes or marker studies, set up unsterile yellow, green, or purple tubes for easy accessibility. The patient should be sure to tell the doctor about any, The patient should notify the doctor about all. The area can optionally be additionally be swabbed with acetone/alcohol to clean the iodine off the skin. This needle is then removed, and pressure will need to be applied to the biopsy region for several minutes to stop any bleeding. If the patient feels pain, either reposition the needle, gently inch along the periosteum with the needle to find the anesthetized spot, or administer more lidocaine. Remove the shaft guard that comes with most aspirate needles unless a sternal aspirate is being performed.

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