What are the steps of bone marrow acupuncture

a) Indications

1. Diagnosis, differential diagnosis and treatment follow-up of various blood diseases.

2. Unexplained increase or decrease in the number of red blood cells, white blood cells and platelets and morphological abnormalities.

3. The diagnosis and differential diagnosis of unexplained fever can be used for bone marrow culture, bone marrow smear to find parasites, etc.

(2) Operation method

1. Selection of puncture site ① Anterior superior iliac spine: usually take 1-2cm behind and above the anterior superior iliac spine as the puncture point, where the bone surface is flat, easy to fix, convenient and safe to operate; ② Anterior and posterior superior spine: located at the two sacral vertebrae. The bony protruding part on the side and above the buttocks; 3. Manubrium: the bone marrow is rich here. When the puncture of the above-mentioned parts fails, the manubrium can be punctured. Because of the danger of penetration, it is less used; ④ Spinous process of lumbar spine: it is located at the protrusion of the spinous process of lumbar spine, and it is rarely used.

2. Posture The supine position was taken when the sternum and the anterior superior iliac spine were punctured. The lateral decubitus position should be taken during puncture of the posterior superior iliac spine. The lumbar spinous process was punctured in a sitting or lateral position.

3. Routinely disinfect the skin, wear sterile gloves, lay a sterile towel, and use 2 percent lidocaine for local infiltration anesthesia until the periosteum.

4. Fix the bone marrow puncture needle fixer at an appropriate length (about 1.5cm for iliac puncture, lengthen for obese patients, and about 1.0cm for sternum puncture), fix the skin at the puncture site with the thumb and index finger of the left hand, and hold the needle in the right hand. The bone surface is punctured vertically (if the puncture of the manubrium is used, the puncture needle and the bone surface should be inserted obliquely at an angle of 30-40 degree ), when the puncture needle touches the bone, rotate left and right, and slowly pierce the bone. When the resistance disappears and the puncture needle is fixed in the bone, it indicates that it has entered the marrow cavity.

5. With a dry 20ml syringe, withdraw the inner plug by 1cm, pull out the needle core, connect the syringe, and slowly aspirate with appropriate force. A small amount of red marrow fluid can be seen entering the syringe. The amount of marrow fluid aspirated is 0.10.2ml. If appropriate, remove the syringe, push the bone marrow fluid on the glass slide, and quickly make 5-6 smears by the assistant, and send them for inspection of cell morphology and cytochemical staining.

6. For bone marrow culture, connect the syringe and aspirate 23ml of bone marrow fluid into the culture medium.

7. If the marrow fluid cannot be extracted, the needle cavity may be filled with skin, subcutaneous tissue or bone fragments, or the needle is inserted too deep or too shallow, and the needle tip is not in the medullary cavity. At this time, the needle core should be reinserted. , rotate a little or drill a little more or withdraw a little more, pull out the needle core, if you see blood on the needle core, you can expect to get bone marrow fluid by suction again.

8. After the suction is completed, insert the needle core, turn it slightly and pull out the puncture needle, then cover the needle hole with a sterile gauze, press it slightly, and fix it with adhesive tape.

(3) Matters needing attention

1. After the puncture needle enters the bone, avoid swinging too much to avoid breaking.

2. The puncture of the manubrium should not be inserted vertically, and excessive force should not be used to prevent penetration of the medial bone plate.

3. When aspirating bone marrow fluid, gradually increase the negative pressure. When doing cytomorphological examination, the suction volume should not be too much, otherwise the bone marrow fluid will be diluted, but it should not be too small.

4. The smear should be smeared immediately after the extraction of bone marrow fluid.

5. Bone marrow biopsy should be performed when multiple dry aspirations are performed.

(4) Contraindications

Bone marrow aspiration should not be performed in patients with hemophilia.

If you have any questions, please contact us. Our company can produce various customized needles, medical needles, puncture needles, hypodermic needles, biopsy needles, vaccine needles, injection needles, syringe needles, veterinary needles, pencil point needle, ovum pick up needles, spinal needles, etc. If you need customized needle products, please contact us. We look forward to your inquiry! The quality of the products manufactured in our factory will surely satisfy you!

Please contact us if you need: zhang@sz-manners.com