| ID | 416 |
|---|---|
| Name | BONE MARROW |
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| Management | Sites: Before 2 years- tibia. After 2 years or any age- ant. or posterior iliac crest or posterior iliac spine. Anterior iliac crest: 1. Position of patient - lateral recumbent or supine position. 2. Site of puncture- the anterior superior iliac spine and iliac crest are located and outlined by palpation. The site for puncture is one-fourth the distance from the anterior superior iliac spine to posterior superior iliac spine. The point of puncture is approximately 2.5 cm. below the superior margin of the crest. 3. Preparation of site- as with any other sterile procedure. 4. Technique- infiltrate the point and small surroun-ding area with LA including the periosteum. During this process judge the depth the needle has to go to reach the bone. The guard of the marrow needle mus’t be fitted 0.3.0.5 cm. longer than this distance. Make sure guard is firm. Insert needle at the point, first going through skin then into the bone. When a “give” is felt one is in the medullary cavity. Remove stylet and suck with a 20 cc syringe. Take out just sufficient amount as excessive suction may withdraw blood also and hence cause dilution. Tibia: Technique essentially similar to above. Position- infant in supine position with leg restrained manually. Site of puncture- 1 cm. medial and 1cm. distal to tibial tuberosity. |
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