Bone Marrow Aspiration from Sternum

The puncture site is located by palpation. The optimal site is in manubrium sterni half-way between the jugulum pit and the angulus sterni or slightly closer to the angulus (in the video the puncture is made a bit too close to the jugulum). The skin and the periosteum are infiltrated with a sufficient amount of local anaesthetic. The tip of the needle touches the periosteum gently, and an area of about one square centimetre on the surface of the bone is infiltrated. Wait for 1-2 minutes to let the anaesthetic to act. The sternal tap needle is inserted with a rotating movement and even downward pressure. Sudden disappearance of resistance indicates that the needle has entered the bone marrow cavity. Aspirate using brisk suction with a (2-) 5 (-10) ml syringe. Warn the patient about possible painful sensation during aspiration. Pass the syringe immediately to the laboratory nurse waiting beside. After removing the needle the puncture site should be compressed at least for 5 min to prevent bleeding (or even longer in a patient with thrombocytopenia).

Bone Marrow Aspiration from Sternum