Bone Marrow Aspiration from the Posterior Iliac Crest

The patient is lying on the side, the upper hip flexed, the lower hip straight. The iliac crest is located by palpation. The periost is anaesthetized by infiltrating lignocaine on an area larger than 1 cm in diameter. After infiltration wait for 1-2 minutes to let the anaesthetic to act. Use a longer needle than for sternal tap. The needle is inserted in the sagittal plane, slightly into the lateral direction, with a rotating movement and even downward pressure. The bone may be thick and the insertion may take some time. 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). See video Bone Marrow Aspiration from Sternum for a sternal tap.

Bone Marrow Aspiration from the Posterior Iliac Crest