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How to perform a bone marrow aspirate | VETgirl Veterinary CE Videos

In this VETgirl online veterinary CE video, we demonstrate a bone marrow aspirate procedure. Prior to the procedure, first make sure that you are appropriately set up. This should include:

  • Sedation
  • Clean glass slides on a tray
  • Appropriate sample tubes
  • Scrub/flush
  • Drapes
  • 3 ml syringe (for local anesthesia)
  • Lidocaine
  • A scalpel blade (11 or 15 blade)
  • A 10 ml or 20 ml syringe (for the actual bone marrow aspirate)
  • A bone marrow aspirate needle (Klima/Jamshidi 15 gauge)
  • Sterile gauze (which may also be helpful if there is bleeding during the procedure)

The procedure is often performed either under heavy sedation or general anesthesia. In this online veterinary CE video, we demonstrate a bone marrow aspirate procedure of the humerus.

To perform the procedure:

1. The patient is placed in left lateral recumbency if you are right-handed, and the opposite direction if you are left-handed.

2. The site is prepared, specifically the craniolateral aspect of the humerus, just distal to the greater tubercle. The area is aseptically prepared by clipping and scrubbing.

3. Once the site is prepared, a small stab incision is made over the craniolateral aspect of the humerus, distal to the greater tubercle, to allow easier passage of your bone marrow needed.

4. To best access the bone marrow aspirate site, a right-handed person would grasp the humerus with their left hand and advance the bone marrow aspirate needle through the skin and subcutanoues tissue towards the bone.

5. Once the bone is found using the BMA needle, it is advanced through cortical bone by applying firm pressure with a twisting motion.

6. Once seated within the medullary cavity of the bone, the stylet is removed and a 10- or 20 mL syringe is attached with suction applied.

7. Often a fair bit of suction is needed to obtain a sample. When applying pressure, as soon as bloody fluid is seen within the syringe, negative pressure should be released.

8. The needle and syringe are removed together at that time.

9. One drop of marrow is applied to each slide.

9. To make the bone marrow smear, a second slide is placed directly on top of the first slide, lightly crushing the marrow spicules. The upper slide is then pulled across the lower slide, creating the desired smear.

The slides can be evaluated under the microscope to see if there are cell line precursors, ultimately then submitting the slides to a pathologist for evaluation. When in doubt, this is an important, easy diagnostic tool that is often necessary to evaluate underlying red blood cell lines, white blood cell lines, and platelet lines.

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