Bone marrow biopsy

Antiseptic cleaning fluid, local anaesthetic and a small dressing are used in the procedure. The person doing the procedure will wear gloves. 

If you are allergic to anything, please tell the staff before the procedure.

There is often some discomfort at the site of the biopsy.

Please make sure that you have some painkillers (e.g. paracetamol) to take when you get home.

Bleeding at the site of the biopsy occurs in about 1 in 100 biopsies. The risk of bleeding is increased if you are taking certain medicine (e.g. aspirin, warfarin, apixaban, rivaroxaban, non steroidal anti-inflammatory drugs), or if you have certain blood conditions. 

If the biopsy site starts to bleed, press firmly on the area with a clean dressing for 10 minutes. If the bleeding does not stop, call ward A7 at Rotherham Hospital and make arrangements to go to the ward.

The biopsy site could become infected. If the biopsy site becomes red, swollen or more tender, call ward A7 and arrange to be seen by the team.

The bone marrow biopsy needle is very sharp. If the needle accidently pierces tissue beyond the bone there could be serious consequences. This would be managed with treatment immediately.

A bone marrow biopsy is performed using local anaesthetic (you are awake and numb in the area) as a day case. The whole procedure takes about one hour. 

Although the procedure should not prevent you from driving, it is advisable to have someone to take you home afterwards. Please ask for hospital transport at the time your bone marrow biopsy is arranged if you need this.

There may be some discomfort at the site of the biopsy, so we advise to have some painkillers at home (e.g. paracetamol). If you are unable to take paracetamol, please discuss this with the healthcare professionals before your bone marrow biopsy.

Please tell the staff if you are allergic to any medicines or dressings. You will be asked what medicines you are taking. Please include any herbal or non-prescribed medicines.

Make sure that staff know if you are taking medicines that can affect blood clotting e.g. Warfarin, Aspirin, Clopidogrel, Heparin, Apixaban and Rivaroxaban. You may be asked to stop these medicines before the bone marrow biopsy to decrease the risk of bleeding from the biopsy site.

Please tell the staff if you are, or could be pregnant, or if you have been in contact with an infectious disease.

You will then be asked if you give your consent to have the procedure and to sign a form. You can change your mind at any time.

You can eat and drink normally before this procedure.

Before the procedure begins, you may be asked if you have any questions and if you have any allergies.

A bone marrow biopsy can be performed as a day case which means that you can go home the same day. Your appointment takes about one hour. Local anaesthetic is always used and Entonox (gas and air) is also available for pain relief.

You will need to remove some clothing and will be asked to lie on a couch.

The bone marrow biopsy is taken from either your pelvis or, very rarely, your sternum (front of your chest). We clean the area with antiseptic solution and a local anaesthetic is injected into your skin, the tissues beneath your skin and the outer layer of your bone. This may sting at first and then the area will go numb.

When the anaesthetic has worked and you are numb, a special needle is used to remove the bone marrow. The needle is introduced through the bone using a special mechanical drill. Both the bone marrow aspirate and the bone marrow trephine are taken using the same needle. When staff have all the samples they need, the needle is removed.

If the procedure is causing you unacceptable discomfort, you can ask for Entonox (gas and air). This may make you feel lightheaded. The effects wear off quickly and it should not delay you leaving the department.

We apply firm pressure to the biopsy site after the procedure and put on a small dressing, followed by a pressure dressing to reduce the risk of bleeding.

If you have had the procedure performed as a day case you will be asked to wait for about 30 minutes. After 30 minutes, the biopsy site dressing will be checked and then you will be able to leave as long as the bleeding has stopped.

You are advised not to drive yourself home. Please arrange to have someone to collect you if no one is accompanying you.

You need to keep the dressing over the biopsy site dry for 36 hours.

You can remove the outer pressure dressing after 24 hours.

You can remove the smaller dressing underneath after 36 hours.

If you have any bleeding from the biopsy site, or the site becomes swollen or more painful, please contact ward A7 on 01709 424231 or 01709 426532.