“Trained clinical nurse specialists proficiently obtain bone marrow aspirates and trephine biopsies in a nearly painless procedure-a prospective evaluation study.”
Properly trained nurses can performe bone marrow biopsies as well as doctors.
An interesting approach in a very small study with the idea of using ultrasound to precisely localize posterior iliac crest.
Link to the article: http://www.ncbi.nlm.nih.gov/pubmed/23493477
An interesting research article published by Kuivalainen A-M et al. at the Department of Hematology, Helsinki University Hospital in Finland. According to their results pain intensity scores didn’t show any significant difference between patients receiving sublingual fentanyl as premedication and the placebo.
They do however recognize the role of anxiety prior the procedure as a pain influencing factor that could be addressed to reduce a painful experience.
A link to the study: http://www.ncbi.nlm.nih.gov/pubmed/23509019
We recently received a very interesting article on our mail. This article, published in 1983, describes how ice applied to the contralateral part of the aspiration site, can be used as a simple, cost efficient and risk free tool to decrease pain during a bone marrow aspiration.
The study can be found on PubMed, following this link: http://www.ncbi.nlm.nih.gov/pubmed/6550398
Thanks to Dr. Steven Sampson for sending us the article
Our first publication is now published in Annals of Hematology and readily available online (http://www.ncbi.nlm.nih.gov/pubmed/23224244).
Have a look and leave us a comment below if you have any remarks
Christmas is here which also means that soon yet another year is coming slowly to an end, we finally managed to publish our review article in Annals of Hematology (a link is coming up soon) and we are slowly starting to process data gathered from our clinic in hope to be able to present our results during spring 2013. The forthcoming year seems to be a truly an exciting one…
But first things first, let us first gather among our beloved ones and enjoy Christmas times and to all our friends, family and colleges throughout the world, may we wish you a
Merry Christmas and Happy New Year
I have invited 4 doctors from 4 different centers to join the project. I am looking forward to their imput. Already I have heard about another strategy which is to give patients who have experienced problems with previous biopsies petidine before the biopsy. They say it works.
If you want to proof your skills – database and questionnaire are ready and avaliable upon request. The questionnaires and databases are in English and Polish.
My experience with filling the database was that I suddenly discovered that there is some pain which associated with anesthesia – and somehow this is probably the most painful moment during the whole procedure – I know what I have to work with now. So I hope I can make that better with future patients. The whole ideas is to see who is good at what part and be able to learn from that person. If you are interested in joining in the project – as a doctor or maybe as a patient – please contact us.
The database analyses the pain during the bone marrow biopsy once the data of patient is filled into the questionnaire. Here is what it looks like – the data comes from my first 16 patients.
It is summer time. I am slowly accumulating biopsies – and the results are good, quite good indeed. Once I am ready with 20 biopsies survey I will put it on the web page.
What is important is that the process of filling the database with patients data is also learning process. Feeling of pain is very subjective – but everyone can at least can say if it was or not significant. I need 5-6 more biopsies and will be ready to publish results.
First, Emil Jaddini got the speaker award at the Conference – very nice start indeed.
Second, I put myslef to the test and also our questionnaire and started to enter the data from my patients.
As I put the questionnaires into database there are some questions appearing. I have one patient in which I was unsuccessful and needed to go into the bone for 5 times. Should this patient be included in the database? I know this was something extraordinary in my practice. We will have to think how to make rules to exclude the extraordinary from what is standard and might bias the results. It is surprising to get this form of data providing instant feedback on something I usually do not get one. My weakest point seems to be pain during… anesthesia – this is where my average is on average level and only moment when few of my patients said that the pain was significant. On the other hand other pain scores are well under the average. There is some bias as some of the patients were referred to me because the relatively high pain sensitivity or problems during previous biopsy. Overall, it is a nice experience to put the data into database and get the instant feedback. I hope we can have soon a nice questionnaire and excel file for doctors willing to participate.