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    Where is the pain from bone penetration?

    Generally speaking, puncture will cause pain when the needle passes through the skin. This is a problem.  Secondly, the nerves of the bone are mainly distributed on the periosteum. When the needle punctures the periosteum, the patient will definitely feel pain.  For the above two, when the doctor gives the patient local anesthesia before surgery, the local anesthetic can be injected into the skin and periosteum to solve these pain problems.  The third pain is the pain that cannot be solved. It is the pain caused by the negative pressure generated when the needle enters the bone marrow cavity and extracts the bone marrow.  At this time, in order to relieve the patient's pain, the doctor needs to pump more slowly.

    How much to smoke depends on the specific case.  In some cases, bone marrow can be extracted by withdrawing 1 ml, but in some cases this may not be the case.  A simple bone marrow smear does not require many tests.  If you want to do additional tests such as breeding genes, you must draw more points, use a large syringe or even a 20 ml syringe.

    The assistant stands opposite the doctor responsible for puncture, helping to observe the condition of the child, helping to prepare bone marrow smears, etc.  A bone marrow smear is made by extracting the bone marrow and placing it on a glass slide. It is somewhat similar to doing plant leaf slides in a middle school biology class.  For a child like today, more than five slides were needed for the initial diagnosis.

    Dr. Tian told the students: "Compared with other punctures, bone puncture has less risk, so don't be nervous."

    The teacher¡¯s words can be understood this way.  To extract bone marrow, you must find a big bone in the body.  The bone target is large, unlike deep venipuncture, which requires piercing deep, thin and slippery blood vessels, which is like a blind man touching an elephant.  Lumbar puncture is difficult and risky. As mentioned before, careless removal of cerebrospinal fluid can affect the patient's brain.

    ??For bone puncture, you can feel the bones that can be felt through the skin. It is easy to place one needle, the probability of error is small, and the risk of complications is also small.  Moreover, there are many targets for doctors to choose from for bone penetration.  If this bone doesn't work or can't be pulled out, you can find another bone to pull out.

    Usually in clinical practice, bone puncture can extract the sternum, ilium and tibia.  The best place to wear it is the iliac bone. The large medullary cavity of the iliac bone contains a lot of bone marrow and is easy to extract.  Children under six months old tend to have shin splints, so the puncture location of the tibia is relatively safe.

    In view of the high risk of sternocentesis, for safety reasons, and with such family members present, the doctor did not dare to risk the sternum after much deliberation, and directly chose the ilium, which is everyone's favorite.  The needle insertion point for iliac bone extraction can be the anterior superior iliac spine or the posterior superior iliac spine.

    Zhang Desheng had been an intern at the Hematology Department of the National Association of Chinese Medicine before. He had seen and assisted the teacher in performing bone punctures, so he was assigned by Teacher Tian to do the punctures.  Zhao Zhaowei serves as an assistant.

    Several surgical students who had never been to the Department of Hematology of the Chinese Association were observing from the sidelines.  What is special is Xie, who was named by the patient's family to take care of the child and stood beside the puncture doctor to help hold the child down.

    For any puncture operation, it is most important to accurately locate the anatomical location of the puncture target.

    Zhang Desheng touched the child's ilium with his sterile-gloved fingers, and asked classmate Xie with his eyes: Is the position I touched correct, Yingying?

    As we all know, Xie is a super academic in anatomical positioning.  The smarter classmates would seize the opportunity to ask Mr. Xie for advice.

    The child¡¯s position is supine. Based on this, Xie Wanying inferred that the student might want to insert the needle from the anterior superior iliac spine. She said: If you are not too sure about the puncture, it is better to choose the posterior superior iliac spine.  The posterior superior iliac spine is larger than the anterior superior iliac spine and is easier to puncture.  If you are worried that the position of a child with posterior superior iliac spine will be difficult to maintain, we are here to help.

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