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    If you look at the anatomy diagram, you will find that the bony plane of the posterior superior iliac spine is larger than that of the anterior superior iliac spine.  The bone plane is large, so it is easier for the needle tip to implant.  Unlike the small bone surface, the needle tip falls like a needle point against a wheat awn. It is easy to rub it and it is difficult to insert the needle vertically.

    It is important to insert the needle vertically.  Bone piercing itself has to be penetrated into the bone. The bone is hard, which means it takes a lot of effort.  Vertically inserting a needle is like hammering a nail with vertical force, it is easy to insert, and the force can be used to the minimum to cause minimal damage to the child's bones.

    Some bones that are difficult to penetrate are common in clinical practice. When the clinical teacher pricks the bone, his expression will be as if he is drilling the bone.  This kind of exertion is not only laborious but also afraid of overexertion.  Classmate Zhang Desheng was not afraid of death for the first time, so he dared to start drilling hard all of a sudden.  If the needle cannot be inserted vertically or penetrated, the psychological frustration of the novice is far less than that of the veteran who will collapse instantly.

    Secondly, clinically, the bone marrow dilution rate caused by bone marrow extraction is quite high.  What is bone marrow dilution, that is, no bone marrow can be extracted or too little bone marrow is extracted, and the specimens extracted are mostly blood.  If such a specimen is sent to the laboratory for bone marrow examination, it will definitely fail and will need to be drawn again, which is equivalent to a failure of bone puncture.

    If the problem is the posterior superior iliac spine, the child needs to lie down to sleep, which will inhibit breathing to a certain extent.  Perhaps based on this consideration, Zhang Desheng did not dare to choose the posterior superior iliac spine.  The main reason is that the child's parents are too difficult to deal with, and the doctor doesn't dare to take the risk.

    Rather than letting the child lie prone, another method is to have the child lie on his side and hug his knees tightly to expose the posterior superior iliac spine.  This position is not easy to fix.  For this reason, classmate Zhang Desheng respects classmate Xie¡¯s opinion.

    It may be a little difficult to get into a good posture, but when the time comes, the anterior superior iliac spine cannot be inserted as Xie said, and the needle hangs around in the middle for a long time, which will cause greater consequences.

    There is no need to be too afraid when classmates are here to help.

    Reported to Teacher Tian to choose the posterior superior iliac spine, Teacher Tian and Teacher Wang agreed.

    Several classmates began to help the child adjust his position.  Two other surgical students saw this and came up to help.

    Carefully change the child to a side-lying position. When controlling the child, control the joint movement position instead of pressing hard on the child.

    The location is said to be the posterior superior iliac spine, but in fact the puncture point is the protrusion between the posterior superior iliac spine and the fifth lumbar vertebra.

    After changing the child¡¯s position, Zhang Desheng felt something different.  When you touch it with your gloved hand, you can feel a relatively flat bone surface, which means that this position exposes the bony location to be operated on well.  Unlike when he touched the anterior superior iliac spine at the beginning, he only felt a bump and it was difficult to acupuncture.

    It turns out that the current position of the child was put in by classmate Xie.  Classmate Zhang Desheng praised in his heart: Classmate Xie is awesome.

    Being able to feel the wide range of acupuncture points will naturally make the doctor more confident.

    Zhang Desheng then worked hard and injected the anesthetic onto the periosteum with great accuracy, making it easy to do it.  I pressed the area that had been anesthetized, and because I had the confidence to inject the needle again, I inserted the bone puncture needle straight down. I pulled the syringe plunger and quickly felt something coming up.  The process was incredibly smooth.

    The doctor¡¯s quick action will definitely reduce the child¡¯s pain and discomfort a lot.  Children, like adults, are most afraid of long-term pain.

    Seeing the students extracting the bone marrow in twos and twos, the two supervising teachers nodded sharply: These students did a good job and they didn¡¯t need the teacher¡¯s guidance to do it on their own.

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