Checklist – Counseling “Explain a bone marrow aspiration”

IntroductionPoints
Introduces and identifies patient1
Gains consent1
Explore 
Checks patients understanding for reason for Bone Marrow Aspiration2
Check’s patients understanding of the procedure1
Inform 
Preparation: Taken in as a day case1
Procedure: Takes 10 minutes. You are laid on your back and given a local anaesthetic which is make it less sore. They tunnel a needle into you pelvis bone and suck out some cells. Then given a dressing over the site.3
Post-procedure: Apply pressure over site for 5 minutes. Given pain medication. Will be sore for 2-3 days2
Risks and complications 
Very safe procedure. Bleeding may occur2
Pain is the main problem post procedure1
Closure 
Any questions1
Alleviate fears1
Offer further information source1
Closure 
Gave information in chunks and tested understanding1

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Charlson Comorbidity Index (CCI) Online Calculator

Charlson Comorbidity Index predicts 10-year survival in patients with multiple comorbidities.

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History of definite or probable MI (EKG changes and/or enzyme changes)

Exertional or paroxysmal nocturnal dyspnea and has responded to digitalis, diuretics, or afterload reducing agents

Intermittent claudication or past bypass for chronic arterial insufficiency, history of gangrene or acute arterial insufficiency, or untreated thoracic or abdominal aneurysm (≥6 cm)

History of a cerebrovascular accident with minor or no residua and transient ischemic attacks

Chronic cognitive deficit

Any history of treatment for ulcer disease or history of ulcer bleeding

Severe = cirrhosis and portal hypertension with variceal bleeding history, moderate = cirrhosis and portal hypertension but no variceal bleeding history, mild = chronic hepatitis (or cirrhosis without portal hypertension)

Severe = on dialysis, status post kidney transplant, uremia, moderate = creatinine >3 mg/dL (0.27 mmol/L)


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