To diagnose thrombocytopenia, leukemias, granulomas, anemias, and primary and metastatic tumors

To determine causes of infection

To help stage diseases such as with Hodgkin’s disease

To evaluate chemotherapy

To monitor myelosuppression

Make sure that the consent form is signed by the child’s parents or legal guardians.

Note and report all allergies.

Explain that collection of a blood sample is necessary before the biopsy for laboratory testing.

Explain to the child that he’ll feel pressure on insertion of the biopsy needle and a brief, pulling pain on removal of the marrow.

Explain which bone site (sternum, anterior or posterior iliac crest, vertebral spinous process, rib, or tibia) will receive the test.

If age appropriate, allow the child to “perform” the procedure on a doll (use correct positioning, a syringe, and a bandage) to enhance the child’s understanding of the procedure and help ease his fears.

Give a mild sedative 1 hour before the test, as ordered.

Provide analgesics as ordered.

Explain that the test usually takes about 20 minutes.

Explain that the puncture site may remain tender for a few weeks.