Crowdsourced wisdom for performing medical procedures (not surgery!) safer, better and more humanely

Dear all,

I’m a haematologist and one of the procedures that that I perform often for diagnostic purposes is called the Bone Marrow Aspirate and Trephine Procedure

I think that it is fair to say that this procedure is notorious for being rather uncomfortable and painful.

However, in the last 4 months having performed probably 80 of these and trying out variations of different techniques, I’m convinced that if done properly this procedure does not have to be painful and anxiety provoking.

There are two main goals of this procedure:-

  1. Ensure that the patient is as comfortable as possible
  2. Ensure that adequate specimens are obtained to enable accurate and reliable diagnosis

It has occurred to me that every haematologist have their own tips and tricks on how to achieve both goals. Some of these wisdom has been passed down from others, others from personal insight and some are derived from solid scientific principles.

I’m very keen to create an online site for us to share tips and tricks on different stages of this procedure.

I’m of the opinion that as doctors (I’m not referring to surgeons) we are generally very poorly taught about doing procedures. The mantra of see one, do one, teach one prevails. So, it is often the least experienced being taught how to do a procedure by the second least experience person. Indeed, even though I have performed bone marrow biopsies for 5 years, last week was the only time a consultant actually watched me do one and it was only because it was his/her private patient and not to teach me!

So, how would a crowdsourced medical procedure (not major surgery!) resource look like? Wiki-style? Discussion thread style? Hybrid of both? Stackoverflow style? I think that if we built something useful, there may be funding from some charities.

The web is full of tutorials and youtube videos but this is not what I’m looking for.

Too many people are having procedures done in suboptimal ways. I’ve seen too many patients traumatised by poor technique. I will be the first to admit that over the years I have been guilty of the same.

Who wants to have a go at this at NHS Hackday Oxford?

Some resources to start you off:

Notes from Patients Site re: Bone Marrow Aspirate and Trephine
http://csn.cancer.org/node/162494

Youtube Video of the Procedure from the University of Leicester
http://www.youtube.com/watch?v=svTQ-zJHY9M

Contribute to the discussion for at the NHS Hackday Google Group:
https://groups.google.com/forum/?fromgroups=#!topic/nhshackday/kz7k9po4oGk