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Clean Needle Technique for Acupuncture
Clean needle technique
Infection Control – Practitioner’s Hygiene
Physical hygiene includes not only adequate hand washing, but also such things as wearing clean clothing (ie, a lab coat), keeping long hair tied back, and keeping nails clean and short. Cuts/scratches should be covered with a band-aid and/or gloves. Do not work with upper respiratory position.
wash hands –
Practitioners should wash their hands before and after each patient contact. Soaps containing antibacterial agents are preferred and strongly recommended. Clean paper towels should be used to dry hands. When washing your hands, friction and running water are very important to help remove surface germs from the epidermal layer of the skin.
germ theory –
If a sterile object touches a non-sterile surface, the object is no longer sterile. All needles must be properly sterilized for needle insertion. Needle shafts, especially long needles, can be immobilized with sterile cotton balls or sterile gauze. If the needle touches any object (ie, pants, clothing, bed) or is dropped on the floor, the needle is considered contaminated and should not be used. All used alcohol swabs and needle packaging must be disposed of in a clean area. Suction cups that come into contact with the skin require sterilization or sterilization before each use.
All packaged needles should be checked for sterile expiration dates. Any package that is wet, torn or expired is no longer considered sterile.
Types of sterilization
3. Dry heat sterilization
4. Chemical disinfection
3 Types of sterilization
1. Halogen – includes chlorine and
2. Phenol – Pure phenol is obtained from coal tar
3. Alcohol – Two types of alcohol: isopropyl and ethyl
There are 3 types of antisepsis
Iodine is a popular disinfectant and is used in concentrations of 70%-90%. Be careful when using iodine, as it can cause permanent stains on clothing. Isopropyl alcohol is also an effective disinfectant. Always keep the lids of alcohol bottles closed to maintain 100% concentration. When swiping the skin, a cotton ball or swab should be dipped in a fluid wipe. Do not swipe the skin in a back-and-forth or circular motion. Alcohol should not be applied to mucous membranes or open wounds.
All needles must be disposed of in an appropriate sharps container in accordance with public health regulations. Alcohol swabs or cotton balls should be discarded in the trash without being completely soaked with blood.
1. Forgotten needle: There are instances when a practitioner forgets to remove the needle. Practitioners should try to keep the number of needles. This can reduce the risk of forgotten needles. A forgotten needle can cause potential harm/injury.
2. Broken needle: Very thin needles (> 34 gauge) are more likely to break. A broken needle with the shaft visible above the skin can be safely removed in a sterile clamp, but if the needle is broken and below the surface of the skin, it will require medical referral.
3. Locked or Stuck Needle: A locked or stuck needle can be caused by muscle spasms or patient movement. As a result the needle becomes stuck as the muscle tissue around the needle spasms and locks the needle in place. Never force the needle out when this happens. You stop the electro-acupunctoscope and let the patient rest. Gently massaging the stuck needle area or meridian helps dislodge the needle. If the stuck needle is the result of patient movement, the patient should assume the original position and then the needle can be withdrawn.
This is the most commonly reported complication of acupuncture in the medical literature. A pneumothorax occurs when the surface of the lung is punctured, allowing air to escape from the lung into the pleural cavity. The most common points are GB21 and points around the neck and shoulder girdle. The best prevention is to use the correct needle depth and angle.
Puncture of small superficial veins is not uncommon. When this happens, one should apply pressure on the affected site for about a minute. The practitioner should always inform the patient of the hematoma. Arterial puncture is more serious. You need to apply strong pressure for about 3-5 minutes to get the bleeding from the small artery.
All organs are likely to be punctured if needed incorrectly. Bladder, kidneys, enlarged spleen or liver are the organs most likely to be punctured. and peritoneal cavity. If one needs acupoints in the lower abdomen, for the patient to empty the bladder.
Spinal cord injury
A needle inserted into the spinal cord may cause loss of sensation or movement.
Nerve irritation can be caused by direct needling on the nerves or by needling using strong electrical stimulation. If the nerve is inflamed, the patient may experience numbness, electrical sensations, or motor weakness.
Signs and symptoms include redness of the skin, itching/burning, and pain or discomfort at the site of entry. Acupuncture needles containing nickel and chromium can cause allergic dermatitis.
Various infections that can occur include septicemia, osteomyelitis, bacterial endocarditis, meningitis, and hepatitis. Use of sterile needles and identification of high-risk patients are the only methods of prevention for this condition.
Other complications or side effects
1. Nausea – Acute parasympathetic stimulation during needle withdrawal may cause nausea in the patient. Needles should be withdrawn immediately if nausea or vomiting persists.
2. Common side effects – You will often hear comments like “I feel light headed” or “mild disorientation” or “excitement”. These are all common side effects of acupuncture. Sometimes the patient may also feel cold due to prolonged needle stay (more than 20-30 minutes).
Contraindications to treatment
People who are under the influence of drugs or alcohol, who are on an empty stomach, who are emotionally unstable, or who have just finished physical exertion should not be treated with acupuncture.
Contraindications of electro-acupuncture
When using the electro-acupunctoscope, the current should never pass through the back or chest. The two branches of the same electrode should always be on the same side of the patient’s body. Electro-acupuncture is contraindicated during pregnancy and in patients with any type of cardiac pacemaker.
Traditional Chinese medicine recommends injecting during asymptomatic, normal pregnancies. If symptoms occur, it is permissible to go specifically to the symptom.
Electrical stimulation and acupuncture
Specifications for Model AWQ-104E
• Pulse Shape: Biphasic rectangular wave
• Pulse Width: 350 uS on X1, 40us on X10
• Pulse Rate (Frequency): 1-120Hz at X(1) 10-1200Hz at X(10)
• Wave form: adjustable, dense-disperse, intermittent
• Output Current (Intensity): 0-18mA (Lo) 0-40mA(Hi)
• Channel: 4
• Point detector
• Make sure you check the electro-acupunctoscope before each use.
• Insert needle (with metal handle) and get Qi sensation
• Make sure all knobs are turned to zero before inserting the electro-acupunctoscope needle.
• Attach the electrical stimulator to the needle.
• Turn on the power.
• Adjust the electro-acupunctoscope to the appropriate waveform and frequency
• Adjust the intensity to a comfortable level.
• If an intensity “high-low” switch or frequency “1-10” switch or polarity change is required, the output intensity (and sometimes frequency) must be turned to zero.
• Treatment should last 15-20 minutes
• Make sure all knobs are at zero and remove the conducting wire before turning off the power.
• 2 needles complete a circuit
• Connect negative end to primary point, positive end to secondary point
thick wave (continuous)
High frequency: 50-100 pulses per second
Functions and Indications:
Inhibit sensory nerves and motor nerves
Relieve pain, calm the mind, relieve muscle spasms
Dispersion / Sparse Wave (Continuous)
Low frequency: 2-5 pulses per second
Function: Induce muscle contraction and increase muscle and ligament tension.
Indications: Muscle, ligament and joint injuries.
Disperse waves and dense waves appear alternately, 1.5 s each. Prevent adaptation of the body
Relieve pain, improve organ function, improve Qi and blood circulation, improve tissue nutrition, reduce inflammation
Indications: Pain, trauma, sprain, rheumatism, sciatica, facial paralysis, muscle weakness etc.
A wave appears to turn on and off rhythmically. Interval: 1.5 sec
Function: Stimulate muscles
• Gradually increase the intensity of the electro-acupunctoscope to avoid muscle spasms, broken needles and bent needles due to increased intensity.
• The number one priority is to always keep the patient comfortable.
• Electro-acupuncture near the spine and brain stem requires gentle stimulation.
• When applying electro-acupuncture on the chest and back in the area of the heart, do not connect the points on the two sides of the body to avoid current from the heart.
• Do not apply stimulation to the heart area.
• Do not apply stimulation to patients with pacemakers or other electronic implants.
• Use electro-acupuncture with caution in patients with heart disease, dizziness and pregnant women.
• Electro-acupuncture should be used with caution in elderly or debilitated patients.
1. Great for nervous problems
2. Stimulation is more measurable than manual
3. Multiple points can be stimulated simultaneously (manual can only stimulate one at a time)
4. Stimulation can last longer. A typical treatment usually lasts 20 minutes. If you stimulate manually, you usually only stimulate for a few minutes at most.
• Points are selected in pairs
• Usually unilateral
(Do not cross the left or right side of the pair from one side to the other as this may interfere with the heart’s action)
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