Managing Accidents Stuck or Bent Needle Stuck – caused by: Excessive force Uneven manipulation Twirling in one direction, causing muscle fibres to bind Tense muscles

Managing Accidents Stuck Often loosens if left alone for few minutes Lightly stroking or massaging the skin near insertion Apply warmth If fails, insert another needle an inch or so from first If due from excessive twirling, twirl in opposite direction Never try to force a stubborn needle

Managing Accidents Bends Unwise to twirl or rotate as withdrawing Slightly shake from side to side and pull directly out Do not force as may break

Managing Accidents Broken Needle Cause: Imperfections in body of needle Sudden movement of patient Strong muscle contractions Excess force during needle manipulation OR withdrawing stuck needle

Managing Accidents When break discovered: Remain calm Keep patient still If broken needle protrudes from skin use tweezers or forceps to extract it If just below surface of the skin apply pressure with thumb and index finger against skin. If protrudes remove with tweezers Do not probe or push the area to expose the needle If in deep tissue, must be removed surgically The standard protocol is to circle the site of insertion with an indelible marking pen Immobilise the area Arrange for immediate transport to a suitable medical facility for surgical intervention

Managing Accidents Organs Signs and Symptoms: Other Organs: Lung: Caused by needling too deep in chest or upper back = traumatic pneumothorax  Signs and Symptoms: Pain or sensation of fullness in the chest Difficulty in breathing Cyanosis Sweating Lowered Blood Pressure Symptoms associated with shock Any of the above symptoms are associated with a suspected pneumothorax the patient should be hospitalised immediately. Patient could also be suffering NEEDLE SHOCK. Other Organs: Most susceptible to puncture include bladder, kidneys, an enlarged spleen or liver and the peritoneal cavity.

Managing Accidents Brain and Spinal Cord: Signs and Symptoms: When needling between the upper cervical or beside vertebrae – too deeply or on wrong angle Danger of the medulla oblongata may be at upper cervical or occipital muscles needled at wrong angle.   Signs and Symptoms: Convulsions Paralysis Coma Severe bleeding Post Treatment Signs and Symptoms : Headache Nausea Vomiting Disorientation Between other vertebrae: Danger to spinal cord Signs and Symptoms : Electric flash pain felt in extremities if stimulation prolonged. Pain continues after Treatment.