1. Acupuncture Acupuncture Preparations, Precautions & Possible Accidents Management Preparations, Precautions & Possible Accidents Management By: Colin Chan

2. Acupuncture 针器检查与体位 Preparation prior to acupuncture treatment 1.Inspection: Instruments include all needed acupuncture needles and devices, moxa cones, moxa rolls and all disinfecting solutions etc. 2.Posture of the patient An appropriate posture is important for: Correct location of acupoints Manipulation for acupuncture and moxibustion Retention of needle Prevention of possible accidents 针刺前的准备 Copy Right: Colin Chan

3. 针器检查与体位 Preparation prior to acupuncture treatment 3.Selection of needles The selection of appropriate needles are based on the following factors: Patients size Site of treatment Condition of illness 针刺前的准备 Copy Right: Colin Chan

4. Preparation prior to acupuncture treatment 消毒 针刺前的准备 1.Sterilization (needle): Autoclave (1.5 atmospheric pressure, 115-125 degree x 30 minutes) Boiling (10-15 minutes) (30 minutes) Medicinal (75% alcohol x 30-60 minutes) 2.Sterilization (Skin): Site: (75% alcohol or 2.0% tincture iodine, follow by 75% alcohol) Copy Right: Colin Chan

5. Precautions in acupuncture treatment (Points to note) Acupuncture is not advisable for hungry,overeaten and drunk and fatigue cases Acupuncture is contra-indicated for pregnancy cases Acupuncture is not suggested for patient during menstruation unless treatment is for regulation of menstruation Acupuncture is not for infant with unclosed fontannel (points on the head) and no retention of needle 针刺注意事项 Copy Right: Colin Chan

6. Precautions in acupuncture treatment (Points to note) Acupuncture is prohibited in areas with infection, ulcer and sores Avoid acupuncture if patient has coagulation problem, avoid vascular regions to prevent possible bleeding post acupuncture Caution acupuncture technique must be observed when needling points near the eye., on the chest, abdomen and hypochondriac region 针刺注意事项 Copy Right: Colin Chan

7. Possible accidents in acupuncture Faint (Acupuncture Syncope) 晕针 Stuck Needle (Sticking of the needle) 滞针 Bent Needle (Bending of the needle) 弯针 Broken Needle (Breaking of the needle) 断针 Hematoma 血肿 异常状况 Copy Right: Colin Chan

8. Possible accidents in acupuncture Faint (Acupuncture Syncope) 晕针 Causes:  Weakness and tiredness of patient.  Nervous tension.  Hunger.  Profuse sweating, Diarrhea, Hemorrhage.  Improper posture during acupuncture treatment.  Excessive manipulation during acupuncture treatment. 异常状况 Copy Right: Colin Chan

9. Management Faint (Acupuncture Syncope) 晕针 Stop needling and withdraw all needles immediately Lie the patient in supine position, elevate the legs, loosen all tight clothing and keep the patient warm For light cases, serve the patient with warm or hot water or glucose drinks, patient’s condition will improve after a short rest For severe cases, acupressure or emergency acupuncture can be rendered by acupuncturing the following acupoints: GV 26 Shuigou 水沟, PC 6 Neiguan 内关, LI 4 Hegu 合谷, LR 3 Taichong 太冲, LI 1 Yongquan 涌泉 and ST 36 Zusanli 足三里 异常状况的处理 Copy Right: Colin Chan

10. Moxibustion can also be applied on the following acupoints: GV 20 Baihui 百会, CV 6 Qihai 气海, CV 4 Guanyuan 关元 to resuscitate the patient If the patient remains unconscious, has shallow/ weak respiration and weak pulse or does not respond to treatment, other emergency and resuscitating measures should be taken Faint (Acupuncture Syncope) 晕针 Management 异常状况的处理 Copy Right: Colin Chan

11. Prevention 异常状况的预防 Prevention (Acupuncture Syncope) 预防 Proper briefing to allay fear and anxiety Adopt the supine position Gentle insertion and manipulation with short retention time Withdraw all needles if s/s of pallor, dizziness, sweating occurs during course of treatment Advise patient to have their meals proir to acupuncture treatment Copy Right: Colin Chan

12. Physician to advise the patient to relax and stay calm if the cause of the incident is due to nervousness, excitement, apprehension, local muscle tension or local muscle spasm/contraction Apply gentle tapping and compression maneuvers on the surrounding areas around the punctured site Or, insert a second needle near the “ stuck needle”. This is to sooth and disperse the stagnation of Qi and Blood as well as to relieve muscle spasms Or, flick the handle of the “ stuck needle” gently with the finger tips to elicit a light vibration Twirl or rotate the “ stuck needle” in the opposite direction if the incident is caused by excessive rotation in one direction Stuck Needle (Sticking of the needle) 滞针 Management 异常状况的处理 Copy Right: Colin Chan

13. Encourage the patient to calm down and relax Gentle manipulation technique Do not over twirl the needle in one direction Ensure that the patient’ s position is maintain during retention of needle Prevention (Sticking of the needle) 预防 Prevention 异常状况的预防 Copy Right: Colin Chan

14. Stop all manipulation technique immediately If the needle is slightly bent, withdraw or remove the needle with the normal removal technique slowly and gradually If the needle is severely bent, take note of the direction of the bent, the needle can be removed by following the course of the bent slowly and gradually If the needle is bent at different or several sites, take note of pointing direction of the handle of the needle and gradually remove the bent needle segment by segment Bent Needle (Bending of the needle) 弯针 Management 异常状况的处理 Copy Right: Colin Chan

15. Do not pull or pluck or remove the bent needle with force. This is to prevent the incident of “ Broken Needle” If the incident is caused by the change in body posture of the patient, physician is to instruct and help the patient to resume the original body posture, relax the muscles and tissues of the affected site before removing the bent needle Bent Needle (Bending of the needle) 弯针 Management 异常状况的处理 Copy Right: Colin Chan

16. Skillful insertion and even manipulation Correct and comfortable position Maintain body posture during treatment Prevention (Bending of the needle) 预防 Prevention 异常状况的预防 Copy Right: Colin Chan

17. Physician to remain calm and instruct patient to maintain body posture to prevent the broken portion of the needle from piecing deeper into the skin Remove the broken portion of the needle with a forcep if it is protruding from the skin If the broken portion of the needle is slightly embedded or is at the level of the skin surface, press the skin gently around the slightly embedded portion using the thumb and the index finger of the left hand until the broken portion is visible, then remove it with a forcep with the right hand If the needle is totally embedded under the skin, Xray investigation is necessary to determine the exact position of the broken needle and surgical intervention is needed to remove the embedded needle Broken Needle (Breaking of the needle) 断针 Management 异常状况的处理

18. Inspection of needles Do not insert the needle body completely into the skin surface Bent needle should be withdrawn immediately Never insert a needle forcefully Prevention (Breaking of the needle) 预防 Prevention 异常状况的预防 Copy Right: Colin Chan

19. Slight hematoma may resolve by itself Painful/serious: press and apply cold compress Hematoma 血肿 Avoid injury to blood vessels Press puncture site with sterile cotton ball as soon as the needle is withdrawn Prevention 预防 Management 异常状况的处理 Prevention 异常状况的预防 Copy Right: Colin Chan

20. The End Copy Right: Colin Chan