1. Benchmark Review Acupuncture Techniques, CNT, and Herb Basics March 16, 2013

2. Acupucture Techniques 15 questions

3. Identifying correct location  Review your point location information covered last week. Look at:  Anatomical landmarks – bony prominences, hairlines, etc.  Proportional measurements guides  Hand guidelines  How to count the vertebra and ribs  Etc.

4. Positioning your patient  Supine  Prone  Lateral recumbent  Sitting  Etc.

5. Anatomy and needling considerations This is a little bit of a repeat from Point Locations and Deadman.  Depth  Precautions Children, elderly, people on blood thinners, hemophiliacs, etc.  Contraindications (Ren 8, St 17, Du 25, etc.)

6. Precautions related to treatment  http://catstcmnotes.com/downloads/Ac upuncture%20Techniques/Acupuncture% 20Techniques%201/Acu%20Tech%20I%20- %20Class%209%20handout.pdf http://catstcmnotes.com/downloads/Ac upuncture%20Techniques/Acupuncture% 20Techniques%201/Acu%20Tech%20I%20- %20Class%209%20handout.pdf

7. Insertion techniques  Guide tube insertions  Two handed and one handed  Pressing with non-dominant hand.  Stretching the skin  Pinching the skin

8. Angles  Transverse/horizontal – 15-25 degrees  Thin areas  Over organs  Next to mouth  Between the fingers  Oblique – 45 degrees  hinner areas such as the chest, abdomen, intercostal muscle spaces, into the back muscles in the thoracic areas or anywhere there is a danger of hitting an organ or nerve. This is especially important in thinner patients.  Perpendicular insert

9. Depth of insertion  Age Shallower for kids, elderly  Constitution Deeper for large (either muscley or fat) Shallower for small folks  Area of the body you are needling  Disease conditions Shallow for skin problems, close to the bone for bone problems, deeply for steaming bone, somewhat deeper for blood and deficiency problems, shallower for external invasions.  Seasons Shallower in spring/summer due to greater yang, deeper in winter/fall when Qi hides and goes deeper, deeper on rainy days/shallower on sunny.  Sensitivity of the patient Depends on how quickly your patient feels the qi.

10. Direction of insertion  Back – 1 st and 2 nd bladder lines  Upper back  Lower back  Chest – intercostal spaces  Head  Abdomen  Limbs

11. Manipulation and arrival of Qi  Normal needling reactions/patient sensations Soreness, aching, numbness, heaviness, distention, radiating sensations, etc.  Not-so-normal reactions  Electrical zaps  Pain when hitting a blood vessel – sharp and doesn’t recede  Hitting a bone can result in sharp pain or dull ache also  Getting Da Qi

12. Reinforcing/Reducing  Reinforce for deficiencies, reduce for excesses.  Lift/thrust  Rotating methods  Pressing (pressing around the needle to call qi)  Plucking  Scraping  Shaking  Flying  Trembling  Rotate + lift/thrust

13. Cupping techniques and application See Dr. Qiu’s Cupping lectureCupping lecture

14. Moxa and application Dr. Qiu’s Moxibustion lecture notesMoxibustion lecture

15. Four Needle Technique…again Been there, done that last week.

16. Clean Needle Technique  5 questions

17. Equipment maintenance and safety

18. Emergency situations  Fainting  Broken Needles  Stuck Needles  Organ Punctures  Burns  Bleeding  Cardiac arrest  Other

19. Precautions and contraindications  Pregnant patients  Upper back and chest points  OSHA requirements

20. Herbs  8 questions

21. The basics  Dosages  Tastes  Properties  Safety

22. Release exterior cold

23. Release exterior heat

24. Clear heat

25. Drain downward

26. Drain damp