Clean Needle Technique for Acupuncture

Clean Needle Technique

Infection Control – Practitioner Hygiene

Physical cleanliness includes not only adequate hand washing, but also things like clean clothes (i.e. lab coat), back plucking long hair, keeping nails clean and short. Cuts/abrasions should be covered with a Band-Aid and/or gloves. Do not work with upper respiratory disease.

Hand washing –

A practitioner should wash their hands before and after contact with each patient. Soap with antibacterial agent is preferred and highly recommended. Clean paper towels should be used to dry hands. When washing your hands, rubbing and running water are essential to help remove surface microbes from the epidermal layer of the skin.

The germ theory –

If a sterile object comes into contact with a non-sterile surface, the object is no longer sterile. All needles must be properly sterilized for needle insertion. The spindles of the needle, especially longer needles, can be stabilized with a sterile cotton ball or sterile gauze. If the needle touches any object (i.e. pants, clothing, bedding) or falls on the floor, the needle is considered dirty and should not be used. All used alcohol wipes and needle packaging should be discarded from the clean area. Suction cups that come into contact with the skin must be sterilized or disinfected before each use.

Packaging –

Sterilization expiration dates of all packaged needles should be checked. Any package that is wet, torn, or expired is no longer considered sterile.

Sterilization Types

1. Steam

2. Boiling

3. Dry heat sterilization

4. Chemical sterilization

disinfection

3 Types of Disinfection

1. Halogen – contains chlorine and

2. Phenol – pure phenol obtained from coal tar

3. Alcohol – two types of alcohol: Isopropyl and Ethyl

antisepsis

There are 3 types of antisepsis

1. Iodine

2. Alcohols

3. Hexachlorophenes

Iodine is a popular antiseptic and is used in concentrations of 70-90%. Be careful when using iodine as it can leave permanent stains on clothes. Isopropyl Alcohol is also an effective antiseptic. Always keep the caps of alcohol bottles closed to maintain 100% concentration. When swiping the skin, a cotton swab or swab should be applied in a single wipe of liquid. Do not slide the skin back and forth or in circular motions. Alcohol should not be applied to mucous membranes or open wounds.

Needle Disposal

All needles should be disposed of in appropriate sharps containers according to Public Health Regulations. Alcohol swabs or cotton swabs should be thrown in the trash unless they are completely covered with blood.

Iatrogenic Complications

1. Forgotten Needle: There have been cases where a practitioner forgot to remove the needle. Practitioners should try to keep the needle count. This can reduce the risk of missed needles. A forgotten needle may cause possible harm/injury.

2. Broken Needle: Very thin needles (>34 gauge) are more prone to breakage during insertion. A broken needle with the handle visible above the skin can be safely removed in a sterile clamp, but if a needle is broken and is 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 by patient movement. It results in pinprick as the muscle tissue around the needle spasms and locks the needle in place. In this case, the needle should never be forcibly removed. You should stop the electro-acupuncture and let the patient rest. Gently massage the area or meridian of the stuck needle to help release the needle. If needle jamming is due to patient movement, the patient should assume the original position and the needle can be removed.

pneumothorax

It is one of the most frequently reported complications of acupuncture in the medical literature. A pneumothorax occurs when the lung surface is punctured, allowing air to travel from the lung into the pleural space. The most common point held is GB21 and points around the neck and shoulder girdle. The best measure is to use the correct needle depth and angle.

Blood vessel

Puncture of small superficial veins is not uncommon. When this occurs, pressure should be applied to the affected area for about one minute. The practitioner should always inform the patient about the hematoma. Arterial puncture is more serious. For a small artery to bleed, you need to apply firm pressure for about 3-5 minutes.

Organ Perforation

All organs are susceptible to puncture if needled incorrectly. Organs more prone to perforation are the bladder, kidneys, enlarged spleen or liver. and peritoneal cavity. To empty the patient’s bladder if needles are being injected into the lower abdominal points.

Spinal Cord Trauma

Loss of feeling or movement can result from a needle entering the spinal cord.

neuritis

Inflammation of the nerve can result from needles directly on the nerves or from needling using strong electrical stimulation. If the nerve is inflamed, the patient may experience numbness, electric sensation, or motor weakness.

infection

allergic dermatitis

Signs and symptoms include skin rash, itching/burning sensation, and pain or discomfort at the entry site. Acupuncture needles containing nickel and chromium are known to cause allergic dermatitis.

Various Infections

Various infections that can occur include septicemia, osteomylitis, bacterial endocarditis, meningitis, and hepatitis. The only way to avoid these situations is the use of sterile needles and the identification of high-risk patients.

Other Complications or Side Effects

1. Nausea – If strong parasympathetic stimulation occurs during needling, the patient may experience nausea. If nausea or vomiting persists, the needles should be withdrawn immediately.

2. Normal Side Effects – You will often hear comments like “feeling dizzy” or “mild disorientation” or “euphoria”. These are all normal side effects of acupuncture. Sometimes the patient may feel cold with prolonged needle holding (more than 20-30 minutes).

Treatment Contraindications

People who are under the influence of drugs or alcohol, have an empty stomach, are emotionally unstable, or have just finished physical exertion should not be treated with acupuncture.

Contraindications of Electro-acupuncture

When using electro-acupuncture, 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. Electroacupuncture is contraindicated during pregnancy and in patients with any type of pacemaker.

Pregnancy

Traditional Chinese Medicine advises against needles during any asymptomatic, normal pregnancy. If symptoms are present, specifically symptom-oriented needling is allowed.

Electrical Stimulation and Acupuncture

Waveform/Frequency/Intensity

Specifications for model AWQ-104E

• Pulse Shape: Biphasic Rectangular Wave

• Pulse width: 350 uS at X1, 40us at X10

• Pulse rate (frequency): 1-120Hz at X(1), 10-1200Hz at X(10)

• Waveform: adjustable, densely dispersed, intermittent

• Output current (density): 0-18mA (Low) 0-40mA (High)

• Channel: 4

• Point detector

manipulation

• Be sure to inspect the electro-acupuncture device before each use.

• Insert the needle (metal handle) and get a sense of Qi

• Make sure all knobs are turned to zero before attaching the electro-acupuncture device to the needles.

• Connect the electrical stimulator with needles.

• Turn on the power.

• Tune the electro-acupuncture device to the appropriate waveforms and frequency

• Adjust the intensity to a comfortable level.

• Intensity “Hi-Lo” switch or “1-10” frequency switch, or if polarity needs to be changed, the output density (and sometimes frequency) must be reduced to zero.

• Treatment should last 15-20 minutes

• Before turning off the power, make sure all the buttons are zero and remove the lead wire.

Notes:

• 2 pins complete a circuit

• Connect the negative lead to the primary point and the positive lead to the secondary point

waveforms

Intense wave (continuous)

High frequency: 50-100 pulses per second

Function and indicators:

Inhibits sensory and motor nerves

Relieves pain, calms the mind, relieves spasm of muscles

Dispersion / Sparse wave (continuous)

Low frequency: 2-5 pulses per second

Function: Induce the contraction of the muscles and increase the tension of the muscle and ligament.

Indication: injury of muscles, ligaments and joints.

Dense diffuse wave

The diffuse wave and the dense wave appear alternately, each lasting approximately 1.5 seconds. Block the body’s adaptation

Function:

Relieve pain, improve the function of organs, improve qi and blood circulation, improve tissue nutrition, reduce inflammation

Indication: Pain, trauma, sprain, arthritis, sciatica, facial paralysis, muscle weakness, etc.

intermittent wave

A wave appears that opens and closes rhythmically. Interval: 1.5s

Function: Stimulating muscles

Indicator: paralysis.

Precautions/Contraindications

• Increase the intensity of electro-acupuncture gradually, so that we can avoid events such as muscle contraction, needle breakage, and bent needle caused by increased intensity.

• The number one priority is to make the patient comfortable at all times.

• Light stimulation is required when performing electro-acupuncture near the spine and brainstem.

• When applying electro-acupuncture to the chest and back area in the heart area, do not connect the points on both sides of the body to avoid current flowing through the heart.

• Do not stimulate the heart area.

• Do not stimulate patients with pacemakers or other electronic implants.

• Use electroacupuncture with caution in patients with heart disease, seizures, and pregnant women.

• Electroacupuncture should be used with caution in elderly or frail patients.

disease treatment

Advantages

1. Better for nerve related problems

2. Stimulation is more measurable than manual

3. Many points can be stimulated at the same time (manual can only stimulate one at a time)

4. Stimulation may take longer. A typical treatment is usually 20 minutes. If you are stimulating manually, you will usually only stimulate for a few minutes at most.

• Points are selected in pairs

• Usually unilateral

(Left or right pair on the same side Do not switch from one side to the other, as this may hinder heart movement)

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