Acupuncture Safety Guidelines Quiz

Safety Guidelines for Acupuncture

Preventing Bruising, Bleeding, and Vascular Injury

• Critical: avoid needling directly into arteries and major veins using anatomical knowledge
• Identify acupuncture points near major vessels (e.g. LU 9, HT 7, ST 9, etc.)
• Palpate subcutaneous structures before preparing the site for insertion
• Apply pressure to points after removing needles to prevent bleeding or hematoma
• Reexamine needled sites for signs of bleeding or hematoma

Preventing Needle Site Pain

• Strongly Recommended: allow alcohol to dry before needling
• Visualize anatomical structures while inserting needles
• Avoid using needles longer than the safe needling depth
• Method to reduce risk at GB 21 (Jianjing): isolate and lift the trapezius muscle, needle obliquely, and avoid directing the needle inferiorly toward the lung

Preventing Organ and Central Nervous System Injury

• Critical: observe safe needling depth and angles to avoid cardiac injury
• Use an oblique angle when needling on the sternum
• Limit the depth of acupuncture needle insertion to the subcutaneous layer
• Do not cup over needles on the abdomen to avoid tissue compression
• Limit vertical manipulation of needles on the abdomen

Preventing Traumatic Tissue Injury

• Critical: follow Safety Guidelines to Prevent Bruising, Bleeding and Vascular Injury
• Avoid aggressive needle manipulation in high-risk areas (e.g. hand, wrist, ankle)
• If a patient experiences acute severe pain, withdraw the needle to a shallower depth or remove it entirely

Preventing Infection

• Critical: follow Clean Needle Technique and Standard Precautions
• Use single-use sterile needles and lancets
• Check needles before use for sterilization expiration dates, breaks in packaging, or contamination
• Wear gloves or finger cots to cover broken skin on practitioner’s hands
• Maintain clean procedure while handling needles

Preventing Fainting

• Strongly Recommended: place first-time patients in a supine position with knees slightly elevated
• Explain the acupuncture procedure in detail and answer all questions to alleviate concerns
• Inform patients to eat 1-2 hours before acupuncture treatments
• Limit needle manipulation during the first acupuncture treatment

Preventing Stuck Needles

• Strongly Recommended: identify recommended depth of needle insertion for a particular point
• Situate patients in a relaxed position where they won't need to move
• Remind patients to remain still during acupuncture treatment
• Stimulate the area near a stuck needle with simple finger manipulation or another needle insertion

Preventing Needle Removal Errors

• Strongly Recommended: count and document the number of needles used
• Count and confirm the number of needles withdrawn from the patient
• Document needle counts in the patient chart

...( remainder of notes not included due to character limit )...### Safety Guidelines for Gua Sha and Other Acupuncture Therapies

Safety Guidelines for Gua Sha

• Any application of gua sha for children should be done in the presence of a parent or assigned guardian.
• Explain the therapeutic intention of gua sha and the timeline for the resolution of intended therapeutic petechiae with a handout on gua sha.
• Disinfect all tools using an FDA-cleared high-level disinfecting solution for semi-critical devices, in accordance with label instructions.

Safety Guidelines for Plum Blossom (Seven Star) Therapy

• Follow Safety Guidelines for Establishing and Maintaining a Clean Field.
• Follow Safety Guidelines for Skin Preparation.
• The area to be treated with plum blossom must be clean and free of any skin lesions or traumatic injury.
• Personal protective equipment (PPE) is required; wear gloves at all times as blood and OPIM will be present.
• Use only single-use sterile plum blossom/seven star needles or devices with single-use removable heads.

Safety Guidelines for Press Tacks or Intradermal Needling

• Follow Clean Needle Technique.
• Follow Standard Precautions.
• Follow Safety Guidelines for Establishing and Maintaining a Clean Field.
• Follow Safety Guidelines for Skin Preparation.
• Clean skin before inserting a press tack.
• Inspect area to be treated for evidence of inflammation, lesion, infection, or a break in skin barrier.

Safety Guidelines for Preventing EA Adverse Events

• Electrical stimulation should not be applied from one side of the chest across to the other side of the chest (front to back or side to side) in the region of the heart.
• A circuit should not cross the midsagittal line of the patient.
• Avoid applying EA near the brainstem.
• Consult with the primary physician of any patient with a history of a seizure disorder before instituting EA.

Safety Guidelines for Preventing Excessive Muscle Contraction During EA

• EA should not be used on infants, children, incapacitated, sleeping or unconscious persons.
• Turn up the amperage of the EA machine slowly and ask for constant feedback from the patient about sensation of pain.

Safety Guidelines for Preventing Electrical Injury During EA

• Prevent water, moisture, liquids or metal objects from coming in contact with the patient or treatment table.
• Do NOT use EA in wet or moist environments.
• Do not use if any part of the EA machine is cracked or otherwise damaged.

Safety Guidelines for Preventing Interference with a Cardiac Pacemaker During EA

• Avoid use of EA on the trunk of anyone with an implanted cardiac device, including a pacemaker.

Safety Guidelines for Acupuncture Bleeding Therapy

• Follow Safety Guidelines for Hand Sanitation.
• Follow Safety Guidelines for Skin Preparation.
• Practitioners must take a thorough history including bleeding disorders, medication, and supplement history before using bleeding techniques.
• Personal protective equipment (PPE) is required; wear gloves at all times as blood and OPIM will be present.

Safety Guidelines for Gua Sha

• Follow Standard Precautions.
• Follow Safety Guidelines for Establishing and Maintaining a Clean Field.
• Follow Safety Guidelines for Hand Sanitation.
• Take a careful patient history to identify if the patient is taking medications that thin the blood, such as anticoagulant and antiplatelet therapies, pain medications such as NSAIDS and supplements such as vitamin E and fish oils.

Safety Guidelines to Prevent Bruising, Bleeding, and Vascular Injury

• Avoid needling directly into arteries and major veins through anatomical knowledge.
• Identify those acupuncture points which lie over or next to major vessels.

Safety Guidelines to Prevent Needle Site Pain

• If alcohol is used to clean the acupuncture sites, allow alcohol to dry before needling.
• Visualize anatomical structures while inserting the needle and during all needle manipulation.

Safety Guidelines to Prevent Fainting

• Place a first-time patient in the supine position with the knees slightly elevated for the first acupuncture treatment.
• Explain acupuncture procedure in detail and answer all questions before acupuncture needle insertion to allay concerns and nervousness.

Safety Guidelines to Avoid and/or Respond to Stuck Needle

• Identify the recommended depth of the needle insertion for a particular point and utilize proper stimulation techniques for needles inserted below the subcutaneous level.
• Situate patients in an initial position where they are relaxed and not likely to need to move.

Safety Guidelines for Needle Removal

• Count and write down the number of needles used, including those discarded due to improper needle placement.
• Count the number of needles withdrawn from the patient.
• Confirm that the same number of needles inserted has been withdrawn and discarded.

Safety Guidelines to Prevent Pneumothorax

• Obtain a medical history from a patient regarding lung function, lung diseases and smoking history before needling on the chest or back.
• Assess physique of a patient.
• Limit the depth of acupuncture needle insertion to the subcutaneous layer and initial perimysium of the intercostal muscles.

Safety Guidelines to Avoid and Respond to Moxa Burns

• Take a careful patient history to identify neuropathies or other conditions that might limit a patient’s response to pain or the ability to sense heat.

• During moxa therapy the practitioner must remain in the room at all times.

• Anticipate and shield a patient from falling ash when utilizing needle-top moxa.### Acupuncture Safety Guidelines

• If there are indications or suspicions that an organ may have been punctured, emergency transport should be called to take the patient to an emergency medical facility.

• To avoid organ and central nervous system injury, observe safe needling depth and angles.

• Limit the depth of acupuncture needle insertion to the subcutaneous layer.

• Avoid needling Du 22 (Xinhui) in infants.

• Take a patient history to identify diseases that might lead to changes in organ size.

Preventing Traumatic Tissue Injury

• Follow safety guidelines to prevent bruising, bleeding, and vascular injury.
• Avoid aggressive needle manipulation in areas with a risk of peripheral nerve injury (e.g., hand, wrist, ankle, and fibular head).
• If a patient experiences acute pain from needling, withdraw the needle to a shallower depth or remove it entirely.

Preventing Infection

• Follow clean needle technique and standard precautions.
• Use single-use sterile needles and lancets.
• Check needles for sterilization expiration dates, breaks in packaging, or contamination before use.
• Wear gloves or finger cots or cover up broken skin on hands.
• Maintain a clean procedure while handling needles.
• Discard used needles in a sharps container.

Cupping Safety Guidelines

• Take a patient history to identify diabetes, neuropathies, or other conditions that might limit response to pain or sense of heat.
• Assess the patient carefully when utilizing fire cupping.
• Remove burning material from the cup before applying it to the patient's skin.
• Follow standard precautions, establish and maintain a clean field, and use hand sanitation.
• Cupping should be applied on clear skin only, and not over active lesions.

EA Safety Guidelines

• Electrical stimulation should not be applied across the chest or near the brainstem.
• Avoid applying EA near the heart or on patients with pacemakers or other electronic implants.
• Prevent water, moisture, or liquids from coming into contact with the patient or treatment table.
• Ensure the EA machine is not damaged or cracked, and wires or leads are in good condition.

Acupuncture Bleeding Therapy

• Follow safety guidelines for hand sanitation, skin preparation, and personal protective equipment.
• Take a thorough patient history, including bleeding disorders, medication, and supplement history.
• Use lancets that are limited to single-patient use and discard them after use.
• Use eye protection when performing bleeding techniques.

Gua Sha Safety Guidelines

• Follow standard precautions, establish and maintain a clean field, and use hand sanitation.
• Take a patient history to identify medications that thin the blood or other conditions.
• Apply gua sha on clear skin only, and not over active rash, lesion, inflammation, or break in skin barrier.

Plum Blossom (Seven Star) Therapy

• Follow safety guidelines for establishing and maintaining a clean field, skin preparation, and hand sanitation.
• Use only single-use sterile plum blossom/seven-star needles or devices with single-use removable heads.
• Discard used plum blossom needles in a sharps container immediately after use.

Press Tacks or Intradermal Needling

• Follow clean needle technique and standard precautions.
• Inspect the area to be treated for evidence of inflammation, lesion, infection, or break in skin barrier.
• Use only single-use sterile instruments, including press tacks, when breaking the skin surface.

Tui Na

• Follow safety guidelines for hand sanitation.
• Never apply tui na to areas with dermatitis, active lesions, or other wounds.
• Provide appropriate pressure and adjust tui na treatments according to age, location, body constitution, and medical history.

Preventing Bruising, Bleeding, and Vascular Injury

• Avoid needling directly into arteries and major veins.
• Identify acupuncture points that lie over or next to major vessels.
• Palpate subcutaneous structures, including major vessels, before preparing the site for insertion.

Preventing Needle Site Pain

• If alcohol is used to clean the acupuncture sites, allow it to dry before needling.
• Visualize anatomical structures while inserting the needle and during all needle manipulation.