Acupuncture Safety Guidelines Quiz
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Questions and Answers

What is a strongly recommended safety guideline to prevent bruising, bleeding, and vascular injury during acupuncture?

  • Identifying acupuncture points near major vessels
  • Applying pressure to points after needle removal
  • Palpating subcutaneous structures before needle insertion (correct)
  • Visualizing surface vessels during needle insertion

    • Which acupuncture point should caution be applied when treating patients on blood-thinning medications or supplements?

  • HT 7 Shenmen
  • LU 9 Taiyuan
  • LR 12 Jimai (correct)
  • SP 11 Jimen

    • Why is it important to visualize anatomical structures during needle insertion?

  • To apply pressure to the points after removing needles
  • To prevent needling directly into arteries and major veins (correct)
  • To avoid superficial bleeding or hematoma
  • To palpate major vessels before needle insertion

    • Which acupuncture point lies over the axillary artery?

    <p>HT 1 Jiquan</p> Signup and view all the answers

    What is the recommended action for preventing needle site pain if alcohol is used to clean the acupuncture sites?

    <p>Allow alcohol to dry before needling</p> Signup and view all the answers

    What is the recommended method to reduce risk when needling at GB 21 (Jianjing)?

    <p>Isolate and lift the trapezius muscle</p> Signup and view all the answers

    What is the critical safety guideline to prevent infection while practicing acupuncture?

    <p>Use single-use sterile needles</p> Signup and view all the answers

    What is prohibited when needling Du 22 (Xinhui)?

    <p>Needling in infants</p> Signup and view all the answers

    What should a practitioner do if a patient experiences acute severe pain from needling a point?

    <p>Withdraw to a shallower depth</p> Signup and view all the answers

    Why is it strongly recommended to guide tubes being sterile at the beginning of treatment?

    <p>To reduce peripheral nerve injury risk</p> Signup and view all the answers

    What safety measure is strongly recommended to prevent fainting during acupuncture treatment?

    <p>Placing a first-time patient in the supine position with slightly elevated knees</p> Signup and view all the answers

    How should stuck needles be addressed according to the safety guidelines provided?

    <p>Leave the stuck needle in place for a few minutes</p> Signup and view all the answers

    What is the significance of the patient's physique when needling on the chest or back to avoid pneumothorax?

    <p>A tall and thin physique increases the risk of penetrating the lung</p> Signup and view all the answers

    What should be done to avoid tissue compression over needles in the thoracic area?

    <p>Limit vertical manipulation of needles</p> Signup and view all the answers

    What is the safe needling depth to avoid pneumothorax on most patients?

    <p>10-20 mm</p> Signup and view all the answers

    What should be done with the burning material before applying a cup to a patient's skin?

    <p>Remove it</p> Signup and view all the answers

    When should cupping not be applied related to chemotherapy treatment?

    <p>48 hours before or after chemotherapy treatment</p> Signup and view all the answers

    Why is it recommended to take a careful patient history when performing fire cupping?

    <p>To assess the patient's response to heat and pain</p> Signup and view all the answers

    What is strongly recommended when performing cupping over active herpes zoster lesions?

    <p>Use advanced training on how to safely treat lesions with cups</p> Signup and view all the answers

    What is critical to do when disinfecting cups?

    <p>Disinfect cups using an FDA-cleared disinfecting solution following label instructions</p> Signup and view all the answers

    What is the practitioner advised against doing after cleaning the skin and before needling to locate an acupuncture point?

    <p>Tracing fingers across a wide area of skin</p> Signup and view all the answers

    In moxa therapy, what is strongly recommended for practitioners to do during the application of moxa therapies?

    <p>Monitor skin temperature and heat generated</p> Signup and view all the answers

    What is a critical safety guideline for preventing broken needles?

    <p>Inspect needle for defects before use</p> Signup and view all the answers

    What is recommended in case of moxa burns to prevent secondary infections?

    <p>Clean burns with cool running water immediately</p> Signup and view all the answers

    When using heat lamps on patients with reduced response to heat, what is strongly recommended for practitioners?

    <p>Utilize air filter units with HEPA filters</p> Signup and view all the answers

    What is a recommended alternative for press tacks or intradermal needles in auricular therapy for immunocompromised patients?

    <p>Ear seeds</p> Signup and view all the answers

    What should be done after withdrawing intradermal needles from acupuncture points?

    <p>Apply pressure with clean cotton or gauze</p> Signup and view all the answers

    What is a critical safety guideline for practicing Tui Na?

    <p>Avoid areas with dermatitis or active lesions</p> Signup and view all the answers

    What factors should be considered when adjusting Tui Na treatments?

    <p>Age, location, body constitution, and medical history</p> Signup and view all the answers

    Why is it important to identify patient allergies to medical tape in auricular therapy?

    <p>To prevent allergic reactions during the procedure</p> Signup and view all the answers

    What is the critical safety guideline for disinfecting gua sha tools?

    <p>Use a high-level disinfecting solution for semi-critical devices.</p> Signup and view all the answers

    Why is it important to avoid 'flinging' the hammer around during Plum Blossom (Seven Star) therapy?

    <p>To prevent blood or OPIM spray.</p> Signup and view all the answers

    What is advised concerning the use of press tacks or intradermal needles to prevent complications?

    <p>Discard if contaminated and never reinsert into the skin.</p> Signup and view all the answers

    Which safety guideline is strongly recommended in relation to press tacks or intradermal needling?

    <p>Provide direct contact information to patients.</p> Signup and view all the answers

    What is the critical safety guideline for the area to be treated with plum blossom therapy?

    <p>Keep the area clean and free of skin lesions or injuries.</p> Signup and view all the answers

    What safety guideline is Critical to follow to prevent Electrical Injury During EA?

    <p>Prevent water, moisture, liquids or metal objects from coming in contact with the patient or treatment table</p> Signup and view all the answers

    Which statement is False regarding Gua Sha treatment?

    <p>Gua sha should not be applied 48 hours before chemotherapy treatment</p> Signup and view all the answers

    What is a Safety Guideline that is Critical to follow for preventing Excessive Muscle Contraction During EA?

    <p>Apply EA in such a manner as to avoid muscle contraction except when expected</p> Signup and view all the answers

    What should Practitioners do before using bleeding techniques according to the text?

    <p>Inspect area to be treated for evidence of inflammation, lesion, infection, or a break in the skin barrier</p> Signup and view all the answers

    What is a critical safety guideline for preventing bruising, bleeding, and vascular injury during acupuncture?

    <p>Palpating subcutaneous structures before preparing the site for insertion</p> Signup and view all the answers

    Why is it important to visualize anatomical structures while inserting the needle?

    <p>To ensure correct needle placement and avoid vascular injury</p> Signup and view all the answers

    What is a strongly recommended safety measure to prevent fainting during acupuncture treatment?

    <p>Palpating subcutaneous structures before preparing the site for insertion</p> Signup and view all the answers

    What is advised when needling acupuncture points near major vessels?

    <p>Limiting the depth of needle insertion</p> Signup and view all the answers

    Why is precaution necessary in patients on blood-thinning medications or supplements?

    <p>To prevent superficial bleeding or hematoma</p> Signup and view all the answers

    What is the recommended position for a first-time patient during the first acupuncture treatment?

    <p>Supine position with knees slightly elevated</p> Signup and view all the answers

    How should practitioners address stuck needles according to safety guidelines?

    <p>Stimulate the area near the stuck needle and try removing it again</p> Signup and view all the answers

    What is a critical safety guideline to avoid pneumothorax during acupuncture?

    <p>Limit needle manipulation on the chest or back</p> Signup and view all the answers

    What is important to do before needling on the chest or back regarding patient history?

    <p>Obtain lung function and smoking history</p> Signup and view all the answers

    Which technique is strongly recommended to avoid tissue compression and potential needle penetration into internal organs?

    <p>Needling at an oblique angle in the thoracic body</p> Signup and view all the answers

    What is critical to ensure when applying pressure to an acupuncture point with clean cotton or gauze after needle withdrawal?

    <p>Use dirty hands to apply pressure</p> Signup and view all the answers

    What is strongly recommended when moxa therapy is applied?

    <p>Multi-task during moxa application</p> Signup and view all the answers

    What is a critical safety measure when utilizing heat lamps on patients with a reduced response to heat?

    <p>Expose the lamp to moisture</p> Signup and view all the answers

    What is a strongly recommended action for preventing secondary infections from moxa burns?

    <p>Refer to a western medical practitioner</p> Signup and view all the answers

    What is recommended before utilizing a heat lamp to avoid fainting during acupuncture treatment?

    <p>Use the lamp in close proximity to combustible materials</p> Signup and view all the answers

    What is the recommended method to reduce risk at GB 21 (Jianjing)?

    <p>Use an oblique angle and needle across the muscle</p> Signup and view all the answers

    When needling Du 22 (Xinhui) in an infant, what is prohibited?

    <p>Superficial needling</p> Signup and view all the answers

    In avoiding internal organ penetration, what angle should be used for needling on the sternum to avoid a sternal foramen?

    <p>Oblique angle</p> Signup and view all the answers

    What is recommended if a patient experiences acute severe pain from needling a point?

    <p>Remove the needle entirely</p> Signup and view all the answers

    What is advised when disinfecting cups to prevent infection?

    <p>Follow guidelines for disinfecting reusable adjunct therapy tools</p> Signup and view all the answers

    What is strongly recommended to prevent cupping-related infections?

    <p>Decant lubricants into secondary disposable containers</p> Signup and view all the answers

    Why is it important to limit the retention time of cups during cupping?

    <p>To prevent adverse skin reactions like bullae formation</p> Signup and view all the answers

    What safety guideline is critical when applying cupping over needles in the thoracic region?

    <p>Avoid direct application of cups over needles inserted obliquely</p> Signup and view all the answers

    What should be done before applying cupping to patients who might have reactive skin lesions?

    <p>Take a careful patient history</p> Signup and view all the answers

    What should practitioners do to avoid misinterpretation of cupping-related skin effects?

    <p>Explain the therapeutic intention and effects of cupping</p> Signup and view all the answers

    What is a Critical safety guideline to follow when performing Acupuncture Bleeding Therapy?

    <p>Do not reuse lancets and discard them in a sharps container</p> Signup and view all the answers

    Why is it Critical to avoid using electrical stimulation from one side of the chest across to the other side?

    <p>To prevent adverse events in the region of the heart</p> Signup and view all the answers

    Which of the following is a Strongly Recommended safety measure to prevent excessive muscle contraction during Electrical Acupuncture (EA)?

    <p>Apply EA in a manner to avoid muscle contraction</p> Signup and view all the answers

    What is a Recommended action to prevent electrical injury during Electrical Acupuncture (EA)?

    <p>Avoid using cracked EA machine parts</p> Signup and view all the answers

    When reusing gua sha tools, what should be done to significantly reduce the risk of needlestick injuries?

    <p>Select only tools that are disposable</p> Signup and view all the answers

    Which safety guideline is critical for disinfecting gua sha tools?

    <p>Disinfect tools using FDA-cleared intermediate- to high-level solutions.</p> Signup and view all the answers

    What is strongly recommended to prevent puncturing the skin during Plum Blossom therapy?

    <p>Avoid raising the hand holding the hammer too high or tapping too forcefully.</p> Signup and view all the answers

    What should practitioners consider utilizing when using the plum blossom device?

    <p>Eye protection.</p> Signup and view all the answers

    What is a strongly recommended safety measure to prevent complications when using press tacks or intradermal needles?

    <p>Provide patients with direct contact information in case of needle complications.</p> Signup and view all the answers

    What is a recommended action for patients using press tacks or intradermal needles at home?

    <p>Return to the office for removal of press tacks.</p> Signup and view all the answers

    What is a key consideration for immunocompromised patients when it comes to auricular therapy?

    <p>Avoiding the use of ear seeds or magnets</p> Signup and view all the answers

    What is advised after the withdrawal of intradermal needles in acupuncture?

    <p>Applying pressure with clean cotton or gauze</p> Signup and view all the answers

    What is a strongly recommended safety guideline for Tui Na practitioners?

    <p>Follow safety guidelines for hand sanitation</p> Signup and view all the answers

    Why is it important to adjust Tui Na treatments according to age and medical history?

    <p>To ensure the patient's comfort and safety</p> Signup and view all the answers

    What is a critical step for practitioners during the application of auricular therapy on immunosuppressed patients?

    <p>Considering the use of ear seeds or magnets</p> Signup and view all the answers

    What is a critical safety measure to prevent superficial bleeding or hematoma after removing needles?

    <p>Reexamine needled sites for signs of bleeding</p> Signup and view all the answers

    Which acupuncture point should caution be applied when treating patients on blood-thinning medications or supplements?

    <p>SP 11 Jimen</p> Signup and view all the answers

    What is a strongly recommended safety guideline to prevent needle site pain?

    <p>Allow alcohol to dry before needling</p> Signup and view all the answers

    When visualizing surface vessels during needle insertion, which action is recommended?

    <p>Palpate major vessels before preparing the site</p> Signup and view all the answers

    What is a critical safety guideline to prevent vascular injury?

    <p>Identify acupuncture points over major vessels</p> Signup and view all the answers

    What is advised to prevent cardiac injury while needling at GB 21 (Jianjing)?

    <p>Needle across the muscle taking care to direct the needle directly inferiorly.</p> Signup and view all the answers

    What is a critical safety guideline to follow to prevent organ puncture?

    <p>Limit the depth of acupuncture needle insertion to the subcutaneous layer.</p> Signup and view all the answers

    What is strongly recommended to reduce the risk of peripheral nerve injury?

    <p>Avoid aggressive needle manipulation in anatomical areas with a record of risk.</p> Signup and view all the answers

    What should practitioners do if a patient experiences acute severe pain from needling a point?

    <p>Withdraw the needle entirely without adjusting the depth.</p> Signup and view all the answers

    What is a strongly recommended action after withdrawing intradermal needles from acupuncture points?

    <p>Immediately isolate used needles in an appropriate sharps container.</p> Signup and view all the answers

    What is the most critical safety guideline to follow to prevent secondary infection from moxa burns?

    <p>Utilize air filter units which include HEPA filters when performing moxibustion</p> Signup and view all the answers

    What is strongly recommended to ensure patient safety when using heat lamps?

    <p>Take a careful patient history to identify diabetes or neuropathies</p> Signup and view all the answers

    What is a critical safety measure when using heat lamps on patients with reduced heat response?

    <p>Heat must be monitored at all times on patients with reduced heat response</p> Signup and view all the answers

    What is a strongly recommended safety measure to prevent adverse reactions to moxa smoke?

    <p>Utilize air filter units which include HEPA filters during moxibustion</p> Signup and view all the answers

    What is critical to prevent heat-related complications during moxa therapy?

    <p>The practitioner should monitor skin temperature and amount of heat generated</p> Signup and view all the answers

    What is a strongly recommended safety measure to avoid pneumothorax in acupuncture?

    <p>Limit the depth of needle insertion to the subcutaneous layer and initial perimysium of the intercostal muscles.</p> Signup and view all the answers

    What should be done if a needle becomes stuck during acupuncture treatment?

    <p>Rotate the needle back in the opposite direction.</p> Signup and view all the answers

    What is advised to prevent fainting during acupuncture treatment for first-time patients?

    <p>Place the patient in a prone position with knees elevated.</p> Signup and view all the answers

    What is a key aspect to consider when removing acupuncture needles safely?

    <p>Count and write down the number of needles used and discarded.</p> Signup and view all the answers

    Why is it important to inform patients about possible symptom aggravation from acupuncture?

    <p>To prepare them for transient worsening of symptoms as a possible outcome.</p> Signup and view all the answers

    What is the critical safety guideline to follow when performing cupping over active herpes zoster lesions?

    <p>Apply cupping with advanced training only</p> Signup and view all the answers

    Which is a strongly recommended action to prevent cupping-related infections?

    <p>Dispose of used wet cups in biohazard trash</p> Signup and view all the answers

    What is the critical safety measure to prevent complications when applying cupping on patients taking anticoagulant and antiplatelet therapies?

    <p>Limit the retention time of cups based on physical tolerance</p> Signup and view all the answers

    What should be avoided when using lubricants during cupping to prevent cross-contamination?

    <p>Retouching the spout of a pump container</p> Signup and view all the answers

    What safety guideline should be followed for preventing cupping adverse events in relation to chemotherapy treatment?

    <p>Avoid cupping 48 hours before or 24 hours after chemotherapy</p> Signup and view all the answers

    What is a critical safety guideline for preventing interference with a cardiac pacemaker during EA?

    <p>Use EA on the trunk of anyone with an implanted cardiac device</p> Signup and view all the answers

    What is strongly recommended to avoid excessive muscle contraction during EA?

    <p>Apply EA in a manner to avoid muscle contraction</p> Signup and view all the answers

    What is a Recommended safety guideline for preventing electrical injury during EA?

    <p>Ensure water does not come in contact with the patient</p> Signup and view all the answers

    What is a Critical safety guideline to follow for preventing acupuncture bleeding therapy complications?

    <p>Inspect the area for inflammation before bleeding</p> Signup and view all the answers

    What is a Safety Guideline that is Critical to follow for preventing Gua Sha complications?

    <p>Avoid gua sha over recent trauma or sunburns</p> Signup and view all the answers

    What is a strongly recommended safety guideline for practitioners using Plum Blossom (Seven Star) therapy?

    <p>Avoiding touching the tips of the needles at the device head</p> Signup and view all the answers

    What is a critical safety measure to follow when utilizing Press Tacks or Intradermal Needling?

    <p>Discarding contaminated needles immediately</p> Signup and view all the answers

    When should patients return to the office after Press Tacks or Intradermal Needling treatment?

    <p>After two weeks for device removal</p> Signup and view all the answers

    What is a strongly recommended safety measure for practitioners applying Gua Sha for children?

    <p>Ensuring the presence of a parent or guardian</p> Signup and view all the answers

    What is a critical safety guideline for disinfection of Gua Sha tools?

    <p>Disinfecting with an FDA-cleared solution as per instructions</p> Signup and view all the answers

    What is a critical safety measure recommended for treating immunocompromised patients with auricular therapy?

    <p>Utilizing ear seeds or magnets instead of press tacks</p> Signup and view all the answers

    What should practitioners avoid doing when applying Tui Na treatments?

    <p>Applying Tui Na to areas with dermatitis or wounds</p> Signup and view all the answers

    What is strongly recommended when providing Tui Na treatments?

    <p>Adjusting treatments based on the patient's location</p> Signup and view all the answers

    Why is it important for practitioners to consider a patient's allergic reaction to medical tape before auricular therapy?

    <p>To prevent allergic reactions or complications</p> Signup and view all the answers

    What critical safety measure should be followed when practicing Tui Na?

    <p>Following safety guidelines for hand sanitation</p> Signup and view all the answers

    Study Notes

    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.

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    Test your knowledge on safety guidelines to prevent bruising, bleeding, and vascular injury during acupuncture. Learn about avoiding needling directly into arteries and major veins, and identifying acupuncture points near major vessels.

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