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Acupuncture Needling Techniques - Class 05
Detailed instructions on the use of Acupuncture needles and Moxibustion techniques
By: David Botton

Accidents and Their Management

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Class 5 - Accidents and Their Management


Fainting

Reasons:

First time patients from nerves

Constitutional issues

Over stimulation

Electrical stimulation


Symptoms:

Palpitations

Nausea

Pale complexion

Sweating

Cold limbs

Unresponsive patient


Management:

1. Remove needles

2. Let patient lie down face up with elevated feet (do not allow patient to walk around)

3. Cover patient to warm them

4. Pressure or needle PC 6 then Du 26 to restore consciousness if needed

5. Give warm water to patient

6. After another 5 to 10 minutes of lying down allow to site

7. Wait another 5 to 10 minutes and allow patient to go


Stuck Needle

Reasons:

Patient nerves can cause muscle spasm

Poor patient position causes patient to move and needle to lodge

Turning needle in one direction constantly causing muscle fibers to twist around needle

Electric stimulation

Bending of needle inside


Symptoms:

Difficult to turn needle Difficult to remove

Attempting removal causes pain


Management:

Never use force to remove needles

(can cause muscle fiber removal or broken needles)


1. Remove all other needles first


Gentle twisting and pulling after:

2. Massage around area

3. Tapping meridian line to disperse qi

4. Bring patient back to good position

5. Moxa area

6. Puncture adjacent area (needles toward stuck needle)


Bent Needle

Reasons:

Patient nerves can cause muscle spasm

Needle to deep (bending against bone)

Electrical stimulation

Poor patient position causes patient to move and needle to lodge


Symptoms:

Difficult to remove needle


Management:

Slowly withdraw needle following with angle


Broken Needle

Reasons:

Poor quality needle

Needle very thin

Electrical stimulation

Needle punctured to root


Symptoms:

None from patient, but needle is shorter


Management:

(Delay telling patient to avoid their movement or muscle spasm)

If part of needle out use forceps to remove needle

you can use two fingers to push surrounding area


If needle broken under skin

If area near organs, joints or arteries requires immediate attention

Send patient to hospital or call ambulance


Hematoma (blood swelling in tissues)

Reasons:

Damaged needle

Poor location

Location that commonly bleeds (Head, PC 6)

Symptoms:

Location rising up, bruise forms

Pain felt during punction


Management:

Pressure for about 2 minutes to stop bleeding and swelling reduction

Use moxa after to disperse swelling


After-effects

Reasons:

Over stimulation

Electrical stimulation


Symptoms:

Sensation or sourness in area after 12 hours (ideally not more than 2 hours)


Management:

In general: Advise patients not to allow cold water on punctured points with in 2 hours of needling.


Hot compress

Massage and/or tapping

Shaking area

Moxa of area


Puncture Internal Organs

Symptoms:

1. Lung (pneumothorax)

Chest  pain, fullness in chest, palpitations

Difficult breathing

Cough

Sweating

Blood pressure drop and possible shock


2. Heart

Pain, internal bleeding


3. Liver (GB 24, GB 25, Lv 13, Lv 14) (on right side) or Spleen (on Left)

Pain, internal bleeding


4. Kidney

Back pain, blood in urine

5. Gall Bladder

Jaundice, local inflammation


6. Urinary Bladder

If bladder was full when punctured can cause urine to enter abdominal cavity and may cause infection


7. Large arteries

Internal bleeding if not dealt with


8. Brain stem

Headache, nausea, vomiting or coma


9. Major nerves (e.g. GB 30, Ki 3, SI 8, SJ 17)

Burning pain, distal numbness, muscle atrophy


Managment:

1. Lung

Place bandage over area to prevent air from entering

Call emergency


2. to 5. Heard, Liver, Spleen, Kidney, Gall Bladder

Call 911


6. Urinary Bladder

If bladder was not full send to hospital


7. Large arteries

Pressure

If internal bleeding present do to oversight send to hospital


8. Brain stem

Call 911


9. Major nerves

Left needle from nerve as soon as felt

Long term if damaged, Injection of various herbs (Dang Gui Liquid) usually at Sea-he, Back-shu, or Jia ji, vitamin B12 or B6


(c) 2005 All Rights Reserved - David Botton