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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

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