Caution/Triage/Accessory Techniques Flashcards
(72 cards)
What’s the most common adverse event with acupuncture?
bleeding/bruising
Caution for needling which acupuncture points due to proximity to large blood vessels?
ST9, ST12, ST13, ST42, HT1, HT7, LU9, LV12, UB40, SP11
What can you do to decrease risk of fainting?
1) have patient eat 1-2 hours beforehand
2) explain everything before needling (first time)
3) position pt supine with legs elevated
4) limit needle manipulation initially
What can be done to remove a stuck needle?
1) rotate in opposite direction of insertion
2) stimulate nearby area with finger manipulation/tapping or by inserting another needle nearby
3) wait then try again
What are the symptoms of iatrogenic pneumothorax with acupuncture (2/250,000)?
immediate or delayed: dyspnea on exertion, tachycardia, chest pain, dry cough, cyanosis, diaphoresis/sweating
Who is at increased risk for an iatrogenic pneumothorax?
thinner patients, smokers (cigarette/marijuana), lung disease patients (asthma, emphysema, COPD, lung cancer, steroids), Marfan syndrome, homocysteinuria, thoracic endometriosis
Which points require caution d/t risk of pneumothorax?
GB21, UB13, ST12, CV22
Also UB18, CV14, CV15, SI9, SI13, Ding chuan
What can cause injury to the heart during needling?
1) sternal foramen (4th ICS level)
2) upward angle at CV15
3) excessive needle length/insertion
What’s the safe insertion depth to avoid heart injury?
25 mm
To avoid lung injury, what’s the safe insertion depth for acupuncture points over the lung fields?
10-20 mm
What are the S/S of cardiac tamponade?
anxiety, restlessness,
low blood pressure, weakness,
chest pain radiating to neck/shoulder/back/abdomen,
chest pain that gets worse w/deep breathing or coughing, problems breathing or rapid breathing,
discomfort alleviated by sitting or leaning forward,
fainting or light headedness,
palpitations,
drowsiness,
weak or absent peripheral pulses
Who is at higher risk for cardiac tamponade?
patients with cardiomegaly (from CHF, chronic HTN)
Who is at higher risk for liver organ damage w/acupuncture?
patients with hepatomegaly (from alcoholism, hepatitis, hepatocellular carcinoma, infectious mono, Reye’s syndrome, biliary cirrhosis, sarcoidosis, steatosis…
Who is at higher risk for spleen organ damage w/acupuncture?
patients with splenomegaly from infections (mono), AIDS, malaria, anaplasmosis, cancers, sickle cell dz, thalassemia, spherocytosis
What are the S/S of abdominal organ puncture?
abdominal pain, rigidity of abdominal muscles,
rebound pain upon pressure
lumbar pain & positive Murphy’s sign, bloody urine
What is the distance from the skin surface to the spinal cord or roots of spinal nerves?
25-45 mm depending on patient constitution
Most acupuncture related infections were from which bacterium?
mycobacterium
What can cause a broken needle situation?
1) Manufacturer defects or poor needle quality
2) patient change in position
3) strong muscle spasm
4) excessive force in needle manipulation
5) needle struck by external force
6) rigid withdrawal of bent needle
What do you do in a broken needle situation?
Remain calm & advise patient not to move
If needle is above skin, remove w/forceps
If needle level w/skin, press tissues around site gently until needle exposed for forceps removal
If needle completely under skin, seek medical attention immediately (remove all other needles & call for emergency transport)
What types of conditions is moxa effective for?
musculoskeletal, GI, gynecologic, breech presentation, stroke rehab, cancer symptoms, infectious diseases
Which body regions are off limits for moxa?
face/head, within hairline, nipples, genitals
If moxa results in a burn, what do you do?
If small 1st degree burn: run cool water over the burn & then apply sterile gauze secured to the skin w/medical tape; may use OTC burn creams
If severe burn or concern w/infection, refer to a physician
If more than 1 cm of skin is burned, assess skin damage & consider referral
What are the 3 kinds of cupping?
Fire (dry), Suction (dry), Wet
What is cupping used to treat?
Pain, colds, flu, fever, respiratory problems (asthma, bronchitis, emphysema, functional & internal organ problems, musculoskeletal problems, persistent/recurring fixed pain
