Final Flashcards
(87 cards)
1
Q
The 8 functions of bleeding techniques are
- removing blood ______, treating local blood stasis such as a _______ area
- promoting ________ of blood
- promoting growth of new ______
- unblocking and freeing the _______
- relieving ______
- treat ______
- clear wind _____, damp _____ or blood ____ skin disorders
- open ______
A
stagnation, bruised, circulation, tissues, channels, swelling, edema, heat, orifices
2
Q
What are some indications for bleeding techniques?
A
- stubborn pain (particularly of the joints)
- spider veins
- luo issues
- lumbago
- fever
- sore throat
- coma/ loss of consciousness (due to true heat/false cold, NOT for true yang collapse)
- numbness
- bruising
- hypertension
- swelling and pain of the joints or limbs
- acute diarrhea from damp heat or summer heat
- stubborn ring worm
3
Q
Point pricking is done with a:
A
three edged needle
4
Q
Separative pricking
a) diseased area is pricked many times in a ____ or ______ fashion within one treatment
b) this includes ____ _____ (ie. on luo points)
A
spiral, circular, plum blossoming
5
Q
Amount of pricking depends on the size of the _____ ____.
A
diseased area
6
Q
cupping can follow bleeding in order to pull out ____ ____ and have the body regenerate ____ ____.
A
stagnant blood, fresh blood
7
Q
You should only use bleeding techniques on what kind of conditions?
A
Use only for acute or chronic excess conditions!
Heat or blood stagnation or bi syndrome
8
Q
How do you support/bank back the blood after bleeding technique?
A
moxibustion
9
Q
BE ____, ____, and ____ WHEN PRICKING
A
GENTLE, SHALLOW, AND FAST
10
Q
DO NOT USE Bleeding Technique ON ___ _____, ONLY ON _____ ____.
A
BIG VESSELS, SPIDER VEINS
11
Q
Apply bleeding technique once a day or every other day, ___ to ___ treatments constitute a course.
A
3-5
12
Q
What are the contraindications to bleeding?
A
A) Deficiency Syndromes B) After childbirth C) After Sweating D) If patient is on blood thinning medicines E) If patient has blood clotting issues F) Recent blood loss
13
Q
The Plum Blossom is applied by tapping, gently or with force, in order to activate and regulate the functions of the ____ ___ or the ___ ___ in order to treat disease.
A
zang fu, jing luo
14
Q
Manipulation of the Plum Blossom:
- Sterilize the area to be treated
- hold the posterior end of the handle between the ____ and ___ finger
- tap the hammer so that the surface of the needles is flush with the surface of the skin
- treat meridians or specific points such as:
A
thumb and index, xi cleft, luo, ashi, huatoujiaji
15
Q
For what type of patients would you use mild stimulation with a plum blossom?
A
Use for elderly, for women and children, deficiency, numbness, thin skin, nervous
patient
16
Q
For what type of patients would you use moderate stimulation with a plum blossom?
A
for most patients
17
Q
For what type of patients would you use strong stimulation with a plum blossom?
A
for strong constitutions, excess cases (ie. acute or ‘hot’), for disorders over fleshy areas, to treat luo points
18
Q
What are the indications for plum blossoming?
A
Headache Numbness Depression Back pain Hypertension Prolapse Alopecia Poor circulation Nerve dermatitis Flank pain Scars Ring worm
19
Q
What are the precautions for plum blossoming?
A
- when tapping, the surface of the needles should strike the body at a right angle to avoid causing pain
- When treating a meridian, a single tap is given every centimeter. 8-16 taps is standard for one pass over a meridian
- use only sterilized needles and sterilize the area
- clear blood from the surface of the skin to prevent infection
- contraindicated over ulcers and wounds (except for scars).
20
Q
Generally, cupping has a variety of therapeutic functions including inducing _____ and dispelling ______ pathogens, dredging the _____, relieving ______ and alleviating pain, warming the channels to expel ____, promoting qi and blood _______, accelerating healing, and regulating body temperature.
A
sweating, exogenous, channels, swelling, cold, circulation
21
Q
For what common diseases is cupping used?
A
The common cold, torticollis, sciatica, periarthritis of the shoulder, hemiplegia, epigastric pain, abdominal pain, lumbago, and obesity
22
Q
When using the cup retaining method how long do you keep the cups on? What types of pathologies are you treating with this method?
How long would you leave the cups when treating children, the elderly, and weak patients?
A
5-25 minutes.
diseases caused by cold when the pain is fixed, clearly defined, and deep, also for problems caused by stagnation of qi and blood, channel blockage, and long-term dysfunction of the zangfu.
15 minutes
23
Q
Explain the sequential application of the cup with needle method. What types of patients is this method suitable for?
A
In this case acupuncture is used before or after cupping. It is especially suitable ‘for patients with serious and complicated diseases. Needling is usually performed first and the needles are removed immediately after obtaining deqi. After removing the needles place the cup over the treated acupoints.
24
Q
Explain the simultaneous needling and cupping method of the cup with needle method. What types of patients is this method suitable for?
A
Here the needle is inserted first, and after deqi is obtained the cup is applied over the needle. This combination of cupping and acupuncture increases the stimulation of the acupoints. This method is commonly applied in chronic diseases such as arthralgia.
25
Explain the bleeding method of the cup with needle method. What types of patients is this method suitable for? How long would you retain the cups?
It has the function of promoting blood circulation and eliminating stasis, clearing heat, relieving pain and dredging the channels and is particularly suitable for excess heat patterns, for example apoplexy, coma, heat stroke, high fever, headache, sore throat, lumbago, carbuncles, erysipelas etc. Three-edged needles or plum-blossom needles are most often used for bleeding. Prick or tap on the selected site to make the skin red, weep or bleed, and then cup the area, retaining the cups for five to 15 minutes.
26
What are the precautions with cupping?
Generally apply cups to areas with thick muscle,
avoiding uneven sites and hairy areas of skin.
Choose a proper body position and a suitable size of cup.
The time for retaining the cup should not be too long: generally five to ten minutes is appropriate for most cases.
* Pay attention not to burn or scald the skin by overheating the rim of the cup.
* Do not cup over areas of skin with dermatitis, ulceration,swelling, or over an artery or the heart.
* It is not advisable to apply cupping to the abdominal, sacral and breast regions of a pregnant woman.
* Do not cup patients with bleeding disorders such as aplastic anaemia, haemophilia, leukaemia etc.
27
What is the most commonly used fire method for cupping?
the fire twinkling method
28
What is the flash fire method of cupping?
Usually used to treat wind diseases causing numbness, pain on the body surface, or a changeable disease location. This method uses the fire twinkling method and involves placing the jar on the selected site and immediately taking it off. Repeat this manipulation several times to expel the wind. Apply 15-30 times to the affected area, until the skin becomes red. Take care to avoid areas where the skin is broken.
29
What is the penalty for a HIPPA violation?
The civil and criminal consequences of noncompliances or violations can be severe. Fines can reach $25,000 for multiple violations of the same standard in a calendar year, or $250,000 and/or imprisonment up to 10 years for knowingly misusing individually identifiable health information.
30
What are the OSHA guidelines for a safe workplace for employees?
All floors, passages, stairs should be properly maintained and free of obstruction, power cords, etc. There should be hand rails for staircases. Adequate lighting.
Regular inspection of equipment. Clean furnishings.
Fire extinguisher 40 inches from the floor, checked annually.
Exit signs, and signs indicating what is NOT an exit.
Mark all bottles that have liquids that have been transferred from the original bottle.
MSDS forms
Written Hazard Communication Program.
Blood borne pathogens information.
31
According to OSHA guidelines, what is proper hand washing?
soap and running water for 10-30 seconds 'using friction and making bubbles.'
remove jewelry and keep nails short and clean
use antimicrobial soap when working with immune-compromised patients
wash hands in between patients, before examining patients and immediately before handling needles/lancets
wash after contact with blood and body fluids (or removal of needle or lancets)
no open wounds or abrasions: wear band-aids and gloves. Change gloves with every patient
32
According to OSHA guidelines, what are the regulations for preparation of the site on the body for needling?
must swap acu-point with 70% alcohol or PVP povidone-iodine in one swipe.
point must be dry prior to needling.
do not needle/lance broken or inflamed skin.
do not insert through clothing.
33
According to OSHA guidelines you should only palpate the skin:
that has been cleaned with alcohol/iodine
34
According to OSHA guidelines, what is clean needle technique?
inspect equipment before use
use only sterile needles/lancets
maintain needles/lancets in a sterile state prior to insertion.
do not support needle shaft/lancet with bare fingers during insertion, instead you may support needles with sterile gauze or sterile cotton.
manipulate needle/lancet without touching the shaft.
35
According to OSHA guidelines, what is proper needle/lancet withdrawal?
do not use bare fingers to close the hole after needle/lancet withdrawal
use clean, dry cotton ball to press on skin of insertion site.
immediately isolate and dispose of used needles/lancets in appropriate containers
all needles/lancets/plumblossoms must be disposed of in sharps container
36
According to OSHA guidelines, what should you do in care of accidental spills of blood or body fluids?
Use heavy duty rubber gloves AND eye protection. clean area with soap and water.
wipe with germicide and let stand for one hour of use PureGreen 24 according to directions
discard all waste in a double wrap/biohazard bag.
37
The potential hazard of sharps comes from the potential noscomial infection when the sharp involved is contaminated by blood or bodily fluids from a patient infected by and agent transmissible by such blood or body fluids. What are some examples of these transmissible agents?
HIV, HBV, HCV
38
When setting up your clean field, what are the proper guidelines?
Do not cross field with your sleeves.
Do not get clean field wet. If so, replace.
Open your kit and removed hand sanitizer.
Clean a smooth, flat, stable surface with bleach solution or PureGreen 24.
Sanitize your hands.
Place a clean paper towel on a clean surface.
39
What items are in the CLEAN FIELD?
(these are things that will prep the skin or pierce the skin)
lancet, plumblossom hammer head, sterile gauze, cotton balls, individually sealed alcohol and iodine wipes, tweezers or other clean instruments that will contact sterile items or skin on clean field
40
What items are NEAR the clean field?
(on clean paper towel next to clean field)
cups, gua sha spoon, gloves, and, moxa
lighter, alcohol dispenser, cotton dispenser, salve, oil, hemostat, tweezers
41
What items are in the NON-CLEAN FIELD?
ashtray, moxa extinguisher, incense, moxa remover
place sharps container on opposite side of alcohol and cotton dispenser - furthest from clean field, near the waste basket
42
Moxibustion treats and prevents disease by warming the _____, activating the qi, promoting circulation of ___ and ____, increases qi and nourished the blood, eliminates ____, ____, and ___ pathogens, dissolving _____, dispersing _____, restoring ____ qi - warms KI and strengthens KI yang, tonifies ____ qi, stopping bleeding and preventing disease. Clears heat and dissipates ____ heat.
jing luo, qi, blood, wind, cold, and damp, stagnations, swellings, yang, Central, toxic
43
In direct moxa, the moxa cone is placed directly on the skin or with a layer of ____ ___, _____ ____, or water on the skin. Note with direct moxa the action is _______ and the therapeutic effect lasts ____.
burn slave, garlic juice, immediate, longer
44
What is non-scarring moxa used for?
cold conditions, to augment the blood depending on the point function and deficiency condition. Can also be used to treat warts.
45
What is indirect moxibustion?
In indirect moxibustion the moxa is burned with a barrier covering the skin; such as a slice of garlic, ginger, or aconite. It can also be afflixed to the needle of a needle or used as pole moxa.
46
With indirect moxibustion the action is ____ and the therapeutic effect is a _____ duration than direct moxa.
slower, shorter
47
When using pole moxa, use the mild-warm technique for ____ illness and use the sparrow pecking technique for ____ cases.
chronic, acute
48
Why is sea salt used in Ren 8 during indirect moxibustion?
It restores yang. Look for extremities to become warm and pulse restored. Also for cold diarrhea, damp diarrhea with yang xu, collapsed yang, vomiting, and hernia. Strengthens St and intestines, renews yang, treats rebellious qi.
49
Why is ginger used during indirect moxibustion?
for damp cold, SP yang or KI yang xu causing pain, diarrhea, vomiting, also helpful for cold damp bi, dyspepsia, and abdominal pain
50
Why is garlic used during indirect moxibustion?
dispels toxins, invigorated blood and disperses masses, dissipates swellings.
51
What are the cautions and contraindications for moxa?
1. Not advisable to do moxa on patient with heat syndrome from excess (full heat) or due to yin xu (deficiency of yin)
a. Febrile disease- from excess heat (full, rapid pulse, red tongue with yellow coat) or from yin deficient heat (rapid thin pulse, thin reddish purple tongue with peeled or absent coat)
b. Headache from Lr yang rising
2. Scarring moxa should not be applied to face, near sensory orifices or over large blood vessels
3. Lumbo-sacral area and lower abdominal regions are forbidden to moxa on pregnant women.
4. Caution with diabetics – sensory awareness maybe diminished
5. Caution ~possibly contraindicated with malnutrition or weakened constitution ~ but light moxa may help restore vitality…would need to properly assess patient’s condition
6. Caution with patients that have a loss of fluids from profuse sweating or loss of blood
7. If there are no issues with the patient’s menstruation, it is better to not treat with direct moxa on the abdomen during menstruation ~ because it will move the blood faster.
8. Be careful not to burn patient or clinic materials!!!
52
Lateral Recumbent Postion
(L or R)= sidelying with hands next to head or under head, lower leg is flexed, upper leg is straight “Lateral – Lower Leg bent”
low back pain, buttocks, top of shoulder
53
Sim's Position
(L or R)= upper leg is flexed, lower leg is straight. lower arm is behind and the chest is rolled forward with a pillow supporting the chest. No pillow under the head.
**This position ROTATES the Lumbar Vertebra and so it should be used only for points in sacrum or upper and middle shu points.
sacrum, upper & middle back shu, NOT for lumbar back points or lumbar shu points
***(spine is rotated)***
54
Fowler's Position
bed is raised at the head, bolster under knees for supine position.
pregnant women, acid reflux, cough, respiratory difficulties, may also have back
***Lying down positions prevent passing out, and should be used if patient is fatigued, hungry or has hypotension, or medical history that would indicated a need to lie down (i.e. vertigo)
55
For what types of patients is sitting a good position?
good for elderly, those less flexible, deficient constitution, & after 2nd trimester of pregnancy.
56
A patient may faint if:
Low blood pressure (hypotension), hypoglycemic (hungry), tired, elderly, Nervous, deficient constitution, medical history (ie. vertigo, epilepsy, stroke, medications)
give a light treatment if patient exhibits above tendencies
may start with points on lower body (ie. Ki 3, Ki 9, Ki 10) to keep qi from rising too quickly & making patient feel dizzy or nauseated
patients that are tall or have a long neck may have a tendency for energy to rise – may want to begin the treatment on lower body
57
If a patient feels faint, what should you do?
```
Take out needles
Elevate legs
Take Pulse
Press DU 26 (especially if faint)
Moxa St 36
```
58
If a patient actually faints what should you do?
Press Du 26, Moxa Ki 1
59
What is autogenous contamination?
microbes are present on the individual and get injected in from the surface
60
What is cross contamination?
microbes are introduced by practitioner through
| hands or needle or other objects that come in contact with skin or needles
61
What are the four degrees of cleanliness and what are their definitions?
a) Sterile: absence of all microbial life: required for instruments that pierce the skin or for objects that will touch the instruments
b) Clean: reduction of microbial life
c) Sterile-clean combo: the level of clean we strive for in a treatment setting
d) Asepsis: destroying organisms after they leave body=disinfection of instruments and surfaces. Also destroying organisms before they enter body: wash hands with germicidal soap, sterilize equipment
62
What is a sanitizer and a disinfectant?
a) Sanitizer: low level disinfectant
| b) Disinfectant: reduces microbial life on inanimate objects (Puregreen 24,bleach)
63
What is an antiseptic, germicidal, and sterilant?
c) Antiseptic: reduces microbial life on living tissue- alcohol
d) Germicidal: eliminates microbial life on living tissue and inanimate objects- Betadyne
e) Sterilant: ethylene oxide, autoclave, metricide
64
What are 4 types of surface pathogens?
1. Staph
2. MRSE
3. HBV (can live up to 1 week or more on dry surface)
4. HIV (if blood is wet)
65
Compared to HBV, HIV is relatively _____ to transmit.
difficult
66
Is there a vaccination for HBV? How about HCV?
yes for HBV, and no for HCV
67
1:3 chance with known source 1:30 chance with source unknown
HBV
68
1:30 – 1:100 chance
HCV
69
1:300 chance (0.3%)
HIV
70
Do most exposures to surface pathogens lead in infection?
No
71
How should you respond to a surface pathogen exposure?
1. Clean the area that was exposed to the potentially or known contaminated blood
2. Report & Receive physician care
3. Evaluate the exposure and risk of infection:
4. Test your blood for infection, if the previous steps lead you to think you are at risk (HIV, Hep B, Hep C)
5. Gather information
6. Monitor yourself during treatment for side-effects
7. Counseling should be made available
8. Follow-up according to protocols for the particular pathogen:
9. Paid for by the practice where accident occurred
72
What are sterilization procedures for equipment?
1. For needles, cups, tweezers, and hemostats: AUTOCLAVE:
2. Bleach (stabilized hydrogen peroxide (6-25%) and Metiricide solution are appropriate disinfectants, PureGreen 24 is also an appropriate disinfectant.
3. Alcohol soak or boiling water ARE NOT acceptable cleaning procedures if sterilization is necessary for objects that penetrate the skin.
4. Manufacturers sterilize pre-packaged needles with ethylene oxide.
73
What is the protocol for cleaning surfaces?
1. Bleach solution (1:10, bleach to water) or Lysol are adequate to disinfect and neutralize most viruses. The solutions do lose strength over time, so be sure to replace them according to recommendations by the manufacturer. PureGreen 24 may also be used according to directions to clean surfaces.
2. Surfaces to be cleaned on a daily basis include: tabletops, shelves, and other working surfaces.
74
What is the protocol for cleaning accidental spills of blood or body fluids?
1. Put on rubber gloves and wipe up spill with paper towel.
2. Wash area with soap and water.
3. Wipe all the exposed surfaces with germicide: bleach solution as noted above~2X
4. Double wrap all materials used in clean-up and discard.
5. Remove gloves
6. Wash hands
75
What is the proper management for loss of consciousness?
Help patient lie down. If the patient’s face is red, raise the head, etc., if dizzy, raise knees/legs above head
Loosen restrictive clothing.
Cover patient to keep them warm or let them cool off by removing clothing.
MONITOR VITAL SIGNS: breathing, pulse, blood pressure, color, temperature.
Offer warm water to those who have a mild case.
FOR SEVERE CASES: Can press Du 26, Pc 6, and Moxa Du 20 if treatment was in the lower body. Moxa St 36 and Ren 6 if treatment was in the upper body.
Once recovered, re-check BP and when they are stable, walk them out to their car/ride.
CALL 911 IF RESPIRATION BECOMES FEEBLE OR PULSE REMAINS FEEBLE.
76
What is the proper management of burns?
Clean area and put on burn ointment.
Put a fresh sterile bandage on it. Keep it dry and check in 24 hours.
If not too bad, use aloe gel or burn ointment and cover. You can use Ching Wan Hun for any degree of burn after you clean the area.
CAUTION: with diabetics or with neuropathy.
77
What is the proper management of bruising?
disappear on its own after a few days
apply pressure for 30seconds to 1 minute if blood pools out of hole=venous, with or without cold, to stop the bleeding
apply pressure for several minutes if bump is formed under skin= arterial
once bleeding is stopped, apply heat or light massage to disperse the stagnant blood
could also apply zheng gu shui or herbal poultice or plaster for moving blood
78
What is the proper management for fire?
Stamp out flame with shoe-clad foot/damp cloth or dowse with water
Use Fire extinguisher, if necessary and evacuate patient and people from building.
79
What is SHA Syndrome?
A disease caused by a wind invasion and an External Pathogenic Factor (EPF), (damp, heat, cold, dryness) that is blocking the meridians, leading to the following symptoms: pain, distention, chilliness, fever, vomiting/diarrhea, numbness, rigidity, etc.
80
If blanching disappears quickly:
| If it remains:
there is smooth flow (good circulation of Qi and Blood).
sha is present.
81
Gua sha helps to express & eliminate the sha ‘evil’, sha syndrome, by moving it out through the ____.
rash. The rash becomes and escape route, an exit, for the EPF.
82
Use Gua Sha to:
stimulates movement of qi and blood
releases the exterior & halts progression of illness into the interior
o treats acute & excess disorders
o treats common cold, promotes sweating, dispels wind heat or wind
resolves/transforms dampness ~which effects muscle system. This indirectly supports the Spleen function of digestion, production of blood, clarity of
thoughts, etc
Treats summer heat
Stimulates the Cou Li… the Jin Ye… the San Jiao mechanism
Relaxes tendons & muscles ~ promotes smooth flow of qi, stops pain
Treats wind and phlegm ~ so for resuscitation & stroke of that nature cold, fever
83
In Gua Sha hold the instrument at a ___ to ___ degree angle to the skin; adjust the pressure.
30 – 40
84
Gua Sha: means:
scraping: Wei level illness and to open the Wei level.
85
Pao Sha: means:
digging: for the treatment of blood stasis.
86
Meng Sha: means:
pinching: for the treatment of phlegm accumulation.
87
Avoid these areas during Gua Sha:
Areas that have been injured or bruised.
Areas with abrasions; where there is inflammation (red and swollen).
Areas of sunburn.
Broken skin, pimples, and moles.
Abdomen of pregnant women. In general, we typically do not Gua Sha the yin parts of the body.
Take care with deficient patients OR do not Gua Sha at all.
