Clean needle technique Flashcards
Clean technique:
Use of techniques designed to reduce the risk of infection of patients, practitioners, and office personnel by killing or reducing the strength of pathogens, thereby reducing the chances for contact between the pathogens.
Basic principles of clean needle technique:
Always wash hands - 3 times
-Before patient visit
-Prior to needle insertion (aka before needling)
-After removal of needles
Always use sterilized needles
Always establish a clean field
Always immediately isolate used needles
Clean field:
The area that has been prepared to contain the equipment necessary for acuuncture, in such a was as to protect the sterility of the needles. By extension, this includes not only the clean surface on which equipment will be placed, but also the patient’s skin around the selected acupuncture points, and anything that touches the skin.
Setup of clean field:
All items which are sterile or considered sterile must be placed on this area.
-Use of paper towel or folded gauze pad are acceptable
-Packaged needles, cotton, alcohol soaked cotton are all acceptable
-Needle containers and garbage bags are NOT acceptable
-The clean field is 3 dimensional, therefore passing non-sterile items or contaminated items over the clean field violates the field.
Sterile needles:
All pre-packaged needles come sterilized from manufacturer.
All needles have expiry dates clearly indicated on the outside of the box
Most needles will have the method of sterilization written on the box (ex: Ethylene oxide)
The inside of the bubble package is considered sterile.
*Do not expose needle or tube to non sterile areas prior to insertion
*Your hands are NOT considered sterile but you may handle the outside of the tube and handle of the needle before insertion
The shaft of the needle must remain sterile as it is the portion of the needle that will penetrate the skin.
If you need to rest the needle down before insertion and the tube no longer exists, you must find an object that is sterile to rest the needle shaft on within the clean field.
Examine all needles prior to insertion to ensure a smooth texture and any possible integral deficits.
Needle handles that are discolored, especially Chinese needles, must be appropriately discarded.
Removing needles:
After needling is complete, all needles must be discarded in the biohazard sharps container.
DO NOT WALK WITH THE NEEDLES TO THE CONTAINER, BRING THE CONTAINER TO THE PATIENT PRIOR TO WITHDRAWAL.
Do not attempt to remove more than one needle at a time
Do not attempt to hold more than one needle at a time
Any blood-borne products must be discarded in specific containers
All other waste may go in the garbage
Universal precautions:
Health care workers must assume all patients are infected with HBV or HIV, thus taking adequate non-discriminatory precautions to protect themselves.
Pertains to: Blood, body fluid containing visible blood, semen, vaginal secretions, tissues, CSF, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid and amniotic fluid.
Contraindications:
The following conditions need to be met avoided before and after treatments:
-Alcohol intoxication: Absolute
-Exhaustion: Absolute
-Sever fever: hard to control after tx but do not treat anyone suffering from it before
-Sexual intercourse: Relative
-Over eating: Relative
-Hunger: Relative
-Excessively thirsty: Relative
-Strenuous exercise: Relative
Needle insertion:
1) wash hands
2) Prepare clean field including all equipment required
3) Locate point(s) to be needled and create a mark using a tube by twisting it gently yet firmly to leave a visible mark
4) Cleanse each point with a separate piece of cotton soaked in 7% isopropyl alcohol using one quick swipe over the area of the point, then allow to air dry
5) Once the skin is dry, remove a needle from the package and inspect it
6) Place tube over the cleansed area and allow needle tip to fall to the surface of the skin
7) Give a firm tap to the top of the needle handle allowing for the tip to penetrate the skin
8) Once the needle has entered, remove the tube from around the needle and ensure that the needle does not fall over
9) Using only the handle of the needle, gently yet firmly insert the needle to the desired depth. Twist the needle in both directions as you penetrate deeper or gradually insert the needle without twisting.
Notes on needle insertion:
Prior to insertion, depth and angulation must be researched
Choose the appropriate length and gauge of needle for the area to be needled.
ex) longer for thicker areas, and shorter for thinner areas. Thicker gauge for tough thick areas and thinner gauge for thin, soft areas
Precautions to needling:
Deep needling on the posterior neck
-Brain stem, vertebral artery
Points on the chest, hypochondriac region and back
-organs especially the lungs
Near big blood vessels:
-carotid, jugular, radial, femoral, superficial temporal, popliteal
ST 17, CV 8 are not to be needled
Normal sensations or De Qi (obtaining Qi):
-Aching
-Soreness
-Tingling
-Distention
-Heaviness
-Itching
-Electrical sensation
-Burning
Abnormal sensations:
-Sharpness
-Spastic contraction of the limbs
-Convulsions
-Fainting
-Loss of color in the face
Sharpness is usually due to the needling point touching in a sensitive layer like fascia, vessels, or even nerve fibres
Needle manipulation:
-Leaving needles in for 15 minutes
-Tapping and flicking
-Tonifying methods
-Holding channel Qi: manipulating at certain times
-Moving Qi: usually by tapping or pressing along the meridian adjacent to the point needled
Problems with needling:
-Needle stick injury
-Stuck needle
-Bent needle
-Broken needle
-Fainting
-Arterial puncture
-Hematoma
-Pneumothorax
