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CNT Review Exam Flashcards

1
Q

What are the 5 natural barriers to infection?

A
  1. Skin and mucous membranes of the nose, throat, urethra, and rectum
  2. Stomach acid
  3. Healthy cells of nose and lungs
  4. Normal mucus and saliva
  5. Nonspecific factors: tears, urine, acidity of vaginal secretions
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2
Q

What are the two types of infection?

A
  1. Autogenous infection
  2. Cross infection
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3
Q

What are autogenous infections?

A

Infection caused by pathogens that the patient is already carrying

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4
Q

What are cross infections?

A

Infections caused by pathogens acquired from another person

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5
Q

What are the two types of microorganism on the skin?

A
  1. Transient
  2. Resident
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6
Q

What are transient microorganisms that abide on the skin?

A

Those picked up from one patient and transferred to another patient

Soap is sufficient for cleaning

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7
Q

What are resident microoganisms that abide on the skin?

A

Life-long members of the body’s normal microbial community

Extra risk for immuno-compromised patients

Germicidal soap must be used

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8
Q

What are two of the most serious cross-infections?

A
  1. Hepatitis B Virus
  2. HIV
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9
Q

What are the five types of hepatitis viruses?

A
  1. A
  2. B
  3. C
  4. D
  5. E
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10
Q

Which types of hepatitis are transmitted via fecal-contaminated food and water?

A
  1. Hepatitis A
  2. Hepatitis E
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11
Q

Which types of hepatitis are transmitted via blood and/or sexual exposure?

A
  1. Hepatitis B
  2. Hepatitis C
  3. Hepatitis D
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12
Q

Hepatitis A

A
  • Mainly due to poor sanitation and overcrowding
  • Incubation period 15-30, abrupt onset with high fever to 100.4 F
  • Other Sx: loss of appetite, fatigue, fever, muscle aches, nausea and vomiting
  • 2 weeks later: jaundice
  • Most common in children and young adults, peak in autumn
  • Individual with HAV cannot be reinfected
  • Symptoms are mild, no chronic carrier states, HAV vaccination available
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13
Q

Hepatitis B

A
  • Bloodborne pathogen, most serious threat to health care workers
  • Due to IV users and high sexual activity, most common btn 15-29 years age
  • Incubation period 50-180 days
  • Begins with mild flu-like symptoms such as fever, malaise, insidious onset of anorexia, abdominal pain
  • Other Sx: chills, nausea, joint pains, rash, and diarrhea
  • 2-6 weeks later: extreme fatigue and depression lasting months
  • Of these who recover from symptoms: 70% remain infectious for 3 months or more
  • 6% are lifelong carriers and may develop cirrhosis of LR and LR cancer.
    • Of chronic carriers 15-25% die of LR disease
  • Treatment: there is no biomedical treatment for HBV although an injection of HBIG immediately following exposure may provide protection in unvaccinated persons
  • 3 injections of HBV vaccination is available and lasts for at least 20 years
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14
Q

Hepatitis C

A
  • Transmitted by exposure to contaminated blood. Mostly found in adults.
  • Most common in transfusion associated hepatitis
  • Most prevalent in IV drug users
  • No vaccine
  • Incubation period 20-90 days with most occuring 5-10 weeks after exposure
  • Communicability: 1 week after exposure to chronic stage
  • Insidious onset with anorexia, nausea, vomiting, and jaundice
  • 78-85% of those infected will develop chronic infection
  • 60-70% develop chronic hepatitis and many progress to cirrhosis and cancer
  • Treatment: interferon and ribavirin
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15
Q

Hepatitis D

A
  • aka Delta hepatitis
  • a “defective virus”-requires HBV concurrent infection
  • Most cases occur in IV drug users and hemophiliacs
  • Hep B vaccination will protect against this disease
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16
Q

Hepatitis E

A
  • Aka epidemic non-A, non-B hepatitis. Most common in developing countries.
  • Mostly due to fecal contamination of the water supply
  • Incubation period is 15-60 days, average 40 days
  • Communicability: unknown
  • Sudden onset of fever, malaise, nausea, and anorexia. Possible jaundice.
  • Varies from mild illness for 7-14 days to severely disabling disease that lasts several months
  • No evidence of chronic infection. No vaccine
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17
Q

What are two forms of chronic carriers of hepatitis?

A
  1. Chronic persistent
  2. Chronic active
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18
Q

What is chronic persistent hepatitis?

A

Asymptomatic or has very minimal symptoms but can continue to infect others

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19
Q

What is chronic active hepatitis?

A
  • Progressive symptomatic disease that continues to damage the liver
  • S/s: malaise, weight loss, loss of appetite, and often jaundice
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20
Q

What are the incubation periods for the 5 types of hepatitis?

A

A: 15-50 days

B: 50-180 days

C: 20-90 days

D: Unknown

E: 15-60 days

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21
Q

Which types of hepatitis have an abrupt onset?

A

A + E

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22
Q

Which hepatitis types have an insidious onset?

A

B + C

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23
Q

Which type hepatitis has an unkown onset?

A

D

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24
Q

Which types of hepatitis have vaccines?

A

A + B

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25
Q

Which types of hepatitis can become chronic?

A

B: depends on age group- 6% are lifelong carriers

C: 60-70% develop chronic hepatitis

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26
Q

What are the S/S of hepatitis A?

A

Fever, nausea/vomiting, fatigue, no appetite, muscle ache

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27
Q

What are the S/S of hepatitis B?

A

Flu-like, joints pain, fatigue, depression (2-6 weeks later)

Asymptomatic in 30% of cases and in children

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28
Q

What are the S/S of hepatitis C?

A

After chronic carrier goes to cirrhosis, LR cancer may result in adult

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29
Q

What are the S/S of hepatitis D?

A

Need hepatitis B replicated fulminating

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30
Q

What are the S/S of hepatitis E?

A

Sudden onset of fever, malaise, nausea and anorexia

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31
Q

What is HIV?

A

Human immunodeficiency virus

  • HIV targets CD4 (T4) lymphocytes as its host.
    • play an important role in immune system
  • HIV destroys T4 lymphocytes producing immune deficits
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32
Q

What are the two types of HIV?

A
  1. HIV-1: most infectious & most common
  2. HIV-2: less infectious
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33
Q

What is the infection process for HIV?

A
  • initially infection is usually followed within 2-4 weeks by a febrile illness resembling mononucleosis or influenza which resolves spontaneously
  • As immune damage progresses, symptoms of malaise, body aches, fever, skin rash, lymphadenopathy develop
  • Other s/s: weight loss, chronic diarrhea, persistent cough, persistent fever and night sweats, flat or raised pigmented lesion on the skin ranging from faint pink to red, brown or blue
  • Late stage development of infection diseases: candidiasis, cytomegalovirus, Kaposi’s sarcoma & Pneumocystis carinii
  • Pneumonia: the most common opportunistic infection and cause of death in AIDS
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34
Q

Who is at risk for HIV?

A
  • The population distribution of HIV: initially found primarily among men who had sex w/ men, injection dug users, sex workers, and transfusion recipients. Today HIV is no longer limited to these initial populations. Recently, more cases are associated with unprotected sex between mixed gender couples. Due to successful protocols for perinatal cases, newborns are acquiring HIV from their mothers much less frequently.
  • Incubation: due to its long incubation period (2-15 years to AIDS) most infected individuals are unaware
  • HIV may NOT be transmitted via: shaking hands, touching, hugging, holding hands, or casual kissing, use of objects handled or touched by an HIV-infected person (i.e. toilet seat or phone)
  • Risk of infection: 0-3%
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35
Q

What is the clinical presentation of AIDS patients?

A
  • “Wasting disease”, severe involuntary weight loss, chronic diarrhea, constant or intermittent weakness
  • If HIV enters the CSF: encephalopathy, myelopathy, peripheral neuropathy, dementia, death
  • Rate of disease progression may vary:
    • Contributing factors: stress, nutrition, alcohol, drugs, STD’s
  • Secondary infections pose additional risks to practitioners: tuberculosis, staphylococcus, herpes, hepatitis
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36
Q

Protection for patients, practitioners, and staff (yearly physical)

A
  • PPD (tuberculosis test)–> once/year
  • Practitioners who work in an inner city clinic w/ AIDS patients or drug addicts –> every 6 month
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37
Q

What are the 3 HIV tests?

A
  • ELISA (Enzyme-Linked ImmunoSorbent Assay)
  • IFA (Immuno Fluorescence Assay)
  • Western Blot (Protein Immunoblot)
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38
Q

What is MRSA?

A

Methicillin-resistant staphylococcus aureus

  • Recently, MRSA has become a significant source of antibiotic resistant infections
  • The bacterium Staphylococcus aureus is a gram positive, coagulase positive aerobic coccus associated with wound infections and other medically significant infections
  • Between 25-30% of the population may be carriers of MRSA
  • Majority of MRSA infections appear to be acquired from the health care setting (nosocomial)
  • 12% of the MRSA are community-acquired
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39
Q

How to prevent MRSA?

A
  • Appropriate handwashing and the use of hand disinfectants
  • The use of barrier protection such as gloves, lab coats or gowns and face masks as necessary
  • Proper handling of potentially contaminated materials such as sharps, disposable supplies such as cotton and gauze, and soiled or blood-stained linen
  • Avoid contact with draining wounds or skin lesions that may be a site of infection
  • Scrupulous use of disinfectants
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40
Q

What are the three categories of National Acupuncture Foundation recommendations?

A
  1. Critical
  2. Strongly recommended
  3. Recommended
41
Q

What are the basic principles of CNT?

A
  1. Always wash hands between patients
  2. Always wash hands just prior to inserting needles if hands are contaminated
  3. Always use “DISPOSABLE” sterile needles
  4. Always establish clean field
  5. Always immediately isolate used needles
42
Q

What is an antiseptic?

A

Products designed to reduce the density of microbial life on LIVING TISSUE, particularly on the skin of the patient or practitioner

43
Q

What are aseptic techniques?

A
  • Techniques for preventing infection during invasive procedures such as surgical operations, dressing wounds, or some laboratory procedures
  • Acupuncture is NOT an aseptic procedure because it is not performed in a manner that preserves the sterility of the acupuncturist’s hands or the skin of the patient
  • Acupuncture is a clean rather than sterile procedure. Acupuncture needles must be kept in a sterile condition for use in CNT
44
Q

What is the clean field?

A
  • The area that has been prepared to contain the equipment necessary for acupuncture in such a way 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 prepared acupuncture points, and anything that touches the skin
  • Clean field is not the same as a sterile field
45
Q

What is clean technique?

A
  • The use of techniques (such as antisepsis, disinfection, sterilization, handwashing, and isolation of sharps) designed to reduce the risk of infection of patients, practitioners, and office personnel by reducing the number of pathogens
  • Thereby reducing the chances for contact between the pathogens and the patients and personnel
46
Q

What is contamination?

A

The introduction of contamination viruses, bacteria, or other organisms into or onto previously clean or sterile objects, rendering them unclean or non-sterile

47
Q

What are disinfectants?

A

The chemicals employed in disinfection. They should only be used on INANIMATE objects, and are not to be confused with antiseptics that are applied to the body.

Examples: hypochlorite dilutions such as bleach, commercial disinfectants

48
Q

What is sterilization?

A

The use of procedures that destroy ALL microbial life, including viruses

This is a rigid, uncompromising term. there is NO SUCH THING as PARTIAL STERILITY

In acupuncture, sterilization is required for all instruments that pierce the skin** (needles, plum-blossom needles, seven-star hammers, and lancets) and **insertion tubes

49
Q

What is primary and secondary sterilization?

A

Primary sterilization: for the practitioners and staff

Secondary sterilization: for the patient

50
Q

What are the procedures for sterilization of instruments?

A

Autoclave: 30 minutes at 250 degrees F/ 15 pounds pressure/ rapid decompression at end

Dry Heat: 2 hours at 338 degrees F

51
Q

What clothing constitute office hygiene?

A
  • Should wear clean, washable or disposable protective clothing while performing treatment
  • The fabric should be chosen to avoid trapping and shedding contaminating particles or microorganisms in the clean field
  • Loose or large jewelry, clothing and hairstyles that touch the client or break the clean field should be avoided
52
Q

What is proper hand care for office hygiene?

A
  • It is strongly recommended that all cuts and wounds on the practitioners hands must be washed and dressed immediately for the protection of both patient and practitioner
  • All cuts, wounds, abrasions, chapped hands, hang nails, torn cuticles, etc. must be covered with rubber gloves or finger cots (these do not need to be sterile)
53
Q

What are the general guidelines for office hygiene?

A
  • A sink with running hot or cold water must be located in or near the treatment rooms
  • Liquid soap, not bar soap. Liquid soap container must be washed and dried before refilling.
  • Single use, disposable towels (i.e. clean paper towels), not cloth towels
  • Working surfaces should have a smooth impervious surface, be in good repair, and cleaned once a day with a suitable disinfectant (i.e. Clorox, Lysol, Microquat–> must be labeled with date it was mixed and concentration if not in original bottle)
54
Q

What is proper office hygiene for practitioners with HIV/HBV?

A
  • Positive practitioners should not perform exposure-prone procedures unless they have received counseling from an expert review panel
  • Infected practitioners should notify prospective patients of their seropositive status before undertaking exposure-prone invasive procedures
  • Mandatory testing for practitioner’s for HIV antibodies. HBsAg is NOT recommended
  • In healthcare workplace, the risk of infection from exposure to contaminated blood is greater for HBV than HIV. The risk is lower for both diseases if universal precautions are followed.
  • Universal precautions are defined by the CDC as use of gloves, masks, gowns, goggles, and prevention techniques
55
Q

What are examples of chemicals used in CNT?

A
  • Sodium Hypochlorite
  • Stabilized Hydrogen Peroxide
  • Phenolic compounds
  • 70% Ethyl & Isopropyl Alcohol
  • Betadyne (Benzylconium chloride)
56
Q

What is sodium hypochlorite and what are the appropriate solutions and concentrations?

A

Household bleach

Solutions should be made within 24 hours of use

Concentration

1:100 concentration: smooth surfaces

1:10 concentration: porous surfaces or organic materials

57
Q

Explain stabilized hydrogen peroxide and the appropriate concentration?

A

this is NOT over the counter hydrogen peroxide (3%)

Concentration must be 6%-25%

58
Q

What is phenolic compounds and appropriate use?

A

Lysol. Cannot be used as sterilants

Effective intermediate or low level disinfectants for housekeeping purposes

59
Q

What is the appropriate use of Ethyl & Isopropyl alcohol and percentage?

A

Intermediate level disinfectants

70%- NOT 90% Isopropyl Alcohol

60
Q

What is betadyne (Benzylconium chloride) recommended for and how to use?

A

Recommended for immunocompromised patients

Betadyne then an alcohol swab

61
Q

When do you always wash hands?

A
  • Visibly dirty or contaminated (with soap and water, not alcohol based disinfectant)
  • Hands are not visibly solid (with soap and water or alcohol based disinfectant)
  • Immediately before and at the end of acupuncture treatments
  • Before contact with patients
  • After contact with patients intact skin
  • After contact with fluids or patients dressing
  • After removing gloves
  • After contact with blood or body fluids or obvious environmental contaminants
  • Before and after eating
62
Q

What are the 5 basic principles of handwashing?

A
  1. Always wash hands with soap and water. If unavailable use an alcohol-based or germicidal hand rub
  2. Always wash hands with soap and water before and after work shifts and just prior to inserting needles
  3. Always wash hands after contact with blood or body fluids or obvious environmental contaminants
  4. Always wash hands at the end of the treatment or between treatments
  5. Always wash hands whenever they become contaminated during treatment. Examples of potential contamination before treatment include the practitioner touching his/her face, hair, eye or using a pen, helping a patient adjust clothing or remove shoes, picking up dropped items from the floor and answering telephone
63
Q

What are the steps for handwashing?

A
  1. Gather the equipment: paper towels, liquid soap, and running water
  2. Roll up sleeves, remove watch and jewelry (plain wedding band is ok)
  3. Wet the soap and hands thoroughly
  4. Rub soap to make lather
  5. Wash the entire surface of the hands
  6. Rub water over the hands again to clean them
  7. Lower hand so that the water and soap drain off th fingertips as they are rinsed
  8. Give the hands a final rinse
  9. Turn off the tap with a towel or use an elbow so that the hands do not become soiled. Do not dry hands with the towel used to turn off the tap
  10. Dry hands carefully using a clean paper towel or shake the hands dry in the air
64
Q

What are CNT parameters for acupuncture needles?

A
  • All acupuncture needles and instruments that penetrate the skin must be sterile for each insertion
  • Needles must be filiform (solid) and made from stainless steel since softer metals are more likely to pit, corrode, tarnish, or break
  • All needles must be disposable and sterile for each insertion

Packaging:

  1. Must be appropriate: no bubble wrap, open seals, moisture on the package, or bent packaging
  2. Remove needles from sterile packaging in such a was as to avoid contamination
  3. Needles in soft plastic bags must be carried in hard containers
65
Q

What are CNT parameters for needle guide tubes?

A
  • Must be sterile for each patient but not for each point
  • Guide tubes are NOT recommended for auricular acupuncture
66
Q

What are CNT parameters for needle trays & gauze?

A
  • Must be sterile
  • The practitioner’s bare hands may not come into contact with the needle shaft. If the needle shaft needs support a STERILE gauze pad or cotton ball is used, NOT a clean gauze or cotton ball
67
Q

What are CNT parameters for plum-blossom needles?

A
  • Seven-star and plum-blossom needles must be sterile
  • Either the whole device must be a single use and disposable device, or the head portion that contacts the patient’s skin must be sterile and disposable
  • Do not attempt to sterilize, disinfect, or reuse these devices
  • Each seven-star hammer should be used on one region of the body only
68
Q

What are CNT parameters for cupping devices?

A
  • Cupping is not a sterile procedure. Cups must be CLEAN but need not be sterile
  • After use on a patient, cups must be disinfected in a dilution of hypochlorite (bleach) or other appropriate disinfectant and then cleaned with soap and water
  • In some hospitals, cups must be sterilized in an autoclave or other on-site sterilizer before using
69
Q

How to prepare the site for needling in acupuncture treatment?

A
  • Make sure the skin areas to be treated are free of any cuts, wounds, or diseases
    • Never insert needles through inflamed, irritated, diseased or broken skin
  • Ensure that the part of the body to be treated is clean: If dirty, wash with soap and water
70
Q

What is the depth of needle insertion in acupuncture treatment?

A
  • R12: 0.5 inch in a thin patient
  • Head and face: superficially or obliquely
  • Region with caution: UB-1, ST-1, DU-16, RN-22, near the femoral artery or groin
  • Children needling depths are less than those of adults
  • Thoracic and back: puncture with caution
71
Q

What is protocol for swabbing points in acupuncture treatment?

A
  • Swab in a way that touches area only once as not to re-contaminate the area
  • The same swab can be used for points in the same general area
  • A new swab should be used when changing areas of the body or if the swab begins to change color
  • Spiral & C Swab
72
Q

What is a spiral swab?

A

Using a rotary scrubbing motion, spiral out from the center

73
Q

What is a “C Swab”?

A

Swab from one end of the area to another or in a wide “C” motion

74
Q

What is protocol for disposal of used needles?

A
  • Used needles should be isolated until they are discarded
  • A sharp container should be right beside the treatment table so that there is no delay in placing the needles away from potential accidental contact
  • Used needle containers should be replaced regularly and not be over-filled above the fill mark so that used needles are not stickingout of the top. Replace containers when they are three quarters full, do not attempt to push down the content so that more may be placed inside
  • All needles that are not in such specially designed containers must be sterilized before being discarded
75
Q

What is protocol for dropped needles?

A
  1. Use gloves and forceps for picking them up
  2. If there is chance of dropping used needles on the practitioners clothing and contaminating it, a gown or impervious apron should be used
  3. Wipe all exposed surfaces with a germicide since HBV virus can survive on surfaces for more than one week at room temperature
  4. Bleach, 1:10 dilution, can be used as the first-step cleanser but since contact with the contaminated surface deactivates the cleanser, a second cleaning with bleach must still be done
  5. All material used in the clean up job should be discarded in double wrapping
  6. Wash hands with soap and water
76
Q

What are protocols for bleeding during cupping?

A
  1. Gather gloves and cleaning material
  2. Put on gloves
  3. Remove cups, take care to prevent body fluids from spreading and splashing
  4. Stop bleeding through the use of appropriate pressure
  5. Clean up any bleeding that has occured
  6. Immediately isolate the cups
  7. handle and dispose of all materials used in the cleaning process as biohazardous wastes
  8. Disinfect the cups
  9. Wash the cups with soal and water
77
Q

What are protocols for cleaning spilled blood or body fluids?

A
  1. Put on rubber gloves, a gown or impervious apron if there is a risk of contaminating your clothing during clean up
  2. IF it is a large spill, safety glasses and a disposable or sterilized clothing protector should be worn
  3. Clean hte spill first with soap and water
  4. WIpe all exposed surfaces with germicide
  5. All materials used in the clean up job should be discarded in double wrapping
  6. Hands should be washed at the end of the clean up
78
Q

What are proper protocols for glove use?

A
  • Must wear when there will be contact with other potentially infectious materials, mucus membranes and non-intake skin, when performing vascular access procedures and when handling or touching contaminated items or surfaces
  • Use during procedures such as bleeding where there is a great risk of contact with large amounts of blood. When working with patients who have open lesions or weeping exudates from their skin
  • When the practitioner has cuts, abrasions, chapped skin, hang nails or broken cuticles on his or her hand and the lesions are located in a location where they pose a hazard
  • Gloves do not provide protection from accidental needle stick and if improperly used may actualy increase the risk of accidental needle stick during an acupuncture procedure
79
Q

What is the most common form of cross-infection?

A

Needle stick

58-80% of exposure to HIV in healthcare is from needle stick

Risk of infection from needle stick:

  • HIV: 0.3%
  • HBV: 6-30%

Once stuck by a needle, go directly to a physician

If negative at initial tests, follow-up tests are 3, 6, 23 month check-up

80
Q

What is the risk of infection from needle stick for HIV?

A

0.3%

81
Q

What is the risk of infection from needle stick for HBV?

A

6-30%

82
Q

What is protocol for management of burns?

A
  • people with neural injury, diabetes mellitus or pathology resulting in paralysis have reduced sensitivity of local nerves and are especially susceptible to burns (moxa or heat lamps)
  • First degree: run cool water over burn (never ice), apply sterile gauze and secure with medical tape. If no running water can apply burn cream.
  • Second degree: refer to physician
83
Q

What is proper protocol for fainting?

A
  • Cause: nervous tension, hunger, fatigue or extreme weakness, forceful manipulation
  • Management:
    • Remove all needles
    • Lie patient flat with the feet or legs slightly elevated
    • Offer warm drinks or administer emergency acupuncture
    • If no response- Call 911
  • Emergency acupuncture for Fainting:
    • General: press DU26 with fingernail or puncture Du-26 with PC-6
    • If upper body has been needled: press, moxa, or needle ST-36
    • If lower body has been needled: press, moxa, or needle LI-4
84
Q

What is proper protocol for stuck needle?

A
  • Relax muscle–> massage or tap the skin around the point
  • Give another puncture nearby so as to relax the muscle
  • Turn it slightly in the opposite direction until it becomes loose
85
Q

What is proper protocol for broken needle?

A
  • Remain calm and advise the patient not to move
  • Above the skin: remove the forceps
  • Same level: press the tissues around the site until the needle is exposed
  • Under the skin: seek medical help
86
Q

What are S/S inadvertent lung injury and how to care?

A

S/S:

  • pain in the chest, cough
  • if severe: dyspnea, pallor, cyanosis, coma, etc

Care:

  • carefully remove all needles immediately
  • call 911
87
Q

What are S/S inadvertent injury LR or SP? How to care?

A

S/S:

  • Rupture w/ bleeding, abdominal pain, rigidity of abdominal muscles, and/or rebound pain upon pressure

Care:

  • call 911
88
Q

What are S/S inadvertent injury kidney? How to care?

A

S/S:

  • pain in lumbar region, tenderness and pain upon percussion around KD region, bloody urine
  • Coma may result if blood loss is great

Care:

  • call 911
89
Q

What are S/S inadvertent injury brain & spinal cord? How to care?

A

S/S:

  • such points as DU-15, DU-16, or DU points above T1
  • Bleeding and other severe consequences: convulsions, paralysis, coma

Care:

  • Call 911
90
Q

What are S/S inadvertent injury blood vessels? How to care?

A

S/S:

  • bleeding

Care:

  • VEIN: direct pressure for 30 sec-1 min
  • ARTERY: direct pressure up to 5 min
91
Q

Management inadvertent injury of other/misc. organs

A

Special care should be taken when puncturing regions close to the stomach, intestine, urinary bladder, gallbladder, and eyes

92
Q

What are safety protocols/precautions for e-stim?

A
  • Don’t cross the midsagital line of the patient
  • Don’t use silver needles (may electrolyze in body quickly and result in toxic reaction)
  • Recommended needles: Chinese 32 gauge, Japanese #5
93
Q

What are safety issues/protocols for moxibustion?

A

1st degree: (if burn in small area)

  • Apply sterile gauze over a burn ointment

2nd or 3rd degree: (if any signs of infection)

  • Refer patient to a physician
94
Q

What are safety protocols/precautions for bleeding/bloodletting?

A

Suggested that two layers of gloves be used

95
Q

Define biohazardous waste.

A

Any solid or liquid waste that may present a threat of infection to humans, including non-liquid human tissue and body parts, laboratory disease-causing agents, discarded sharps, human blood or clinic waste such as table paper or cotton balls that contain human blood products and body fluids

96
Q

Name some biohazardous waste generators

A
  • Acupuncturists
  • Hospitals
  • Medical offiices
  • Veterinary clinics
  • Funeral homes
97
Q

How to packagebiohazardous waste?

A
  • Biohazardous waste, except sharps, must be packed in impermeable, red, polyethylene or polypropylene bags and sealed
  • Sharps must be separated from all other waste and placed in leak-resistant rigid, puncture resistant containers
  • All containers must be labeled properly, especially if the treatment and disposal is taking place off-site
98
Q

Name some disposal methods for biohazardous waste

A
  • Heat, incineration, steam sterilization, chemical treatment or other equivalent methods that renders the material inactive
  • An approved carrier should transport biohazardous waste
99
Q

CNT in Public Health Setting (community acupuncture)

A
  • Because of the volume of patients, it is not realistic for a practitioner to wash their hands in a sink after every treatment
  1. Wash hands with soap and water on arrival and prior to leaving work, prior to eating and after restroom use
  2. If hands are dirty with organic material (blood), wash with running water and either anti-microbial or non-antimicrobial soap
  3. Alcohol-based hand disinfectant or non-antimicrobial hand soap should be used between treatments, provided only needles; sterile packages or other materials needed for the treatment werwe touched
  4. Hands must be decontaminated between patients
  5. Hands must be decontaminated after touching a patient’s intact skin, as well as inanimate objects and medical devices near the patient
  6. Alcohol-based hand disinfectant or washing hands with non-antimicrobial soap and water must be done between patients
  7. Gloves should be available in the treatment area and should be worn when there is a biohazardous spill (i.e. bleeding from auricular acupuncture)
  8. Wash hands immediately with soap and water after critical instances (i.e. contact with blood or break in the clean field between or during treatments)
  9. Practitioners must have hand disinfectant available to them at all times in the public health treatment environment

CNT (1 decks)

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