safety

Question 1

how to manage a stuck needle?

Answer 1

needle is hard to rotate, twist or lift from too strong stimulation/ over-rotation of the needle in one direction from movement of pt causing the needle to trap under, muscle spasms

a. Management:
i. correct pt position, tell them to relax to reduce spasm & massage adjacent areas to relieve tension

ii. If over rotated → rotate in opposite direction, shake left and right to loosen

Question 2

bent needle management

Answer 2

from poor technique, strong manipulation, pt position changed, poor anchoring

a. Management:
i. large bends→ wiggle first then removed gently according to the bent angle

ii. slight bends→ withdrawal slowly, gently w/o twisting

iii. Multiple bends→ slowly removed based on the bents of the needle

iv. Correct pt position

Question 3

broken needle management

Answer 3

either broken outside or within the skin→ poor needle quality, movement of the pt while the needles are in, over-rotation in one direction of the needle while in pt, poor management, sudden violent electrical stimulation during electro-accu

a. Management:
i. Broken portion above the skin → remove with forceps/ locking hemostats scissors

ii. Broken at/ near skin → gently press down on either side of site, pinching and removing broken fragments with forceps. Locking hemostats

iii. Cannot be removed → near important area → removal with Xray/ surgery
iv. Non-important areas → broken portion can be left in & checked periodically

Question 4

fainting management

Answer 4

caused by weak constitution, excess mental tension, over stressed excessive hunger, severe diarrhea/ bleeding, incorrect position, strong manipulation

a. Sx: pallor, diaphoretic, dizzy, tight chest feeling, SOB, tachycardic

b. Management
i. stop inserting needles & remove all

ii. elevate feet higher than head, keep pt warm

iii. Recovery takes 30- 60 mins, If Cx continues to decline, BP drops → send to ER

Question 5

hematoma management

Answer 5

bruising/ swelling around the punctured area caused by hooked tip of needle, small blood vessel punctured

a. Management
i. Self limiting, alternating hot/cold compress, bleeding cupping to remove stagnation

Question 6

vein or arterial puncture

Answer 6

blood ejected from arterial puncture site

a. Management
i. Apply direct pressure w/ ice for 5 minutes for small arteries

ii. Larger arterial punctures → ER

iii. Elevate legs for femoral puncture and raise arms for radial artery puncture to allow blood flow back towards the heart

Question 7

pneumothorax management

Answer 7

causes by incorrect angulation, deep needling to thoracic cavity, puncture to the lungs causing chest pain, SOB, dyspnea, shock, tachycardia, cyanosis, severe sweating, BP drops

a. Management
i. Place pt in lateral recumbent position → mild cases: heals within 1-2 weeks

ii. Severe → 911- EMERGENCY