CNT Procedures, Safety, AE
What does AE stand for?
Adverse Event
You should do this in order to know what techniques and tools to use on a new patient
Take a careful patient history
This fecal-oral transmitted disease has a vaccine and can survive outside the body for several months.
Hepatitis A (HAV)
This % of alcohol should be used
70%
A field is considered what when it is completely free of all pathogens
Sterile
You should let the alcohol do this before inserting the needle
Dry
What does OPIM stand for?
Other Potential Infectious Materials
To prepare a persons' skin for needles you should use this on the location of the points you will use
These 4 pathogens are bloodborne
Hepatitis B, C, D and HIV
If hands are visibly dirty you must do this instead of using sanitizer
Wash hands
Hand sanitizer is a low-level what?
Disinfectatnt
What is OSHA responsible for?
Workplace safety
Needling DU 22 in a/an ____ is prohibited.
Infant
Use this to cover the hole after removing a needle
Cotton ball (or other clean, absorbent materials)
This pathogen has the shortest and longest incubation period
HCV
You should rub your hands together for this many seconds when washing them
10-15 seconds
Disinfected
What type of needle is used for acupuncture?
Filiform
Infections may be local or systemic, due to an autogenous or cross-infection source. What is the difference?
Autogenous: from the patient
Cross-Infection: from the practitioner or others
This type of skin should never be needled over
Broken (other acceptable answers: inflamed, irritated, diseased)
This describes a person who is asymptomatic or has minimal symptoms but can continue to infect others
Chronic Persistent
Antiseptic
Provide (at no cost); disposed of properly
What are the most common AE's that result from acupuncture?
Bleeding, bruising and needle site pain.
These two things are considered non-clean items in your travel kit
Trash bag and sharps container
Count the number of needles used (and collected after treatment)
This pathogen can survive outside the body for 1 week
HBV
This is the last step in the Treatment Protocol, done after needles are removed and trash is disposed of
Wash/cleanse hands before leaving the treatment room/area
If you experience a needlestick or sharps injury or are exposed to blood or OPIM, you should
Acceptable answers:
1. Wash needlestick locations and cuts with soap and water
2. Flush splashes to the nose, mouth or skin with water
3. Irrigate eyes with clean water, saline or sterile irrigants
4. Seek medical advice from a licensed physician as soon as possible (Note: in NY it is recommended you be evaluated within the first 2 hours after the incident)
This pathogen is the most likely to be passed by needlestick exposure
HBV
These are placed in the center of the clean field
Needles (in their original packaging) (other acceptable answers: alcohol swabs)
You should do this as soon as you remove a needle
Discard it into a sharps container
Swelling, warmth, redness, pain and pus or drainage in infected skin and fever are symptoms of what disease?
MRSA
Healthcare professionals should do this on a yearly basis
Get a physical (that includes testing for tuberculosis)
What should you use to disinfect surfaces/areas contaminated with blood/OPIM spills?
EPA registered commercial hypochlorite solution (pg 201)
These are placed nearby the treatment table in a clean container or on the periphery of the clean field
Non-sterile cotton balls (other acceptable answers: skin cleansing materials, alcohol swabs)
If a needle has a long shaft, it may be held using this
Sterile gauze (other acceptable answer: sterile cotton ball)
This instance requires a practitioner to use a glove
Acceptable answers:
1. When bleeding occurs or is likely.
2. When needling the genital region or mouth.
3. When palpating near an area where there are lesions on the patient's skin.
4. In the event that there are skin lesions or open wounds on the practitioners hand.
5. When cleaning blood or OPIM from a surface.
Flu-like symptoms, abdominal pain, dark urine and light or greay-colored stools are symptoms of what disease?
Hepatits C (HCV)
Practitioners must wear ___ and ___ when engaging in wet cupping.
Gloves and protective eyewear
OSHA requires an Exposure Control Plan by provided by employers and reviewed and updated how often? (3 instances)
Annually or whenever new or revised tasks or procedures are added to the practice or if new positions are created that may have exposure potential
If a practitioner misses the point on the first insertion and has to re-needle the point, this must be used
A new needle (pg 83 of the manual)
Electro-acupuncture should be avoided in these 6 places:
Anterior triangle of the neck, Posterior Cervical Area, on the Scalp, Across the Spine, Across the Heart, in any patient with an ICD or Pacemaker.
What are the 7 components of CNT?
1. Hand sanitation
2. Clean field
3. Skin preparation
4. Isolation of contaminated sharps.
5. Standard precautions
6. The use of sterile single-use needles
7. Follow appropriate emergency procedures
Which infectious disease has the shortest and longest incubation period?
Hepatitis C (HCV)
If cupping is performed on intact skin only, how must you clean them after use?
First with soap and water and then with an intermediate-level disinfectant.
List 5 of the 9 critical parts of any patient chart
1. Patient information
2. Past medical history
3. Allergies and adverse reactions
4. Family history
5. Dated and signed records of every visit
6. Flow sheets for organization of health maintenance, chronic conditions, well care, etc
7. Narrative notes describing conversations with patients regarding treatment (accepted and refused) and preventative testing
8. Consent documentation
9. Flow sheets or narratives indicating that unresolved problems form previous office visits are addressed in subsequent visits
What are the 4 primary regions associated with acupuncture or dry needling-induced pneumothorax?
Upper trapezius, Thoracic Paraspinal, Medial Scapular, Subclavicular area.