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From Acupuncture training courses with Linda Tagg of Back To Work
Providing western medical acupuncture specialist courses from 1984 - 2006
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Considering Patient Safety and Comfort :
A standard needling protocol has always been taught on all our acupuncture courses, based on a sterile / clean acupuncture needle technique introduced in the 1980’s. The acupuncture treatment technique is patient friendly, in that it is gentle, often painless, with the risk of needle site, or other infection, being minimized. Control of infection is often just using Common Sense. As most infections are caused by invasive techniques, now we are often able to use non-invasive (no needles) stimulation of the acupuncture points and provide as good and sometimes better results than by needling.
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Acupressure is a useful CPD knowledge pool for acupuncture therapists & complementary therapists. Acupressure is any Acupuncture without Needles.
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It does not have to feel like this !
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Modern Western medical acupuncture can be very different to alternative medicine acupuncture, with medical practitioners using specialist techniques. Non invasive (no needle) acupuncture is supported by an increasing level of research.
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Risk Reduction
To Swab or Not To Swab
Palpation to find acupuncture points is important for individual patient accuracy. Palpating through an alcohol swab, as we have taught for many years, is one practical example of creating a barrier between the therapists bacteria and the patients skin. The World Health Organisation also recommends the use of alcohol swabs to reduce the risk of infection.
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Reducing risk
Alcohol swabs are useful for a variety of cleaning and barrier uses, helping reduce the risk of cross infection.
More about SWABS
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Wearing Gloves when Handling Acupuncture Needles
Handling acupuncture needles whilst wearing gloves is not advised for acupuncture treatments. This can prove to be hazardous, as the fine acupuncture needles cannot be properly controlled with a gloved hand. The handling of acupuncture needles should not be confused with the handling of hypodermic needles, the two are completely different in their use. Should bleeding occur when a needle has been removed, then dealing with the bleed is a separate matter, dealt with accordingly to local procedures.
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Infection control,
health & safety, the use of introducers
patient comfort and
risk reduction
are all considerations in western medical acupuncture.
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The debate surrounding the use of swabs quotes studies regarding their cleaning effectiveness. These studies have not considered the effectiveness of alcohol swabs when used as a barrier to introducing the transient microflora (bacteria) of the therapist on to the palpated acupuncture point of the patient. Any ‘ground in’ microflora could be introduced into the patient on needle insertion. We unreservedly recommend a swab ‘barrier’ when palpating points prior to needle insertion to reduce the risk of cross infection.
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Acupuncture needles are very fine and need finger tip control.
Hypodermic and Acupuncture needles are completely different. Infection Control Officers should understand there are differences in the uses and the handling techniques of each.
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Personal Hygiene
Hand washing should always be carried out effectively between tasks, but this does not make the hands sterile or bacteria free.
It is also important that nothing contaminates any part of the needle shaft that is likely to enter the skin of the patient .
Sadly, it seems many people have lost Common Sense.
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Surface wipes for clean preparation of hard surfaces.
Why can’t I buy anything?
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The use of an easy to clean ‘Dressings Trolley’ is recommended to place all the equipment on. NO EQUIPMENT SHOULD BE PLACED ON THE PATIENT OR THEIR BED/COUCH. That contact is sufficient to transfer any infection to the next patient or couch the equipment is placed on.
Therapists contemplating learning to use acupuncture are advised to have up to date Hepatitis vaccinations. With any invasive procedure there is a small risk that a patient may be a symptomless carrier of an infectious disease.
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Health & Safety and Litigation
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Everyone agrees that the risk of infection from acupuncture needling is small. However, with regard to whether or not you use a swab when needling, under Health and Safety the questions to ask yourself are:
Is there a risk?
Yes! it is recognized that there is a small risk of needle site infections when using acupuncture.
If there is a risk, can the risk be removed?
Questionable! But it could be reduced. Most studies on ‘swabbing’ have concentrated on cleaning the skin and have not considered the action of using the swab as a barrier between patient and therapists skins.
If the risk cannot be removed, can the risk be minimized?
Yes! Using a swab to palpate the acupuncture points reduces the risk of pressing bacteria from the therapist finger onto the patients skin at the needle site. The swab can act as a barrier.
If an infection occurs -
Did you take all reasonable measures to reduce or minimize the risk of infection ?
Linda has always taught palpating through an alcohol swab when locating acupuncture points prior to needling. Not because of the ‘questionable’ cleaning ability of the swab, but because the alcohol swab acts as a barrier between the therapist and the patient, in addition to any cleaning benefit, thereby reducing to a minimum the risk of pushing the therapists’ own bacteria into the proposed needling site on the patient.
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Those Practitioners trained by Linda will be aware of the need to use a good clean / sterile needle insertion technique after the alcohol on the skin has dried.
In addition to ensuring that palpation of the point is carried out with an alcohol swab, as a barrier to bacteria on the therapist and to aid skin cleansing, it is important that nothing touches or contaminates any part of the needle shaft that is likely to enter the skin. Sterile, disposable, needles should be used, the protective packing being opened just prior to the needle being used.
All equipment, including packets of needles should be kept on a trolley or hard surface that can be properly cleaned. One possible cause of cross infection is the modern practise of placing equipment, such as needle packets, on couches or beds. Any bacteria present is then transferred to the next patients’ bed when the equipment is transferred.
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Introducers
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If an introducer is used to pass the needle through on insertion, each needle should have its own individual sterile introducer around it in its pack.
Introducers should not be used for more than one needle, as passing a needle handle, that has been touched, through the introducer can contaminate the inside of the introducer. The next needle inserted can contaminate the needle shaft if it contacts the inside of the introducer that has been contaminated by the previous needles’ handle.
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Patient Comfort :
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In the interests of patient comfort we also suggest that certain acupuncture points be contra-indicated to needling and treated non-invasively instead. Not necessarily because it would be dangerous, but because they can be very uncomfortable or painful to needle. Acupuncture is an effective treatment and should be a comfortable patient experience,
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Linda and David ceased training needle acupuncture course in 2005 after 21 years of safely teaching Western Medical Acupuncture to Medical Practitioners. Clinically, Linda has found the need to use needles has reduced as the use of non-invasive techniques are proving to be so effective, without the risks associated with needling. Acupuncture points can be stimulated with Low-Level-Laser (<5mw), Electro-Acupuncture (Micro-Amp Recommended), Magnets and Pressure.
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Medical Advice:
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