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Clean Needle Technique Manual Clean Needle Technique Manual Best Practices for Acupuncture Needle Safety and Related Procedures 7th Edition Published by the Council of Colleges of Acupuncture and Oriental Medicine©2015 CCAOM Clean Needle Technique Manual 7th Edition Best Practices for Acupuncture Needle Safety and Related Procedures Seventh Edition Revised May 2017 Council of Colleges of Acupuncture and Oriental Medicine www.ccaom.org © 2015 by the Council of Colleges of Acupuncture and Oriental Medicine. Reviewed and updated May 19, 2017. All rights reserved, including the right to reproduce this work in any form whatsoever, without permission in writing from the publisher, except for brief passages in connection with a review. Printed in the United States of America ISBN 978-0-9963651-0-9 Editor: Jennifer Brett, N.D., L.Ac. Cover Design: Roberta McGrew Cover Photos: Leaf © 123RF.com, Nanette Grebe © 123RF.com The Clean Needle Technique (CNT) Manual is intended for use primarily by state-licensed acupuncturists and students enrolled in a formal course of instruction at a school approved by the Accreditation Commission for Acupuncture and Oriental Medicine. As a statement of best practices concerning acupuncture needling and related techniques, the manual may also be beneficially used by state-licensed healthcare professionals in other disciplines who have acupuncture and related modalities within their lawful scope of practice and by acupuncturists outside the United States who are appropriately authorized to practice acupuncture within their respective national jurisdictions. The manual is not intended for use by persons without formal training and regulatory authorization to practice acupuncture. The manual focuses on safety and is not a guide to appropriate treatment for particular health conditions. While the manual is intended to reflect best practices as of the date of publication, opinions as to best practices may differ and change over time. Ongoing study and debate concerning best practices within the academic and practitioner communities is encouraged. The Council assumes no liability for any injury that may occur as a result of a practitioner's use of, or reliance upon, any safety protocol contained in this manual. Table of Contents Preface .............................................................................................................................................. xiv Acknowledgements ........................................................................................................................... xvi Introduction ...................................................................................................................................... xvii References ......................................................................................................................................... xix Part I: AOM Clinical Procedures, Safety, Adverse Events (AEs) and Recommendations to Reduce AEs .. 1 References ........................................................................................................................................... 2 1. Acupuncture ........................................................................................................................................ 3 Safety/Adverse Events – A Review of the Literature ........................................................................... 3 Preventing Acupuncture Needling Adverse Events ............................................................................. 4 Bruising and Bleeding ...................................................................................................................... 4 Safety Guidelines to Prevent Bruising, Bleeding, and Vascular Injury .......................................... 5 Needle Site Pain/Sensation .............................................................................................................. 5 Safety Guidelines to Prevent Needle Site Pain ............................................................................. 6 Fainting ............................................................................................................................................ 7 Safety Guidelines to Prevent Fainting .......................................................................................... 7 Stuck Needle .................................................................................................................................... 7 Safety Guidelines to Avoid and/or Respond to Stuck Needle ....................................................... 8 Failure to Remove Needles .............................................................................................................. 8 Safety Guidelines for Needle Removal ......................................................................................... 9 Aggravation of Symptoms ................................................................................................................ 9 Safety Guidelines for Aggravation of Symptoms ........................................................................ 10 Preventing Rare but Serious Adverse Events (SAEs) Associated with Acupuncture Needling ........... 10 Pneumothorax ............................................................................................................................... 10 Safety Guidelines to Avoid Pneumothorax ................................................................................. 12 Injury to Other Organs ................................................................................................................... 13 Central Nervous System Injury ...................................................................................................... 15 Safety Guidelines to Avoid Organ and Central Nervous System Injury ...................................... 15 Traumatic Tissue Injury .................................................................................................................. 15 Peripheral Nerves ...................................................................................................................... 15 i Blood Vessels ............................................................................................................................. 16 Safety Guidelines to Avoid Traumatic Tissue Injury ................................................................... 16 Infections ....................................................................................................................................... 16 Safety Guidelines to Prevent Infection ....................................................................................... 17 Broken Needle ............................................................................................................................... 18 Safety Guidelines to Prevent Broken Needles ............................................................................ 19 References ......................................................................................................................................... 19 2. Moxibustion ....................................................................................................................................... 24 Safety/Adverse Events – A Review of the Literature ......................................................................... 24 Preventing Moxibustion Adverse Events ........................................................................................... 25 Burns .............................................................................................................................................. 25 Safety Guidelines to Prevent Moxa Burns .................................................................................. 26 Secondary Infection from Moxa Burns .......................................................................................... 26 Safety Guidelines to Prevent Secondary Infection from Moxa Burns ......................................... 27 Nausea or Other Adverse Reactions to Moxa Smoke .................................................................... 27 Safety Guidelines to Prevent Adverse Reactions to Moxa Smoke .............................................. 27 Other Heat Therapies ..................................................................................................................... 27 Safety Guidelines for Heat Therapies Other than Moxa ............................................................ 28 References ......................................................................................................................................... 29 3. Cupping .............................................................................................................................................. 31 Safety/Adverse Events – A Review of the Literature ......................................................................... 31 Fire Cupping ................................................................................................................................... 31 Suction Cupping ............................................................................................................................. 32 Wet Cupping .................................................................................................................................. 32 Other Cupping Procedures ............................................................................................................. 32 Cupping Adverse Events ...................................................................................................................
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