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How to puncture safely and accurately? by Qi Jing(祈静) 1. Needling manipulation. 2. Location of points. 3. Body physiological situation. ★ 4. Management of possible accidents in acupuncture. ★ 1. Needling Manipulation The safe needling manipulation depends on three important factors. 1. The angle of needle insertion 2. The depth of needle insertion 3. The amplitude of moving needle 2. Location of Points Nipples.(St.17-Ruzhong) Umbilicus.(Ren8-Shenque) Points inside orbit never use moxibustion by warming needle. Points in these locations need much more attention. 1. Head 2. Edge of eye socket 3. Neck 4. Chest 5. Back Yamen (DU 15)(哑 门) Location : 1 cun directly above the midpoint of the posterior hairline. Fengfu (DU 16) (风府) Location : 0.5 cun directly above the midpoint of the posterior hairline. Attention: Angle:puncture perpendicularly or obliquely downward . Depth:0.5-1 cun Medulla oblongata (延髓)would be damaged if inserting needle upward through occipital pore. Back Chengqi(ST.1) Jingming (BL.1) Jingming 睛明(BL 1) Location: 0.1 cun superior to the inner canthus. Manipulation: To push the eyeball to the lateral side with the left thumb and puncture perpendicularly 0.1-1.0 cun along the infraorbital ridge. Attention: can not manipulate the needle with large amplitude, to spare the blood vessel from hematoma. back The Topography(局解) of Neck Especially anterior cervical region is very complicated. Renying(ST 9)人 迎 Location:1.5 cun lateral to the process of larynx, behind the common carotid artery. Shuitu 水沟(ST 10) Location: 1 cun below Renying. Manipulation: To puncture perpendicularly 0.30.8 cun. Attention: To keep away from the common carotid artery. We can not manipulate the needle with large amplitude. back Points in chest Anatomical location of the lung: Top of the lung locate 2 or 3 cm above clavicle. Bottom of the lung locate inside 6th rib of chest. Attention: Points in intercostal (肋间的)space Manipulation: ---Angle: subcutaneously or obliquely.(the needle is inserted to form an angle of 15°-25°or 45°or so with the skin surface.) ---Depth:0.8-1 cun. back The Back Bladder channel Location: One group is along the first lateral line of Bladder channel. The other group is along the second lateral line of Bladder channel parallel to the first line. Manipulation: Angle:obliquely Depth:0.5-0.8 cun Du channel Points location: Below the spinous process of each vertebra. Manipulation: Puncture obliquely upward 0.5-1 cun. Attention: Can not too deep. back 3. Body physiological situation There are several cases that we can not use needle: 1. Person who is easy bleeding. 2. Recently operation accepter. 3. People whose pulse is too weak and who is too hungry or overtired. 4. Pregnant women. To avoid abortion. points lower than umbilicus Jianjing (GB 21) Hegu(LI 4) Sanyinjiao(SP 6) 4. Management of possible accidents in acupuncture. Fainting Stuck needle Bent needle Broken needle Hematoma(血肿) Fainting(晕针) Reasons: weakness/nervous/ receiving needles for the first time/ too forceful manipulation Prodromes: dizziness and vertigo/irritability/ nausea/pallor///shock/unconsciousness/hypotension Countermeasures: to remove the needle at once/ help the patient to lie down/warm water should be given///--------a mild case Renzhong(Du26),Suliao(Du25),Zusanli(St.36) Baihui(Du20),Qihai(Ren6),Guanyuan(Ren4) other emergency measures-------a severe case Stuck needle(滞针) Symptoms: Difficult to manipulate or withdraw.///pain/ hard to move the body Reasons: extremely nervous/ change of the position Countermeasures: massage the area around the needle/ another needle///adjustment of the position Hematoma(血肿) After withdrawal of the needle, a red pin- point mark may remain.----normal To press the hole of needle when it is taken out.///loose/flabby back THANK YOU!