GB/T 33415-2016Handling methods for acupuncture abnormal conditions (English PDF)

5.1.1 Handling of mild fainting

Stop needling at once and withdraw all the needles. Lay the patient flat with the head slightly lowered. Attend to ventilation and to keeping the patient warm. Give warm water or sugar water to drink and let the patient lie quietly until the symptoms have gone.

5.1.2 Handling of severe fainting

On the basis of the handling above, needle Renzhong, Suliao, Neiguan and Zusanli, or apply moxibustion at Baihui, Qihai and Guanyuan. Where necessary, combine this with other emergency measures. After the condition has been relieved, allow the patient adequate rest.

5.2 Handling of sticking of the needle

Where the cause is the patient's mental tension, explain and reassure to dispel the tension, press and tap around the stuck needle, or prolong the retention time appropriately to relieve the muscular tension.

Where the cause is excessive rotation in one direction, rotate back in the opposite direction and use the handle-scraping and handle-flicking methods.

Where the cause is that the patient has moved position, ask the patient to return slowly to the original position.

Where necessary, insert one further needle shallowly at a point distal to the stuck needle. Do not pull the needle out by force.

5.3 Handling of bending of the needle

Once the needle has bent, do not continue with lifting, thrusting or rotating.

Where the cause is that the patient has moved position, ask the patient to return slowly to the original position.

Where the needle body is slightly bent, withdraw it slowly. Where the angle of the bend is large, first relax the local tissue and skin, then withdraw the needle following the direction of the bend. Where the needle body is bent in more than one place, observe the directions of the bends and withdraw it gradually, section by section.

Do not pull the needle out by force.

5.4 Handling of breaking of the needle

Tell the patient not to move position, so that the broken needle does not sink deeper into the muscle.

Where the broken end is exposed above the surface, take the needle out with the fingers or with forceps. Where the broken end is level with the skin, press either side of the needle hole with the thumb and forefinger along the direction of the needle body so that the broken needle is exposed, and take it out with forceps. Where the broken end has sunk entirely into the muscle, refer the patient for surgical consultation.

5.5 Handling of the lingering sensation

In mild cases, press along the channel above and below the site, apply a hot compress or massage. In severe cases, apply moxibustion to the site.

5.6 Handling of pneumothorax

Withdraw the needle promptly. Where there are no obvious subjective symptoms, the patient should rest in bed and be treated symptomatically. Where the symptoms are severe, give emergency treatment immediately and refer the patient for surgical diagnosis and treatment.

5.7 Handling of burns

Remove the source of injury quickly. Apply a cool wet compress at once or immerse the burned area. Keep the wound surface clean and dry. Blisters that have formed need not be treated; large blisters may be aspirated with a sterile needle. Keep the area clean and dry, apply a burn ointment or similar preparation externally, and dress with gauze.

Where necessary, antibiotics may be given by mouth to prevent infection.

5.8 Handling of local suppurative infection

Instruct the patient to rest and move as little as possible and to elevate the affected limb. Do not squeeze the affected part. An antibacterial anti-inflammatory ointment may be applied externally, with the appropriate use of Chinese and Western medicines that reduce inflammation, relieve pain and clear heat and toxin, combined with hot compress physiotherapy.

5.9 Handling of allergy

Where an adverse allergic reaction appears during needling, moxibustion, point injection or the use of bee-sting therapy, stop the treatment immediately. Where there is a local or general allergic rash, give antihistamines, vitamins and similar medication and encourage the patient to drink plenty of water.

Where necessary, corticosteroids may be used as appropriate.

5.10.1 Central nervous system injury

Where needling has caused, directly or indirectly, cerebral haemorrhage, subarachnoid haemorrhage or injury to the cerebellum, the medulla oblongata or the spinal cord, refer the patient immediately to the relevant department for emergency treatment as soon as it is discovered.

5.10.2 Peripheral nerve injury

Where needling has injured a peripheral nerve, including the cranial and spinal nerves, stop needling, apply hot compress physiotherapy combined with local massage, and strengthen functional exercise.

5.11 Handling of blood vessel injury caused by acupuncture and moxibustion

5.11.1 For superficial spot bleeding, it is sufficient to press the needle hole with a sterile dry cotton ball for one to two minutes.

5.11.2 For a larger haematoma, apply a cold compress first; a hot compress may be used once the bleeding has stopped for 24 hours.

5.11.3 Where a larger artery of a limb has been injured and the bleeding does not stop, apply a pressure dressing at the needle hole.

5.11.4 For bleeding within a body cavity with relatively mild symptoms, use medication to stop the bleeding under close observation. Where the volume of bleeding is large and the patient shows clear signs of shock, treat the shock at the same time as arresting the bleeding.

5.12 Handling of organ injury caused by needling

5.12.1 Where needling has injured the heart, stomach, spleen, liver, kidney, intestine, bladder or another organ, the patient may rest in bed under close observation provided the condition does not develop further.

5.12.2 Where the situation is severe, refer the patient immediately for surgical treatment.