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Centers for Disease Control and Prevention
Occupational Safety and Health Administration
Council of Colleges of Acupuncture and Oriental Medicine
National Certification Commission for Acupuncture and Oriental Medicine
Where is the CDC located?
What is the fundamental role of the immune system?
To differentiate self from non-self
What are autoimmune disorders?
The failure of the ability to differentiate self from non-self
What can be found on skin, in the mouth, respiratory passageways, urinary tract, colon, and mucous membranes of the eyes?
What are some "natural barriers"?
nose, throat, urethra, rectum, and stomach acid
What are humoral components of the immune system?
- Protein systems
What are some cellular components of the immune system?
- macrophages / monocytes
- B cells
- T cells
What is another name for self inflicted infectious agents?
- Autogenous Infections
- i.e. pick nose then rub eye
What is another name for infectious agents coming from elsewhere?
Where is E. coli found?
In the small intestine
Incubation: 15-50 days
Hepatitis A (HAV)
Worst Strain of all (BAD)
Incubation: 50-180 Days
Chronic: Depend on age group
Hepatitis B (HBV)
Most Chronic of All
Incubation: 20-90 Days
Needs HBV to get this one
Incubation: 15-60 Days
What is the difference between HIV-1 and HIV-2?
- HIV-1: more virulent virus and more easily transmitted
- HIV-2: slower than HIV-1 less infectious early on but more infectious over time. Predominately in West Africa.
Incubation: 8-10 years
What percentage of risk of contamination do you get from HBV (Hepatitis B)?
What percentage of risk of contamination do you get from HIV?
What percentage of risk of contamination do you get from HCV?
Which cell type does HIV target?
CD4 (T4) Lymphocytes
This organism is spread by skin-to-skin contact and can be readily transmitted from patients to health care providers?
MRSA (Methicillin-Resistant Staphylococcus aureus)
Products designed to reduce the density of microbial life on living tissue, particularly on the skin of the patient or practitioner.
Techniques for preventing infection during invasive procedures such as surgical operations, dressing wounds, or some laboratory procedures. Acupuncture is not an _________ procedure because it is not performed in a manner that preserves the sterility of the acupuncturist's hand so skin of the patient. Acupuncture is a clean rather than sterile procedure. That having been said acupuncture needles must be kept in a sterile condition for use in CNT.
The area that has been prepared to contain the equipment necessary for acupuncture in such a way as to protect the sterility of the needles. By extension, this includes not only the clean surface on which equipment will be placed, but also the patient's skin around prepared acupuncture points, and anything that touches the skin.
The use of techniques (such as antisepsis, disinfection, sterilization, hand washing, and isolation of sharps) designed to reduce the risk of infection of patients, practitioners, and office personnel by reducing the number of pathogens, thereby reducing the chances for contact between the pathogens and the patients and personnel.
The introduction of contaminating viruses, bacteria, or other organisms into or onto previously clean or sterile objects, rendering them unclean or non-sterile.
The chemicals employed in disinfection. They should only be used on inanimate objects, and are not to be confused with antiseptics that are applied to the body. Examples include hypochlorite dilutions such as bleach, and commercial disinfectants such as Staphene.
The use of chemicals and procedures designed to destroy or reduce the number of pathogens on inanimate objects such as equipment and clinic surfaces. It must be recognized that some bacteria, spores, and viruses may resist the often lethal effects of many chemicals.
The use of procedures that destroy all microbial life, including viruses. This is a rigid, uncompromising term. There is no such thing as partial _________. In acupuncture, _____________ is required for all instruments that pierce the skin (needles, plum-blossom needles, seven-star hammers, and lancets) and insertion tubes.
What is the number one method to kill germs?
What is the first thing you do when you see more than one drop of blood?
Put on Gloves
How should the patient be positioned when needling?
The position where the patient is most comfortable
Should acupuncture needles be inserted through inflamed, irritated, diseased, or broken skin? Why?
No, otherwise infections can be carried directly into the body past the broken skin barrier
What steps should be taken if a needle spill occurs?
- Disinfected with germicide since the HBV virus can survive on surfaces for more than one week at room temperature
- All materials used in the clean-up job should be discarded in double wrapping
What does it mean to be a chronic-persistant disease?
Asymptomatic - minimal symptoms can effect others
What does it mean to be a chronic-active disease?
Progressive symptoms with Liver damage
What is difference between transient and resident?
- Transient - obtained from elsewhere
- Resident - living on you for extended periods
How full should a Sharps Container be before you change to a new one?
What do you do if a patient is unconcious and can not be revived?
What does ECP stand for?
Exposure Control Plan (i.e. if Sharps Container Spills)
What are the three categoriezs requireing sterilization?
- Critical: enters vascular system
- Semi-critical: touches mucus membranes, not intact with skin
- Non-critical: touches intact skin
What are the procedures when cleaning blood and body fluid?
- Gloves go on
- Use Soap and Water
- Dicard all material by double bagging
- Blood products go in a Red Bag
What is HIPAA?
- Patient Confidentiality Records
- Patient must sign releases in front of practitioner
What happens if a needle breaks?
Tell the patient to see their PCP or call ambulance to have them extract it
Who do you not use E-stim on?
Patients with electrical devices implanted (i.e. pacemaker)
What is another name for Artemesia Vulgaris?
What are the herbal properties of Artemesia Vulgaris?
- Used to treat Yang Def.
Restores Weakened Yang
Courses through the three Yin
Expels cold and damp
Opens the 12 primary channels
Regulates Qi and Blood
The effects of Moxa
What are the five materials you can use for indirect moxa?
Superficial puncture for bleeding
Indicated for heat of head and body
Oval-rounded tip and cylindrical body
Indicated for disorders of the muscle and for massage
Millet head, tip is round and slightly sharp
Indicated for pressing on meridians
Triangular head, cylindrical body
Indicated for superficial carbuncles and painful swelling and febrile diseases, swelling from sprains
Sharp-edged Needle (Three-edged needle)
Indicated for regulating meridians for cold, heat and painful syndromes
Slightly large head and thin body, being round and sharp
Indicated for carbuncles and painful swelling / bi-syndrome in deep level
Very fine body like a hair
Indicated for regulating meridian for cold, heat and painful syndromes
Round, sharp tip and long fine body
Indicated for puncturing the deep tissue attacked by pathogens or persistent bi-syndrome, paralysis, threading
Round, Thick body
Indicated for removing fluid for joint disorder with swelling
"Setting the fire on the mountain"
- Tonification Method
- Patient should feel warmth on the point. Often used for def. cold type disorders
"Penetrating Heaven coldness"
- Sedation Method
- Patient should feel cool sensation at the point. Often used for excess and heat disorders
"Green tortoise seeking the point"
To obtain / direct Qi
"Green dragon swinging its tail"
Used to treat severe pain
"White tiger shaking his head"
To push the meridian Qi movement
"Dragon & tiger coming to blows"
- To circulate and regulate Qi in the channels
- To circulate the Ying & Wei
- Very effective for pain
"Yin hidden in Yang"
For chronic problems (tonify then sedate)
"Yang hidden in Ying"
For acute problems (sedate then tonify)
Indicated for wind or skin problems
Technique of bloodletting
To evacuate the stagnated blood
Used for skin conditions
For tendon disorders
Linked with Spleen
Very deep / close to the bone without touching the bone (i.e. bi, arthritis, rheumatism)
Bar soap is always recommended for washing hands. True of False?
The best way to reduced any type of infection is to follow universal precautions. True or False?
Universal precautions should always apply to?
Which alcohol percentage is recommended by the CDP?
Swabbing the hands with alcohol is acceptable for the second hand washing if there is no sink in the treatment room. True or False?
The needle is contaminated if the practitioner is touching the shaft. True or False?
Any solid or liquid waste that may present a threat of infection to humans may be considered biohazardous waste. True or False?
A patient comes in for treatment and is intoxicated. Is it okay to treat?
If a patient faints during treatment, what is the first thing you do?
- 1. Remove needles
- 2. Raise Legs
- 3. CALL 911
When setting up your area of CNT the waste bag and needle bag should be placed where?
Outside the Clean Field
The easiest way for health practitioners to get HIV is?
Getting stuck with a contaminated needle
If a healthcare worker is exposed with a pathogen, the records must be kept for how many years?
How long are patient clinical records kept after the end their care with you?
What are the methods of Tonification?
Insertion on Respiration?
Insetion in Direction?
Pressing / Closing?
Lifting / Thrusting?
- Speed - Slowly
- Depth - Shallow to Deep
- Insert on Exhale, Remove on Inhale
- With the flow of channel
- Massage before inserting
- Press quickly to close point
- Thrust with force, lift lightly
- Rotate Clockwise
- Mother Point
- Thinner Gauge
- Long Time / Short Time
What are the methods of Sedation?
Insertion on Respiration?
Insetion in Direction?
Pressing / Closing?
Lifting / Thrusting?
- Speed - Quickly
- Depth - Deep to Shallow
- Insert on Inhale, Remove on Exhale
- Against the flow of channel
- No Massage
- Do not press, open up point
- Thrust greatly, lift with force
- Child Point
- Thicker Guage
- Short Time / Long Time
What is the the Reason for the bleeding method?
What disorders are they indicated for?
- Activate Blood - Encourage motion
- Reduce Swelling
- (not to be done on major vessels)
- Indicated for Heat / Inflammation-based
- Contraindications include - weak patients, expectant mothers, patients with hemorrage disorders
What is the function of Cupping?
What disorders are they indicated for?
- Warm, move Qi, and move blood in the meridians; dispell cold-damp; diminish swellings and pains
- Indicated for (Bi-syndrome - due to wind-damp; lowback, shoulders, leg; GI - stomachache, vomiting, diarrhea; Lung disease - cough, asthma; Cupping with bleeding method - acute sprains with blood stasis)
- Contraindicated include - skin ulcers, edema, large blood vessels, high fever with convulsions, abdominal sacral regions of pregnant women, patient susceptible to spontaneous bleeding or endlesss bleeding after trauma
Please define these cupping methods and their functions.
- Retention - Stays in one place - used of general illness
- Multiple - many cups Stay at their one place - used for treatment of blood stagnation of certain internal organs
- Flash - Applied then immediately taken off - used for local areas with deficient condition resulting in numbness and lack of function
- Sliding - cover area lightly in oil; apply cup; slide
How does Gua Sha work?
- Promote Qi and Blood circulation
- Draws out fluid ("bad stuff") to skin surface
What is the function of 3-edged needle?
- Derived from Sharp Needle Type
- Indicated for blockage of meridians, blood stasis, excess syndrome and heat syndrome
- Actions - move Qi and Blood in meridians; dispel blood stasis; eliminate the heat
- Contraindicated - weak constitution, for pregnant women and those susceptible to bleeding
What is the function of "hammers"?
- Indicated for disorder of nervous system and skin disease
- Actions - move Qi in the meridians; regulates the zang-fu functions
- Contraindicated - local trauma and ulcers
What is the difference between a plum-blossom hammer and seven-star hammer?
- Plum-Blossom - 5 Long needles
- Seven-Star - 7 Short needles
What is the function of intradermal needles?
Indicated for chronic or painful diseases which need long retention of needles
True or False. When using a Long Needle and having trouble inserting, you can use sterile guaze to support the shaft.
True - "sterile" is the key word in the phrase
If you insert a needle between 30 and 60 degrees what is that term called?
Shallow insertion is good for treating...
a. chronic conditions
c. strong patients
Heat - to bring everything to the surface
Deep insertion is good for treating...
a. Yang body parts
b. in the summer
c. a weak pulse
d. internal organs and blood
Internal organs and blood
If a needle is touched by anyone, at the shaft, is the needle contaminated?
True or False. Always use guide to insert auricular needles.
No always - you can but not required
If a patient is exposed to a pathogen the records must be kept for how long?
If an employee is exposed to a pathogen the records must be kept for how long?
True or False. Laundry is considered sterilized with detergent and hot water.
False - considered clean but not sterilized
Is it permitted to leave acupuncture needles in a patient after treatment?
No - intradermals are not considered acupuncture needles
If a patient stops breathing, not faint, what is the first thing you do?
a. CALL 911
b. perform CPR
c. remove all the needles
d. lay the patient down
Which is an acceptable procedure for sterilization?
d. All of the above