Disinfection of skin before needling?

[Guest guest]

Hi Phil

 

Alcohol as we should realize is useless. Some say it only removes some

surface dirt. Some say it can actually be pushed into the body along with the

needle.

 

A much better way of preventing infection especially if one has a patient who

might be more susceptible is to first use Betadine...then clear it off with

some alcohol. This is taught and done in Acupoint Injection therapy. Much safer

than certain medical counterparts who ONLY use alcohol.

 

I think it was a year or so ago on another group.... when one of the AAMA's

weekend warrior allopaths who blurted out that acupuncturists weren't capable

of sterilizing needles. Obviously he was not aware of prions or mad cows or

JCD. When mentioned he slithered off into lurking territory.

 

Richard

 

> Hi All,

>

> IMO, the MOST important part of preventing infection at AP points

> (and cross-infection - HIV/AIDS, viral hepatitis, CJD, etc) iws to use

> a STERILE SINGLE-USE needle.

>

> IMO it is gross malpractice to reuse AP needles [or any blood-

> touching instrument] on another human patient! Never attempt to

> clean and resterilise a used needle!

>

> I rarely attempt to sterilise skin itself - IMO, that is almost

> impossible because of sweat/sebum glands, etc.Touch wood, I

> have had no serious infection from AP in HUMANS in over 30 years

> of needling.

>

> I had a few cases of cellulitis after needling horses, and a few less

> serious infections of the Ting Points in horses. IMO, the [few]

> horses that fared badly were very immunosuppressed. Otherwise,

> horses rarely have problems after direct needling (without any skin

> preparation).

>

> I have had NO problems with point infection in DOGS.

>

 

 

 

 

[Guest guest]

Hi All,

 

IMO, the MOST important part of preventing infection at AP points

(and cross-infection - HIV/AIDS, viral hepatitis, CJD, etc) iws to use

a STERILE SINGLE-USE needle.

 

IMO it is gross malpractice to reuse AP needles [or any blood-

touching instrument] on another human patient! Never attempt to

clean and resterilise a used needle!

 

I rarely attempt to sterilise skin itself - IMO, that is almost

impossible because of sweat/sebum glands, etc.Touch wood, I

have had no serious infection from AP in HUMANS in over 30 years

of needling.

 

I had a few cases of cellulitis after needling horses, and a few less

serious infections of the Ting Points in horses. IMO, the [few]

horses that fared badly were very immunosuppressed. Otherwise,

horses rarely have problems after direct needling (without any skin

preparation).

 

I have had NO problems with point infection in DOGS.

 

 

 

 

Best regards,

 

 

WORK : Teagasc Staff Development Unit, Sandymount Ave., Dublin 4, Ireland

WWW :

Email: <

Tel : 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

WWW : http://homepage.eircom.net/~progers/searchap.htm

Email: <

Tel : 353-; [in the Republic: 0]

[Guest guest]

Chinese Medicine , " Phil " wrote:

> I rarely attempt to sterilise skin itself - IMO, that is almost

> impossible because of sweat/sebum glands, etc. >>>

 

 

Phil:

 

I use cotton and alcohol mostly out of habit, and for the sake of

ritual. Sometimes when the cotton isn't moist enough and the patient

mentions that there is no alcohol on the cotton, I simply tell them

that their HMO covers the cotton but not the alcohol ;-)

 

 

Jim Ramholz

[Guest guest]

Phil:

> IMO, the MOST important part of preventing infection at AP points

(and cross-infection - HIV/AIDS, viral hepatitis, CJD, etc) iws to use

a STERILE SINGLE-USE needle.

 

>IMO it is gross malpractice to reuse AP needles [or any blood-

touching instrument] on another human patient! Never attempt to

clean and resterilise a used needle!

 

 

Agree completely.. therefore I am surprised that I find western ap. schools

spend so much time on how to sterilize needles???!!!

 

Isn't that a required knowledge in US?

 

Holger

 

 

 

 

[Guest guest]

In a message dated 9/10/2003 10:22:42 PM Eastern Daylight Time,

jramholz writes:

 

> Phil:

>

> I use cotton and alcohol mostly out of habit, and for the sake of

> ritual. Sometimes when the cotton isn't moist enough and the patient

> mentions that there is no alcohol on the cotton, I simply tell them

> that their HMO covers the cotton but not the alcohol ;-)

>

>

> Jim Ramholz

>

 

That is funny.

In Florida, however, I believe we can be sued for not swabbing

" correctly " with alcohol. It is part of the protocol.

 

TTBOMK,

Chris

 

 

 

 

[Guest guest]

In a message dated 9/11/2003 3:48:29 AM Eastern Daylight Time,

holger.wendt writes:

 

> >IMO it is gross malpractice to reuse AP needles [or any blood-

> touching instrument] on another human patient! Never attempt to

> clean and resterilise a used needle!

>

>

> Agree completely.. therefore I am surprised that I find western ap. schools

> spend so much time on how to sterilize needles???!!!

>

> Isn't that a required knowledge in US?

>

> Holger

>

 

In Florida, it is illegal to use needles again. We are required to

use new, presterilized needles on each patient.

 

 

THBOMK,

Chris

 

 

 

[Guest guest]

Nowhere in Chapter 457,F.S. -> Acupuncture Laws or 64B1 F.A.C.->

Administrative Code.... does it discuss being sued for not swabbing with

alcohol.

 

Of course - anyone can sue at the drop of a pin.

 

Richard

 

>

> That is funny.

> In Florida, however, I believe we can be sued for not swabbing

> " correctly " with alcohol. It is part of the protocol.

>

> TTBOMK,

> Chris

>

>

 

 

 

 

[Guest guest]

Chris....

 

WE - the profession - voluntarily made those changes to the Acupuncture laws.

Whereas the weekend warriors such as grossly undertrained Dcs, MDs, DOs,

etc.....they can do whatever they wish in terms of sterilization.

Furthermore......not only are we required to use presterilized needles.....but

something as

important ......'used only once' does not mean stick it in and out a few times

in different areas of the body. It means one time insertion.

 

Richard

 

457.1085  Infection control.--Prior to November 1, 1986, the board shall

adopt rules relating to the prevention of infection, the safe disposal of any

potentially infectious materials, and other requirements to protect the health,

safety, and welfare of the public. Beginning October 1, 1997, all acupuncture

needles that are to be used on a patient must be sterile and disposable, and

each needle may be used only once. History.--ss. 8, 14, ch. 86-265; s. 57, ch.

91-137; s. 4, ch. 91-156; s. 4, ch. 91-429; s. 11, ch. 97-264.

 

 

 

 

 

 

> In Florida, it is illegal to use needles again. We are required to

> use new, presterilized needles on each patient.

>

>

> THBOMK,

> Chris

>

 

 

 

 

 

 

 

 

[Guest guest]

One can sue even if they don't show harm......a more exact statement

is....one can only WIN the suit if they can show harm.

Richard

 

> Nowhere in Chapter 457,F.S. -> Acupuncture Laws or 64B1 F.A.C.->

> Administrative Code.... does it discuss being sued for not swabbing with

> alcohol.

> >>>You can only sue if you can show harm.

> Alon

>

 

 

 

 

[Guest guest]

Hi Richard,

 

> 457.1085  Infection control.--Prior to November 1, 1986, the board

> shall adopt rules relating to the prevention of infection, the safe

> disposal of any potentially infectious materials, and other

> requirements to protect the health, safety, and welfare of the public.

> Beginning October 1, 1997, all acupuncture needles that are to be used

> on a patient must be sterile and disposable, and each needle may be

> used only once. History.--ss. 8, 14, ch. 86-265; s. 57, ch. 91-137; s.

> 4, ch. 91-156; s. 4, ch. 91-429; s. 11, ch. 97-264.

 

Does that apply to ALL instruments that penetrate the skin, i.e. the

heads for plum-blossom- & seven star needles, lancets, etc?

 

 

Best regards,

 

 

WORK : Teagasc Staff Development Unit, Sandymount Ave., Dublin 4, Ireland

WWW :

Email: <

Tel : 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

WWW : http://homepage.eircom.net/~progers/searchap.htm

Email: <

Tel : 353-; [in the Republic: 0]

[Guest guest]

>IMO it is gross malpractice to reuse AP needles [or any blood-

touching instrument] on another human patient! Never attempt to

clean and resterilise a used needle!

 

If you feel this way you must not ever go to a dentist - their practices are a

re-sterilizing nightmare. Unlike the simple, solid shaft acupuncture needle,

dental equipment has a host of factors making proper sterilization most

difficult. Their equipment is expensive which makes them want to sterilize to a

minimum to reduce wear, this equipment often has porous surfaces in which

contaminants can get trapped greatly complicating sterilization procedures, and

many dental offices are under great pressure to see a high volume of patients.

 

Matt Bauer

 

 

-

Holger Wendt

Chinese Medicine

Thursday, September 11, 2003 12:43 AM

Re: Disinfection of skin before needling?

 

 

Phil:

> IMO, the MOST important part of preventing infection at AP points

(and cross-infection - HIV/AIDS, viral hepatitis, CJD, etc) iws to use

a STERILE SINGLE-USE needle.

 

>IMO it is gross malpractice to reuse AP needles [or any blood-

touching instrument] on another human patient! Never attempt to

clean and resterilise a used needle!

 

 

Agree completely.. therefore I am surprised that I find western ap. schools

spend so much time on how to sterilize needles???!!!

 

Isn't that a required knowledge in US?

 

Holger

 

 

 

[Guest guest]

Nowhere in Chapter 457,F.S. -> Acupuncture Laws or 64B1 F.A.C.->

Administrative Code.... does it discuss being sued for not swabbing with

alcohol.

>>>You can only sue if you can show harm.

Alon

 

 

[Guest guest]

hi sterilisation is important.

but we need to start thinking laterally a bit &

undrstand what is going on.

1. strrilisation is supposed to have been better for

reducing cross infection & bacteria.

are you aware that everyone working in a hospital is

these days expected to be carrying all the bacteria

including the dangerous golden staph. this is inspite

of all the precautions taken with barrier nursing,

destroyed clothing & changing linen after first use,

etc etc.

2.its well known that hospitals give patients golden

staph when they have been known not to have had it

before. so what are we talking about

3.we take precautions of washing hands & keep talking

about bacteria in the water. but we use the same water

to wash our hands & claim to be sterlie.

4.the world was going quite well with modeate

sterilising techniques. today inspite of the extra

that we are doing there does not seem to be areduction

in the infection to zero. there is amarginal reduction

- but is it worht the cost.

5. in china in the old days they did things

differently. did they have heaps of infection.

remember that just as if apractitioner had more deaths

people stopped going to see that practitioner.

similarly if there were rampant deaths due to

acupuncture or frequent infections then the same would

have occured,

but that has not happened historically.

i think we are in an era where they haev gone crazy

about sterility to the point that we keep wasjhing our

hands all the time believing that we are more cleaner

even in our homes.

maybe that is part of the cause of our lack of ability

to tolerate all the bacteria of the world that co

exist with us bi=ut we are trying to live awayfrom.

what do you all think.

that does not mean we should use dirty needles. we

must use disposable needles.

but just athought to think about where we are headed,

anand

 

 

 

 

 

--- Holger Wendt <holger.wendt wrote: >

Phil:

> > IMO, the MOST important part of preventing

> infection at AP points

> (and cross-infection - HIV/AIDS, viral hepatitis,

> CJD, etc) iws to use

> a STERILE SINGLE-USE needle.

>

> >IMO it is gross malpractice to reuse AP needles [or

> any blood-

> touching instrument] on another human patient! Never

> attempt to

> clean and resterilise a used needle!

>

>

> Agree completely.. therefore I am surprised that I

> find western ap. schools

> spend so much time on how to sterilize needles???!!!

>

> Isn't that a required knowledge in US?

>

> Holger

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

 

=====

Anand Bapat

Pain Management Specialist

Sports Injury Specialist

Blacktown, Parramatta, Punchbowl, & Hammondville

0402 472 897

 

 

 

 

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[Guest guest]

Phil asks:

Does that apply to ALL instruments that penetrate the skin, i.e. the

heads for plum-blossom- & seven star needles, lancets, etc?

 

And here is the answer as best seen in the Florida Administrative Code which

is quasi-legislative.

 

CHAPTER 64B1-8 INFECTION CONTROL

64B1-8.001 Definitions.

64B1-8.002 Monitoring Sterilization and Infection Control.

64B1-8.003 Office Hygiene.

64B1-8.004 Disposal of Biohazardous Waste.

64B1-8.005 Infection Control Training.

64B1-8.006 Laboratory Test and Imaging Results Education.

 

64B1-8.001 Definitions.

(1) Needles: solid filiform instruments used in the practice of acupuncture.

This includes, but is not limited to, dermal needles, plum blossom needles,

press needles, prismatic needles and disposable lancets.

(2) Sterilization: the use of procedures which destroy all microbial life,

including viruses, thereby creating sterility. In acupuncture this technique is

used for all instruments which pierce the skin including, but not limited to,

filiform needles and

plum-blossom needles or those instruments that may come into contact with

instruments that pierce the skin including, but not limited to, storage strays,

forceps and guide tubes for needles.

Specific Authority 457.104, 457.1085 FS. Law Implemented 457.1085 FS.

History-New 5-6-87, Amended 12-23-87, 6-7-89, Formerly

21AA-8.001, 61F1-8.001, 59M-8.001, Amended 2-26-01.

 

64B1-8.002 Monitoring Sterilization and Infection Control.

(1) Sterilization of acupuncture needles and other equipment shall be

accomplished by proper autoclaving according to the instructions of the

manufacturer

of the autoclave.

(2)(a) A sterilization indicator shall be used with each autoclaving to

monitor the sterilization procedure.

(b) Strips must indicate both exposure to steam and 250º F.

(3) Non-presterilized acupuncture needles shall be sterilized prior to use:

(4) All sterilized items must be stored and handled in a manner which

maintains sterility.

(5) Each acupuncture office utilizing autoclave sterilization techniques

shall post the sterilization procedures and shall maintain documentation of all

autoclave service.

(6) It shall be the responsibility of the Acupuncturist to insure that

personnel responsible for performing sterilization procedures pursuant to this

rule

shall be adequately trained.

(7) The procedures and equipment used for sterilization must have their

efficacy tested periodically. Adequacy of steam under pressure (e.g., autoclave)

must have its efficacy verified by appropriate biological monitoring at least

once every 40 hours (2400 minutes) of use or at least once every thirty days,

whichever comes first.

Specific Authority 457.104, 457.1085 FS. Law Implemented 457.1085 FS.

History-New 5-6-87, Amended 12-23-87, 6-7-89, 11-13-89, Formerly

21AA-8.002, 61F1-8.002, Amended 2-22-96, Formerly 59M-8.002, Amended 2-26-01.

 

64B1-8.003 Office Hygiene.

An acupuncture office shall be maintained in a safe and sanitary manner.

Specific Authority 457.104, 457.1085 FS. Law Implemented 457.1085 FS.

History-New 5-6-87, Formerly 21AA-8.003, 61F1-8.003, 59M-8.003.

 

64B1-8.004 Disposal of Biohazardous Waste.

Biohazardous waste must be managed pursuant to the provisions of Chapter

64E-16, Florida Administrative Code, effective June 3, 1997.

Specific Authority 457.104, 457.1085 FS. Law Implemented 457.1085, 381.80 FS.

History-New 5-6-87, Amended 12-23-87, 5-30-91, Formerly

21AA-8.004, 61F1-8.004, 59M-8.004, Amended 6-8-00.

 

64B1-8.005 Infection Control Training.

Prior to commencement of clinical training, every approved course of study

and tutorial program shall provide training in clean needle technique and

universal precautions for preventing the transmission of bloodborn pathogens and

other infectious diseases, including, for example, HIV/AIDS, hepatitis,

staphylococcus, and tuberculosis.

Specific Authority 457.104, 457.105, 457.1085 FS. Law Implemented 457.1085

FS. History-New 10-25-95, Formerly 59M-8.005.

 

64B1-8.006 Laboratory Test and Imaging Results Education.

During didactic and clinical training, and as part of continuing education,

the Board of Acupuncture requires courses of study as to the safe and

beneficial use of laboratory tests and imaging findings in the practice of

acupuncture

and oriental medicine.

Specific Authority 457.102, 457.104, 457.105, 457.107, 457.1085 FS. Law

Implemented 457.102, 457.105, 457.107, 457.1085 FS. History-New

2-18-01.

 

 

 

> 457.1085 Infection control.--Prior to November 1, 1986, the board

> >shall adopt rules relating to the prevention of infection, the safe

> >disposal of any potentially infectious materials, and other

> >requirements to protect the health, safety, and welfare of the public.

> >Beginning October 1, 1997, all acupuncture needles that are to be used

> >on a patient must be sterile and disposable, and each needle may be

> >used only once. History.--ss. 8, 14, ch. 86-265; s. 57, ch. 91-137; s.

> >4, ch. 91-156; s. 4, ch. 91-429; s. 11, ch. 97-264.

>

>

>