Guest guest Posted January 21, 2007 Report Share Posted January 21, 2007 the sheet vs. paper discussion has been interesting. it's led me to wonder about swabbing points. osha compliency issues aside, i'm wondering if everyone is swabbing points, or if some are not? i ask because early in practice i met a couple of LAcs in a practice who were not swabbing. they felt that the osha reg was absurd, and recounted that they knew md's who agreed: we aren't tearing tissue with hypodermic needles, therefore swabbing is unnecessary, and according to them, ridiculous. (incidently, they were both in the US on visa's.) As a new practitioner, i felt provincial and naive for doing so. since then i've not encountered other practitioners who do not swab, but the issue makes me curious: does everyone swab, or not? -- Kath Bartlett, LAc, MS, BA UCLA Oriental Medicine Experienced, Dedicated, Effective Asheville Center For 70 Woodfin Place, Suite West Wing Two Asheville, NC 28801 828.258.2777 kbartlett www.AcupunctureAsheville.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2007 Report Share Posted January 21, 2007 HI Im Tanya... i'm new to this group. I am a student a Pacific college, chicago. They not only teach us to swab but overly stress it. But it makes sense to me because even though we aren't using hypodermic needles, our needles still penetrate the skin. Obviously points even bleed at times. The prac's that didnt swab were not breakjing the law, but more importantly putting at risk the health of their patients. " " wrote: the sheet vs. paper discussion has been interesting. it's led me to wonder about swabbing points. osha compliency issues aside, i'm wondering if everyone is swabbing points, or if some are not? i ask because early in practice i met a couple of LAcs in a practice who were not swabbing. they felt that the osha reg was absurd, and recounted that they knew md's who agreed: we aren't tearing tissue with hypodermic needles, therefore swabbing is unnecessary, and according to them, ridiculous. (incidently, they were both in the US on visa's.) As a new practitioner, i felt provincial and naive for doing so. since then i've not encountered other practitioners who do not swab, but the issue makes me curious: does everyone swab, or not? -- Oriental Medicine Experienced, Dedicated, Effective Asheville Center For 70 Woodfin Place, Suite West Wing Two Asheville, NC 28801 828.258.2777 kbartlett www.AcupunctureAsheville.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2007 Report Share Posted January 21, 2007 At 12:58 PM 1/21/2007, " " wrote: >... LAcs in a practice who were not swabbing. they felt that the >osha reg was absurd, and recounted >that they knew md's who agreed: we aren't tearing tissue with >hypodermic needles, therefore swabbing is unnecessary, and according >to them, ridiculous. (incidently, they were both in the US on visa's.) 3 issues 1) The strict ideas of sterilization and disinfection that were taught up to the early 1990's have since relaxed to an idea of " clean " for everything except the needle shaft (still " sterile " until exposed to air, then " clean " , and not to be touched outside of where its inserted.). Clean means swabbing. In USA most patients bathe regularly and wear clean clothing, but swabbing can counter anything inadvertently touched, picked-up along the way. This as distinct from the 100 trillion microbes which live on and in our bodies all the time, and which get carried in and out and around by things like acupuncture needles, but our immune systems are quite at home with these -- they even enhance out immunity in many instances. ( " Clean " includes the presence of these " guests " .) Needles, even the narrowest Japanese sizes are invasive, carry stuff in (and out). And everyone likely runs into hematoma from needling (even from thin needles). Swabbing can be used as a ritual element of treatment, honoring the point-- touch/locate and swab. (Much like historically many religious rituals can be related to sanitation, e.g. burning incense (or moxa, for that matter, which is much older than needle therapy)). 2) Practitioners who ridicule and disregard host country governmental regulations, especially rationalizing it and broadcasting this to others, should be " rectified " (to use a fine Confucian term) about the propriety of such behavior. Arguably any of us who encounters such behavior has a responsibility to help such people realize their impropriety, or, in the extreme, cooperate with governmental agencies to get them out of the country. >As a new practitioner, i felt provincial and naive for doing so. Case in point for the downside to that arrogant behavior -- the influence on others. 3) This kind of behavior, even this kind of discussion, exposes our profession to criticism from the skeptics and outright enemies. And legitimatizes their critique. Though much is improving, we're still fighting an uphill battle politically, culturally, economically. We don't need this kind of liability. -- Version: 7.5.432 / Virus Database: 268.17.4/643 - Release 1/21/2007 5:12 PM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2007 Report Share Posted January 22, 2007 I swab, unless a patient tells me they are allergic to rubbing alcohol. I ask every patient about this, every time. " " wrote: the sheet vs. paper discussion has been interesting. it's led me to wonder about swabbing points. osha compliency issues aside, i'm wondering if everyone is swabbing points, or if some are not? i ask because early in practice i met a couple of LAcs in a practice who were not swabbing. they felt that the osha reg was absurd, and recounted that they knew md's who agreed: we aren't tearing tissue with hypodermic needles, therefore swabbing is unnecessary, and according to them, ridiculous. (incidently, they were both in the US on visa's.) As a new practitioner, i felt provincial and naive for doing so. since then i've not encountered other practitioners who do not swab, but the issue makes me curious: does everyone swab, or not? -- Oriental Medicine Experienced, Dedicated, Effective Asheville Center For 70 Woodfin Place, Suite West Wing Two Asheville, NC 28801 828.258.2777 kbartlett www.AcupunctureAsheville.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2007 Report Share Posted January 22, 2007 Hi Kath & Tanya > ... Pacific college ... not only teach us to swab but overly stress it. In practice, few acupuncturists whose methods I have observed swab routinely before or after needling. Exceptions include: visibly dirty skin (in which case a good scrubbing is advisable before swabbing); patients KNOWN to be run-down badly, or immunosuppressed; Pernickety patients, or those who express fears of infection from needling. I suspect that most, if not all TEACHING colleges (Ac, med, vet, nursing, etc) recommend swabbing as a PYA (protect your ***) exercise. If, G_d forbid, one were to have septicaemia or multiple cellulitis in a patient and had not swabbed before needling, one might be hung out to dry. Chris wrote: > (3) This kind of behavior [failure to swab], even this kind of > discussion, exposes our profession to criticism from the skeptics and > outright enemies. And legitimatizes their critique. Though much is > improving, we're still fighting an uphill battle politically, > culturally, economically. We don't need this kind of liability. Point accepted, but based more on POLITICAL (PYA) rather than MEDICAL reasons! IMO. Considering the millions of people treated by acupuncture each year, published reviews of adverse effects of acupuncture suggest very low risk of septicaemia or cellulitis after AP. Outbreaks of AIDS/hepatitis traced to the use of DIRTY (re-used) needles are a separate issue. IMO, it is FAR more important to use STERILE SINGLE USE needles (that are NOT re-used in another session) than to swab the skin. Prion infection can withstand ASHING at 600 degrees centigrade! See: http://www.pnas.org/cgi/reprint/97/7/3418.pdf I have pleaded on several AP lists for a formal BAN by National Licensing Authorities on the re-use of acupuncture needles. IMO, no acupuncturist should attempt to sterilise used needles for reuse. Best regards, Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 Phil, Chris M., I agree that acupuncturists can at the least swipe points with a dab of anti-septic and wash our hands with soap before and after patients. At least, we don't have to wear gloves or wash our hands with the anti-bacterial pink foam that are in hospitals. It's a small price to practice this profound art and medicine. In California, this is the state reg. Title 16 Article 5: http://www.acupuncture.ca.gov/law_reg/art5.htm (b) All acupuncture needles and other instruments shall be sterilized before and between uses in a manner which will destroy all microorganisms. All needle trays which contain sterile needles shall also be sterile. Each time needles or other instruments are sterilized, the acupuncturist shall use a tape or strip indicator which shows that sterilization is complete. © Acupuncture points, where needles are to be inserted, shall be cleaned with an appropriate antiseptic before insertion of the needle. The question is, other than rubbing alcohol, what else qualifies as " an appropriate antiseptic " ? Thanks, K. On 1/22/07, < wrote: > > Hi Kath & Tanya > > > ... Pacific college ... not only teach us to swab but overly stress it. > > In practice, few acupuncturists whose methods I have observed swab > routinely before or after needling. Exceptions include: > > visibly dirty skin (in which case a good scrubbing is advisable before > swabbing); > > patients KNOWN to be run-down badly, or immunosuppressed; > > Pernickety patients, or those who express fears of infection from > needling. > > I suspect that most, if not all TEACHING colleges (Ac, med, vet, nursing, > etc) recommend swabbing as a PYA (protect your ***) exercise. > > If, G_d forbid, one were to have septicaemia or multiple cellulitis in a > patient > and had not swabbed before needling, one might be hung out to dry. > > Chris wrote: > > (3) This kind of behavior [failure to swab], even this kind of > > discussion, exposes our profession to criticism from the skeptics and > > outright enemies. And legitimatizes their critique. Though much is > > improving, we're still fighting an uphill battle politically, > > culturally, economically. We don't need this kind of liability. > > Point accepted, but based more on POLITICAL (PYA) rather than MEDICAL > reasons! > > IMO. Considering the millions of people treated by acupuncture each year, > published reviews of adverse effects of acupuncture suggest very low risk > of septicaemia or cellulitis after AP. Outbreaks of AIDS/hepatitis traced > to > the use of DIRTY (re-used) needles are a separate issue. > > IMO, it is FAR more important to use STERILE SINGLE USE needles (that > are NOT re-used in another session) than to swab the skin. Prion infection > > can withstand ASHING at 600 degrees centigrade! See: > http://www.pnas.org/cgi/reprint/97/7/3418.pdf > > I have pleaded on several AP lists for a formal BAN by National Licensing > Authorities on the re-use of acupuncture needles. IMO, no acupuncturist > should attempt to sterilise used needles for reuse. > > Best regards, > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 Hi all, a bit of a dissenting voice here, and more than a little tongue in cheek, no offense is intended everyone, and so, with your indulgence... I do agree with Chris that we have a hard enough time with the public's and medical profession's regard for us as " dirty primitives " as it is, and don't need to foul ourselves up more with reckless statements of disregard for concepts of sterility. At the same time, like many of western medicine's concepts, sterility is played up to the max, so much so that at one point in time, as we all should know, our modern population was safe harbour for the following beliefs: - bacteria and viruses are the enemy - a healthy person was sterile on the inside, because, as we all know, bacteria and viruses are the enemy - it is important to eradicate bacteria and viruses - every house should use the new antibacterial soap in order to eradicate the bacteria who are, you guessed it, the enemy - the immune system is largely irrelevant, since we all know that bacteria are the primary cause and source of infections (maybe because we have several moles planted inside every human cell? Anyone here ever consider that the mechanistic reason antibiotics damage the righteous qi is because antibiotics damage or kill mitochondria? you can thank me for that flash of brilliance later ) - hospitals, being modern, are places of high cleanliness and bacterial overgrowth, I mean, sterility - people get colds more often in the winter because everyone is packed together into public transit (guffaw) - in order to beat bacteria and viruses, the enemy, we must wash our hands several times a day, not touch infected surfaces, use anti-bacterial substances (and anti-virals, if you can get your grubby little hands on them) as much as possible, and completely ignore the immune system, thereby creating a safe world where weakened immune systems will never again have to face the scourge of bacteria - only mutant super-bacteria (and viruses too, I'm told) There is one faculty member in a famous coast TCM college in the united states whom I have personally spoken to on this matter, and he thinks that clean needle technique has its place, and also thinks that it is usually not applicable to acupuncture. This is not an unusual opinion, and while we're on the topic, let's scare up some of the science: Walsh, B. " There is no evidence at present to suggest that significant numbers of infections are being transmitted through standard acupuncture treatments in the UK. " http://tinyurl.com/22q648 I suppose this is also a good topic for TCMPedia. I know I'm landing hard on a particular side of the fence, and wish to make it clear that I try to be very aware of infectious hazards, and treat them very seriously in both my clinics. If I ever have doubt about blood-borne diseases, I wear gloves and might even forestall treatment pending bloodwork. I swab with witch hazel or 75% alcohol based on the patient's choice, and I let them know that there is not a single study that shows infections are created using sterile single use needles (given reasonable personal hygiene, and yes, there are patients whom I use latex gloves with - communicable diseases, skin problems that weep and damp heat seborrhea). And you know what else, a lot of patients tell me not to swab. Hugo --- < wrote: > Clean means swabbing. In USA most patients bathe > regularly and wear > clean clothing, but swabbing can counter anything > inadvertently > touched, picked-up along the way. This as distinct > 2) Practitioners who ridicule and disregard host > country governmental > regulations, especially rationalizing it and > broadcasting this to > others, should be " rectified " (to use a fine > Confucian term) about > the propriety of such behavior. Arguably any of us > who encounters > such behavior has a responsibility to help such > people realize their > impropriety, or, in the extreme, cooperate with > governmental agencies > to get them out of the country. _________ The all-new Mail goes wherever you go - free your email address from your Internet provider. http://uk.docs./nowyoucan.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 Hugo, I don't think you are 'landing hard' at all. I share your sentiments about sterility and infections. After all, it is hospitals these days that harbor the most virulent viral and bacterial infections, the bastions of sterility. Of course, a 'clean field' is important in acupuncture practice, but let's not get carried away. I remember at a certain point here in California that it was suggested to require rubber or plastic gloves as part of clean needle technique, and of course it went down like a lead zeppelin. There have also been studies that show that anti-bacterial soaps not only do not prevent spread of infection, they actually may disturb the natural bacterial balance of the body and breed resistant germs. Just a good natural soap and warm water should be enough. On Jan 22, 2007, at 7:25 PM, Hugo Ramiro wrote: > I know I'm landing hard on a particular side of the > fence, and wish to make it clear that I try to be very > aware of infectious hazards, and treat them very > seriously in both my clinics. If I ever have doubt > about blood-borne diseases, I wear gloves and might > even forestall treatment pending bloodwork. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 At 03:45 PM 1/22/2007, " " < wrote: >IMO, it is FAR more important to use STERILE SINGLE USE needles (that >are NOT re-used in another session) than to swab the skin. Prion infection >can withstand ASHING at 600 degrees centigrade! See: >http://www.pnas.org/cgi/reprint/97/7/3418.pdf > >I have pleaded on several AP lists for a formal BAN by National Licensing >Authorities on the re-use of acupuncture needles. IMO, no acupuncturist >should attempt to sterilise used needles for reuse. California passed a law last year mandating single-use of needles. Estimate was that even prior to that, something like 99% of practitioners were doing that. -- Version: 7.5.432 / Virus Database: 268.17.5/645 - Release 1/22/2007 4:10 PM Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 Hugo, you say you sometimes swab with witch hazel. Is that the essential oil or a water or alcohol solution? Do anti-bacterial agents such as many standard essential oils qualify as anti-septics? I know of one practitioner who uses white flower oil, consisting of mainly menthol. Going back to Title 16 Article 5 in the Calif. code: © Acupuncture points, where needles are to be inserted, shall be cleaned with an appropriate antiseptic before insertion of the needle. So what qualifies as " an appropriate antiseptic " ? On 1/22/07, Hugo Ramiro <subincor wrote: > > Hi all, a bit of a dissenting voice here, and more > than a little tongue in cheek, no offense is intended > everyone, and so, with your indulgence... > > I do agree with Chris that we have a hard enough time > with the public's and medical profession's regard for > us as " dirty primitives " as it is, and don't need to > foul ourselves up more with reckless statements of > disregard for concepts of sterility. > At the same time, like many of western medicine's > concepts, sterility is played up to the max, so much > so that at one point in time, as we all should know, > our modern population was safe harbour for the > following beliefs: > - bacteria and viruses are the enemy > - a healthy person was sterile on the inside, because, > as we all know, bacteria and viruses are the enemy > - it is important to eradicate bacteria and viruses > - every house should use the new antibacterial soap in > order to eradicate the bacteria who are, you guessed > it, the enemy > - the immune system is largely irrelevant, since we > all know that bacteria are the primary cause and > source of infections (maybe because we have several > moles planted inside every human cell? Anyone here > ever consider that the mechanistic reason antibiotics > damage the righteous qi is because antibiotics damage > or kill mitochondria? you can thank me for that flash > of brilliance later ) > - hospitals, being modern, are places of high > cleanliness and bacterial overgrowth, I mean, > sterility > - people get colds more often in the winter because > everyone is packed together into public transit > (guffaw) > - in order to beat bacteria and viruses, the enemy, we > must wash our hands several times a day, not touch > infected surfaces, use anti-bacterial substances (and > anti-virals, if you can get your grubby little hands > on them) as much as possible, and completely ignore > the immune system, thereby creating a safe world where > weakened immune systems will never again have to face > the scourge of bacteria - only mutant super-bacteria > (and viruses too, I'm told) > > There is one faculty member in a famous coast TCM > college in the united states whom I have personally > spoken to on this matter, and he thinks that clean > needle technique has its place, and also thinks that > it is usually not applicable to acupuncture. This is > not an unusual opinion, and while we're on the topic, > let's scare up some of the science: > > Walsh, B. > " There is no evidence at present to suggest that > significant numbers of infections are being > transmitted through standard acupuncture treatments in > the UK. " > http://tinyurl.com/22q648 > > I suppose this is also a good topic for TCMPedia. > > I know I'm landing hard on a particular side of the > fence, and wish to make it clear that I try to be very > aware of infectious hazards, and treat them very > seriously in both my clinics. If I ever have doubt > about blood-borne diseases, I wear gloves and might > even forestall treatment pending bloodwork. > > I swab with witch hazel or 75% alcohol based on the > patient's choice, and I let them know that there is > not a single study that shows infections are created > using sterile single use needles (given reasonable > personal hygiene, and yes, there are patients whom I > use latex gloves with - communicable diseases, skin > problems that weep and damp heat seborrhea). And you > know what else, a lot of patients tell me not to swab. > > Hugo > > --- < <%40well.com>> wrote: > > Clean means swabbing. In USA most patients bathe > > regularly and wear > > clean clothing, but swabbing can counter anything > > inadvertently > > touched, picked-up along the way. This as distinct > > > 2) Practitioners who ridicule and disregard host > > country governmental > > regulations, especially rationalizing it and > > broadcasting this to > > others, should be " rectified " (to use a fine > > Confucian term) about > > the propriety of such behavior. Arguably any of us > > who encounters > > such behavior has a responsibility to help such > > people realize their > > impropriety, or, in the extreme, cooperate with > > governmental agencies > > to get them out of the country. > > > ________ > The all-new Mail goes wherever you go - free your email address > from your Internet provider. http://uk.docs./nowyoucan.html > > -- 'Freedom from the desire for an answer is essential to the understanding of a problem.' Jiddu Krishnamurti Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 --- " " < wrote: > Prion infection can withstand ASHING at 600 degrees > centigrade! Man, I hate prions. Hugo __ Photos is now offering a quality print service from just 7p a photo. http://uk.photos. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2007 Report Share Posted January 23, 2007 Good points, Hugo. _The microbe is nothing, the terrain is everything_, Louis Pasteur reportedly said in his final days. _When we are more than our differences, the enemy is less than us_, I said in search of a koan. _Drugs 'r bad, unhkay?_, somebody said in a classic SouthPark episode. If you find packaged alcohol wipes too big / moist, an alternative is to lightly sprinkle cotton balls. Joe Reid jreidomd.blogspot.com Quote Link to comment Share on other sites More sharing options...
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