1、 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 ManipulationThe safe needling manipulation depends on three important factors.1.The angle of needle insertion
2、2.The depth of needle insertion 3.The amplitude of moving needleNipples.(St.17-Ruzhong)Umbilicus.(Ren8-Shenque)Points inside orbit never use moxibustion by warming needle.Points in these locations need much more attention.2.Location of Points1.Head 2.Edge of eye socket3.Neck4.Chest5.BackYamen(DU 15)
3、(哑哑门）门）Location:1 cun directly above the midpoint of the posterior hairline.Fengfu(DU 16)（风府）（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 cunMedulla oblongata（延髓）would be damaged if inserting nee
4、dle upward through occipital pore.BackChengqi(ST.1)Jingming(BL.1)Jingming 睛明睛明(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 manipula
5、te the needle with large amplitude,to spare the blood vessel from hematoma.backEspecially anterior cervical region is very complicated.The Topography（局解）（局解）of Neck Renying(ST 9)人人迎迎Location:1.5 cun lateral to the process of larynx,behind the common carotid artery.Shuitu 水沟水沟(ST 10)Location:1 cun be
6、low Renying.Manipulation:To puncture perpendicularly 0.3-0.8 cun.Attention:To keep away from the common carotid artery.We can not manipulate the needle with large amplitude.backPoints in chestTop of the lung locate 2 or 3 cm above clavicle.Bottom of the lung locate inside 6th rib of chest.Anatomical
7、 location of the lung:Attention:Points in intercostal（肋间的）spaceManipulation:-Angle:subcutaneously or obliquely.(the needle is inserted to form an angle of 15-25or 45or so with the skin surface.)-Depth:0.8-1 cun.backThe BackBladder channelLocation:One group is along the first lateral line of Bladder
8、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 cunDu channelPoints location:Below the spinous process of each vertebra.Manipulation:Puncture obliquely upward 0.5-1 cun.Attention:Can not too deep.back3.
9、Body physiological situationThere 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)Sanyi
10、njiao(SP 6)4.Management of possible accidents in acupuncture.FaintingStuck needleBent needleBroken needleHematoma（血肿）Fainting（晕针）Reasons:weakness/nervous/receiving needles for the first time/too forceful manipulationProdromes:dizziness and vertigo/irritability/nausea/pallor/shock/unconsciousness/hyp
11、otensionCountermeasures: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 caseStuck needle（滞针）Symptoms:Difficult to manipulate or withdra
12、w./pain/hard to move the bodyReasons:extremely nervous/change of the positionCountermeasures:massage the area around the needle/another needle/adjustment of the positionHematoma（血肿）After withdrawal of the needle,a red pin-point mark may remain.-normalTo press the hole of needle when it is taken out./loose/flabby back THANK YOU!
