Publicity re infection control

[Guest guest]

Hi All

 

One PR step to publicise infection control in acupuncture clinics is

to have a notice posted in the clinic, like:

 

Infection Control

 

Only sterile single-use needles are used in this clinic.

 

Before needle insertion, acupoints are swabbed with an alcohol swab

 

Best regards from

[Guest guest]

 Hi Phil, I personally don't recommend the specificity of the cotton

swab comment. If someone practices clean needle technique, then publicise that,

but it may even be taken as irresponsibility or ignorance by some to imply

that all it takes is a cotton swab. The creation of a sterile field followed by

the correct swabbing technique is kind of a minimum. Cotton swabbing for the

most part just moves flora around, anyway.

 Certainly the one-use needle policy is important since all outbreaks have been

caused by re-use of needles.

 

 Hugo

 

________________________________

Hugo Ramiro

http://middlemedicine.wordpress.com

http://www.middlemedicine.org

 

 

 

 

 

________________________________

<

" Chinese Medicine "

<Chinese Medicine >

Tue, 23 March, 2010 13:52:41

Publicity re infection control

 

 

Hi All

 

One PR step to publicise infection control in acupuncture clinics is

to have a notice posted in the clinic, like:

 

Infection Control

 

Only sterile single-use needles are used in this clinic.

 

Before needle insertion, acupoints are swabbed with an alcohol swab

 

Best regards from

 

 

 

 

 

 

 

[Guest guest]

There is no " sterile " field created when using the CNT. It is aseptic technique

and it creates a clean fielf. Sterility implies all micro-organisms are killed.

This, of course, does not happen when using CNT.

 

 

 

Dr. Don J. Snow, DAOM, MPH, L.Ac.

 

 

 

Chinese Medicine

subincor

Tue, 23 Mar 2010 17:57:55 +0000

Re: Publicity re infection control

 

 

 

 

 

Hi Phil, I personally don't recommend the specificity of the cotton swab

comment. If someone practices clean needle technique, then publicise that, but

it may even be taken as irresponsibility or ignorance by some to imply that all

it takes is a cotton swab. The creation of a sterile field followed by the

correct swabbing technique is kind of a minimum. Cotton swabbing for the most

part just moves flora around, anyway.

Certainly the one-use needle policy is important since all outbreaks have been

caused by re-use of needles.

 

Hugo

 

________________________________

Hugo Ramiro

http://middlemedicine.wordpress.com

http://www.middlemedicine.org

 

________________________________

<

" Chinese Medicine "

<Chinese Medicine >

Tue, 23 March, 2010 13:52:41

Publicity re infection control

 

 

Hi All

 

One PR step to publicise infection control in acupuncture clinics is

to have a notice posted in the clinic, like:

 

Infection Control

 

Only sterile single-use needles are used in this clinic.

 

Before needle insertion, acupoints are swabbed with an alcohol swab

 

Best regards from

 

 

[Guest guest]

  Hi Donald, you are correct. A single-use needle may be considered a sterile

object, even when opened, but is usually downgraded to " clean " . When I stated

that the creation of a sterile field is a minimum, I was trying to state that it

is an unreasonable proposition, in my eyes, to treat aseptic technique as a

magic bullet in clinic. A private clinic is a far from aseptic environment,

there are hundreds of opportunities for contamination, and the creation of clean

fields is not as easy as we might think. Therefore, if we are to deal with very

ill and immunocompromised patients, for example, and remain blameless, a sterile

field is a minimum (not that it's going to happen). Therefore, anything less

must be considered with caution *for legalistic reasons* as well as for

infection control.

 

 Again, once we are using disposable single use needles, the risk of infection

occurring is tiny. This minimal risk must be considered however, as Alon reminds

us, anytime we are going to perform this procedure, and especially when we deal

with patients who are higher risk.

 

 But we must be realistic: just looking at swabbing, not only must the skin be

cleaned in the small circle spiralling outwards method (once the patient is

*already* clean of dirt, fine particles etc), but the swab should come from a

sterile source and be held by sterile forceps, which are held by gloved hands

(which gloves are clean, but not sterile). Of course, there is the whole process

of acquiring, handling and transitioning all the materials without contaminating

them! How many of you who practice CNT wear a mask, have your patient wear a

mask if they are coughing / sneezing (or breathing heavy), and have no carpet in

your treatment room? Is all this really worth it, or are we merely buying into

western culture's hatred and fear of micro-organisms (and resultant potentiation

of that fear into reality. Didn't WM ever hear the story about running from your

shadow? geezz. us.)?

 

 Aseptic technique / CNT as *the* infection control measure is not a reasonable

proposition in the private clinic, although an attempt at it makes us look good

and remain legally blameless (and it does help with high-risk patients). *The*

standard infection control measure in a private clinic with low and medium risk

patients is single use disposable needles and good personal hygience on the part

of the patient as well as therapist. CNT and other infection control measures in

uncontrolled environments (even outside the operating rooms in a hospital) are

often more ritual than real: How many times have I either observed poor setup of

a clean field by an assistant to the doctor, or the doctor saying " woops, that's

not a clean field anymore " but going ahead with the procedure. When we wipe the

clinic down at the end of the day, I recognise that a large component of it is a

ritual. Yes we lower the load of bacteria present in the office when we wipe

down doorknobs, tables, etc, but ease of re-contamination is the real issue - a

3 steps forward, 4 back sort of thing. Bacteria and other germies have been

around a looong time people! In CM they are carried on the Wind, remember? What

are we gonna do, suck all the air out of our clinics too? ththwup!

 

 Aseptic technique as infection control outside of the operating room is a

measure that comes third after 1. single-use, sterile needles, and 2. proper

personal hygience for therapist and patient in low and medium risk populations.

 

 As Daniel mentioned, there are other things to consider with regards to the

infection control methods. One is the cooling effect of the alcohol. As I have

mentioned many times before on this forum - do we buy into our medicine or not?

If it is cooling on the skin, then it is a cooling treatment. What about

constantly breathing in evaporated alcohol every day for the therapist? What

about the effect of a liquid on the electrical conductivity of the channels?

What about the fact that swabbing, even when done correctly, only manages to

move the flora around, adhere it to the skin, and doesn't touch any of the

bacteria that are beneath the first layers of skin cells? How about gloves? I

know that I have *a lot* more difficulty feeling the needle and the channel

through latex gloves - and this totally impacts the effectiveness of my

treatments.

 

 I agree with Phil that a large and important part of the swabbing is the ritual

that impresses the public (or the Public Health officials who may come walking

through your doors (gosh! these savages know about hand washing!)).

 

 I must admit that I, personally, have always wanted the opportunity to wear a

hazmat level 4 suit and walk cautiously (although threateningly) through a

public area. Can you imagine if a patient waiting on the table saw you

approaching in a hazmat suit, holding a clean, single-use disposable needle in

your right hand? What would they think? Well, " What in blazing hell is on that

needle!?!? " , is what they would think, of course.

 

 Anyhow, thanks to everyone for this discussion. This is a great group.

 

 Hugo

(p.s. the savages know about hand-washing comment is based on a true story)

 

 

________________________________

Hugo Ramiro

http://middlemedicine.wordpress.com

http://www.middlemedicine.org

 

 

 

 

 

________________________________

Donald Snow <don83407

Chinese Traditional Medicine

Tue, 23 March, 2010 14:05:06

RE: Publicity re infection control

 

 

There is no " sterile " field created when using the CNT.  It is aseptic technique

and it creates a clean fielf.  Sterility implies all micro-organisms are

killed.  This, of course, does not happen when using CNT. 

 

 

 

Dr. Don J. Snow, DAOM, MPH, L.Ac.

 

 

 

Chinese Medicine

subincor

Tue, 23 Mar 2010 17:57:55 +0000

Re: Publicity re infection control

 

 

 

 

 

Hi Phil, I personally don't recommend the specificity of the cotton swab

comment. If someone practices clean needle technique, then publicise that, but

it may even be taken as irresponsibility or ignorance by some to imply that all

it takes is a cotton swab. The creation of a sterile field followed by the

correct swabbing technique is kind of a minimum. Cotton swabbing for the most

part just moves flora around, anyway.

Certainly the one-use needle policy is important since all outbreaks have been

caused by re-use of needles.

 

Hugo