"THE LUBAN OBSERVATION"
John A. Amaro D.C., FIACA, Dipl.Ac.
Just about the time you feel you've experienced about as much as you can experience, learned about as much as you're going to learn, seen it all, and "been there done that" as the saying goes, someone comes along and shows you something you can't believe you never knew before now. This recently happened to me while teaching an acupuncture program in Chicago.
While discussing the incredulous attributes and benefits of the acupuncture needle as a therapeutic device, I was also relating some horror stories surrounding the use of acupuncture needles. In my 26 years of inserting an average of 500 or more needles a day, believe me when I say I have my share of horror stories. Of course as a professional educator, you can't let the class know the stories you are telling are your own personal clinical catastrophes, so as most of my colleagues standing behind the podium would do, you say "I heard of this doctor who ." This gets us off the hot seat and no one would ever believe anyway these utterly stupid to grossly negligent incidents could ever happen to the teacher, impossible, had to be the class idiot this happened to.
For example, "I
heard of this doctor who" did everything right, observed all of the
sterile procedures, handled the needle in a safe and meticulous manner,
used single minded consciousness when handling the needle. When he was
in contact with an acupuncture needle and the patient he was 100% focused
on what he was doing. This doctor was versed in Hepatitis A knowing it
to be of the infectious variety. That the transmission is mainly via fecal
contaminated food and water with an incubation period of four weeks. That
virus in the bloodstream transferred to the hand or fingers of a practitioner
could potentially pose a hazard. The good news is that most cases are
mild. The chances of anyone of us being contaminated is extremely high,
the rest of the good news is that prolonged carrier states do not seem
It's a known fact
that when the body is through with the acupuncture needles and they have
been indwelling for some time, the body simply may discard them by dropping
them from the body. If each needle is not accounted for or the needles
were not counted prior to and after the treatment, there may be a needle
or two just laying around the office waiting for someone to get stuck
I heard of one time" told of a case where the patient came in for
her treatment brandishing an acupuncture needle, when asked where she
got it replied, from her hairdresser. Where did she get it? "From
the back of my head" she said. Can you imagine the look on that doctors
face when he was told that news and now it was his turn to respond.
One of perhaps the most common incidents to occur in the administration of acupuncture needles is the small drop of blood which accompanies the withdrawal of some acupoints. This particular incident is of vital concern for several reasons. Obviously it is a considerable health issue with the possibility of contamination of either equipment or practitioners hands. It is also an issue concerning the patient who smears blood on their clean white shirt, slacks etc. prior to having it properly wiped off. The average acupuncturist will have an alcohol prep pad at his disposal for such an emergency of seeing a drop or trickle of blood. The problem is that it is always a matter of practitioner protection when using an alcohol pad to wipe blood because it is usual to come into contact with the patients blood on using an alcohol prep pad.
"I heard about this doctor" that when withdrawing the acupuncture needle from Yin-Tang between the eyebrows, spotted a drop of blood which soon became a significant trickle as he fumbled to open an alcohol prep pad, he quickly took it from its package and swabbed generously over the trickle only to have the alcohol flow freely into both of the patients eyes at which time he let out an "AAAAAHHHHHHHHH" which could be heard in the parking lot. Can you imagine the look on the doctors face as he attempted to furiously tear head wrist paper from the table in order to help wipe the alcohol from the patients eyes.
Well just about the time when you feel you have a pretty good handle on all of the little things that can go wrong in an acupuncture practice and you understand all of the tricks of the trade comes one which I count as one of the great lessons of acupuncture. I will fondly refer to it as "The Luban Observation" for Dr. Michael Luban who shared one of the most simple but significant techniques in acupuncture and that is, on withdrawal of the acupuncture needle, have a Q-Tip cotton swab in your immediate possession or possibly in your pocket to act as a dry absorbent for drops or trickles of blood. The advantages are the practitioners hands never contact the skin or blood, the cue tip may be used to place light pressure to stop bleeding, it has an absorbent quality, the Q-tip may be deposited directly into the sharps container for safe disposal taking up far less room than either alcohol prep pads or cotton balls.
This seemingly simple technique is one in which I absolutely will share with all of my future classes. For those of you reading this who are currently using acupuncture needles you can see the apparent wisdom in this procedure. Thanks Dr. Luban of Chicago for your observation during a visit to a remote clinic in a remote part of China, great idea. I bet there are a few hundred additional simple ideas and hints which we would love to hear. Anyone in the world out there have one to match or better "The Luban Observation". If you do we'll name it after you. Let me know.
Wishing all of you the very best in 1998. Have a sensational year!!!
John A. Amaro D.C.,FIACA,
Dipl.Ac. Carefree, Arizona E-mail: DrAmaro@IAMA.edu