Clean Needle Technique( Cnt) For Boards And Clean Needle Certification

Front 1

What is the single most important thing to do to prevent spread of disease ie; cross infection?

Back 1

wash hands

Front 2

What are the differences between antiseptics and disinfectants?

Back 2

Antiseptics reduce density of microbes
Disinfectants are chemicals Used only on inanimate objects. Ex: Bleach

Front 3

What is sterilization?

Back 3

Destroys all microbes, no such thing as partial sterilization.

Front 4

The term Clean technique means?(4)

Back 4

using different techniques like hand washing , isolating sharps, using disinfectants, sterilizing .

Front 5

Describe Hand Washing ( 8 )

Back 5

1.Must have equipment like paper towels, soap and running H2o
2.Roll sleeves up, no jewelry, no watch
3.wet soap and hands 4. Rub Soap
5.Wash between fingers, around and under fingernails , up to wrist 6. run H2o over hands to clean 7.Lower hands so H20 and soap drain off 8. Use paper towel or elbow to turn off h20 DO NOT USE SAME TOWEL TO DRY YOUR HANDS 8. Can dry with another paper towel or shake hands dry

Front 6

For immune compromised patients hand washing is critical because and what kind of soap is best?

Back 6

Staph of skin , these are resident germs, use antimicrobial

Front 7

Resident vs transient infectious agents are?

Back 7

Resident: lodge deeper in skin ex: staph
Transient: picked up from one patient and may be carried to another patient.

Front 8

True or false? It does not matter if you use a guide tube more than once and with multiple patients since they do not penetrate the skin.

Back 8

"it is considered acceptable to use the guide tube more than once on the SAME patient." pg 32 6th Ed.

Front 9

When it comes to patients we need to treat all patients as if and by doing what action ?

Back 9

"The necessity of hand washing between patients and the use of universal precautions reflects the importance of treating ALL patients as if they were carriers of Hep or HIV." pf 30 , 6th Ed.

Front 10

When should you discard needles that have never been used?

Back 10

When packages are bent, have a broken seal or show they have moisture damage

Front 11

How should needles be opened to avoid contamination?

Back 11

The part that has been touched by the fingers has to be pulled back to avoid contact with the needle.

Front 12

In some cases, like when manipulating a needle, we can touch the shaft of the needle as long as our hands have been washed and have touched only the area to be needled?

Back 12

"Needle insertion and manipulation must be performed with out the practitioner's hands coming into contact with the shaft of the needle." pg 32, 6th Ed.

Front 13

When should we use gloves?(6)

Back 13

1. Bleeding Techniques 2. anytime when bleeding occurs in the course of routine acupuncture 3. Abrasions, broken cuticles, cuts, hang nails, hands that are in a place that poses a hazard( like taking a cup off that has blood in it) 4. When a patient has an open wound or it is any weeping skin 5. When palpating or needling in the mouth or genitals 6. when doing guasha or slide cupping ( not in book, new as of fall 2011)

Front 14

Re Positioning of Patient Fainting can occur when?

Back 14

In an AWKWARD position can make a patient fatigued and increase risk of fainting. When a patient is in a chair and is not supported enough.

Front 15

What kind of equipment do you use when needling a patient who is sitting?

Back 15

Have patient face a treatment table or use a massage chair. You can needle in a chair but the patient has to be comfortable so they do not faint.

Front 16

What should be checked and avoided at each point location to be treated?

Back 16

Point should be free of cuts, wounds and diseases.

Front 17

Re previous question: Acupuncture needles should never be inserted where?

Back 17

through broken, diseased, inflamed or irritated skin.

Front 18

Can we use isopropyl that is higher than 70% to clean an acu point before insertion of the needle, and why or why not?

Back 18

No, because it evaporates too fast and won't be antiseptic.

Front 19

If a patient is allergic to isopropyl alcohol what can be used instead?

Back 19

Betadine

Front 20

What would you do if you had a patient who came in with very dirty feet?

Back 20

Wash the feet first and use alcohol as usual to wipe the acu points

Front 21

What should you do if you are ready to needle and have washed your hands but realize that the patients clothing is blocking a point ? Also what if the patient asks you to take off their glasses after you have washed your hands and are ready to needle a point?

Back 21

Before picking up the needle or palpating the point , the hands have to washed again with soap and water or an alcohol based disinfectant.

Front 22

When inserting needles what do you want to keep in mind for adults and kids ?

Back 22

Patients body size. For ex: a thin patient on Ren 12 a good depth would be .5cun but for an obese patient you can go deeper . Children are different ie use less depth than what you would use for an adult.

Front 23

What is the recommendation for needling a point in order to be safe with how far you go and to obtain qi?( 2) What is the purpose of needling this way? (1)

Back 23

Slow penetration allows the acupuncturist to sense changes in resistance and arrival of qi. This helps determine depth of insertion related to body size.

Front 24

On the body where are muscles sometimes thin and what organs can be affected if you are not careful ? Name the organs.

Back 24

Back and Thoracic area.
Organs that can be affected are Heart, Lungs. Liver and Spleen

Front 25

What is used to prevent HBV?

Back 25

series of vaccines

Front 26

For immune compromised patients hand washing is critical because and what kind of soap is best?

Back 26

Staph of skin , these are resident germs, use antimicrobial

Front 27

Resident vs transient infectious agents are?

Back 27

Resident: lodge deeper in skin ex: staph
Transient: picked up from one patient and may be carried to another patient.

Front 28

True or false? It does not matter if you use a guide tube more than once and with multiple patients since they do not penetrate the skin.

Back 28

"it is considered acceptable to use the guide tube more than once on the SAME patient." pg 32 6th Ed.

Front 29

When it comes to patients we need to treat all patients as if and by doing what action ?

Back 29

"The necessity of hand washing between patients and the use of universal precautions reflects the importance of treating ALL patients as if they were carriers of Hep or HIV." pf 30 , 6th Ed.

Front 30

When should you discard needles that have never been used?

Back 30

When packages are bent, have a broken seal or show they have moisture damage

Front 31

Which strains of hepatitis have an Insidious( slow ) onset?(2)

Back 31

B and C

Front 32

Which type of HEP has an abrupt onset?(2)

Back 32

A & E
( way to remember A is the first one and E is the last one)

Front 33

what kind of Hep is this?
Most cases occur 5-10 weeks after exposure.Period of communicability 1 week after exposure through chronic stage. N/V, Anorexia & Jaundice

Back 33

Hep C

Front 34

What Hep does this describe?
Abdominal discomfort, anorexia( no appetite), fatigue, FEVER, muscle aches , N/V, Dark Urine & Jaundice

Back 34

Hep A

Front 35

How long is HBV active and contagious? on what and how long?

Back 35

HBV is active and contagious up 2 weeks on inanimate objects.

Front 36

What Hep does this describe?
Blood transfusion, IV drug use , Possible sex transmission, Mostly Adults

Back 36

Hep C

Front 37

What is the result of this kind of HEP?
70% infections for 3+ months after ss subside. 5-10% are lifelong carriers. Chronic carriers may develop cirrhosis and liver Cancer , 15-25% of these die from chronic Liver Dx

Back 37

Hep B

Front 38

Which Hep does this describe?
Fecal , waterborne, contaminated food, found in underdeveloped countries?

Back 38

Hep E

Front 39

Incubation Unknown for which HEP?

Back 39

Hep D

Front 40

Incubation for this Hep is 15-50 days?

Back 40

Hep A

Front 41

Review and Compare Hep Types:
Hep A and Hep E.
Same:
abrupt onset

Not chonic

Different:
Hep A 15-50days
Vaccine Yes ( Hep A)
Who gets it :Kids/young adults , Mostly Autumn

Hep E differences from Hep A:
15-60 days( 10 more days)
Vaccine:NO

Back 41

Review Main differences between A and E
Hep A
fecal /oral /blood/water
15-50 days
Vaccine: Yes
Kids /young adults
Autumn

Hep E
15-60 days
fecal /oral/water, No blood
No vaccine

Front 42

kids/ young adults , main cases autumn?

Back 42

Hep A

Front 43

incubation 15-60 days?

Back 43

hep E

Front 44

Hep A Incubation ?

Back 44

15-50 days

Front 45

Do Hep A and Hep E have vaccines?

Back 45

No, only Hep A has a vaccine

Front 46

Fecal-Oral transmission?

Back 46

Hep A and E

Front 47

What do A and E have in common regarding how they start( one word) and what transports them?

Back 47

Abruptly -fecal /oral

Front 48

Review ss for Hep A and E
Hep A ss/sx:
Abdominal discomfort, anorexia, fatigue, FEVER, muscles aches, N/V, Dark Urine, and Jaundice, avg sick 28days,Poor sanitation/overcrowding( woodstock) My friend got A in Nica during the war. ss/sx usually last less than 2 mos. some pts can have a longer case or relapse 6-9 mos.
HepE:
Sudden fever, Nausea, severe fatigue( malaise) , anorexia.
BIG Difference: Pt can get this and be mildly sick lasting 7-14 days or very disabled dx lasting several months. average sick 40 days
(underdeveloped countries)

Back 48

Hep A ss/sx;
Ab discomfort, anorexia, fatigue, FEVER, muscle aches , Dark Urine, and Jaundice, average 28 days sick, Poor sanitation, overcrowding( ex: woodstock) My friend got Hep A during the war in Nica.
ss/sx last less than 2 months. sometimes pt can get a relapse or it can last a little longer up to 6-9 mos.
Hep E:
Sudden FEVER!, Nausea, malaise, anorexia, Pt can have a mild case 7-14 days or be disabled for several months. Average 40 days sick
underdeveloped countries ( africa)

Front 49

List three differences between Hep A and E? Questions to think about:
How do they start? How long do they incubate? Do they both have a vaccine?
Who mostly gets it and under what kind of conditions?
What are main ss/sx differences? which is more severe?
How long can Hep A and Hep E last and are they chronic?

Back 49

Hep A:abdominal pain
Dark Urine
Fever
Muscle Aches
15-50 days
Vaccine
Crowded , poor sanitation
Kids/ Young adults , Autumn
Hep E:

Sudden Fever
Malaise
Nausea
15-60 days
average 40 days
No vaccine
varies in severity : either mild 7-14 days or disabling several months
underdeveloped countries

Front 50

Hep B and C Review: How you get it
Hep B: Blood
Body Fluids
Contaminated food/h2o, poor sanitation & overcrowded( prison)
Iv Drug Use
Needle stick
Sex
Hep C:
Blood
Blood transfusion
IV drug use
Maybe sex?
Mostly Adults

Back 50

Hep B and C Review : How you get it
Hep B: Blood
Body fluids
Contaminated food/h20
Poor sanitation and overcrowded( prison)
Iv drug
Needle stick
Sex
Hep C:
Blood
Blood transfusion
IV Drug use
Maybe sex
Mostly adults

Front 51

Hep A and E are transmitted though fecal -oral contact. How does one get Heb B and C? Hep B( 4)
Hep C (count it as 3)
When counting remember that Hep B and C have extra things(ie:) under the transmission category)

Back 51

HepB:1.Blood
ie: Needle stick ( ouch)
IV drug
Sex
2.Body fluids;ex urine, spit , vaginal fluids, tears, sweat, semen, feces)
3. Contaminated food and H20
4. Poor sanitation and overcrowding( how many people at woodstock got this?)
Hep C
1. blood borne ie:
blood transfusion
IV drug use
2.Maybe but not known for sure:sex?
3. Mostly adults get this one.

Front 52

If a patient says they have Delta Hep would you think they were from the South and they were talkin about Delta Dawn or some crazy Hep you never heard about??? What is the more common name for this HEP?

Back 52

Delta Hep is the other name for Hep D and it is caused from Iv drug use and hemophiliacs can get it too.

Front 53

Select correct answer. Hep -? is ONLY contagious during INCUBATION( 180 days), full blown, and chronic stages and NOT during the recovery stage?
A. Hep A
B. Hep E
C. Hep A and B
D Hep B only

Back 53

D. Hep B only

Front 54

How long does HBV remain active and contagious on your treatment table and anything else the patient touched ? how do you clean it in the treatment room?

Back 54

HBV contagious and active for 2 weeks on inanimate objects. If a pt comes in and is in active stage you clean the room with a bleach solution.

Front 55

What kind of pt gets Hep D?

Back 55

Hep D pts are Hemophiliacs and IV drug users

Front 56

Re:HEP What type is this?
description ss/sx
"Most cases occur 5-10 wks after exposure. Period of communicability-1wk after exposure through chronic stage. N/V, anorexia and jaundice

Back 56

Hep C
Hep A has jaundice but the ss/sx are ab pain, FEVER , dark urine , muscle aches

Front 57

75-80% develop chronic infection, 60-70% develop chronic hepatitis, may lead to cirrhosis, 20% liver cancer. What kind of Hep is this?

Back 57

Hep C

Front 58

Hep B is transmitted to people in medical field how especially in case of acupuncturists?

Back 58

Needle stick

Front 59

Re Hep B what are 3 ways that it can be transmitted?

Back 59

1.IV Needle Stick
2. Needle stick
3.Sex
4. Body fluids( spit, feces, sweat, tears , urine, semen)
5. Contaminated food/ water-poor sanitation and overcrowding ( This can happen in prisons and jails )

Front 60

Hep C what are 3 ways it can be transmitted?

Back 60

1.Blood Transfusion
2. IV drug use
3. Maybe sex?

Front 61

What is the Incubation period for HepC?

Back 61

20-90 days

Front 62

What is the Incubation period for Hep B?

Back 62

50-180 days

Front 63

What Hep has the shortest incubation period?

Back 63

Hep A is 15-50 days

Front 64

What kind of Hep has the longest incubation period?

Back 64

50-180 days this is up to 6 frickin months ( Hep B)

Front 65

Which 2 Heps can lead to Liver Cancer and Cirrhosis?

Back 65

Hep B and C

Front 66

Questions on Phases of HBV infection:( next 6 flashcards)

1.this shows that the patient is about to recover from the infection and this phase does not last long?

Back 66

This shows the patient is about to recover from the infection and this phase does not last long.
Anti HBe Ab:
Way to remember: War protestor is about being ANTI Everything!

Front 67

2.First to appear:this is the initial 1-2 weeks of infection and shows that they are in an early stage of infection.

Back 67

2.First to appear:this is the initial 1-2 weeks of infection and shows that they are in an early stage of infection.
Anti HBc Ab

Front 68

3. Two of the phases of HBV infection indicate that the condition is CHRONIC. Name them.

Back 68

Chronic HBV indicators
When HBs Ag and Anti HBs Ab are together. :( note; both of these have an "s"in them. The s--- hits the fan when you find out you have a chronic HBV case:(

Front 69

4.On the blood test what indicates the incubation period for HBV?

Back 69

indicator for incubation period for HBV is
HBs Ag

Front 70

5. This indicates the early stage presence of HBV. This is when people can get infected .

Back 70

This indicates the early stage presence of HBV. This is when people can get infected.
HBe Ag ( Ag means antigen )

Front 71

6.This patient shows they are about to recover from the infection. This does not last long.

Back 71

About to recover from infection. Does not last long -short and sweet
Anti HBe Ab

Front 72

Multiple Choice Questions on HBV ( next 7 flashcards)

1. which type of HBV indicates the early stage presence of HBV?
A. HBe Ag
B. Anti HBe Ab
C. HBs Ag
D. Anti HBc Ab

Back 72

indicates early stage presence of HBV;
HBe Ag

Front 73

2. what confirms that the patient has chronic HBV?
A. HBs and Anti HBs Ab
B. Anti Hbs Ab and HBe Ag
C. Anti HBc only
D. Anti HBs Ab and HBs Ag

Back 73

2 Chronic type:
A. Anti HBs Ab and HBs Ag

Front 74

3.What type of Hep has to have HBV at the same time ( HBV is Hep B)?
A. Hep C
B. Hep D
C.. Hep A
D. Hep E

Back 74

3. B. HEp D has to have HBV at same time

Front 75

4. Which HBV ( HEP B) is one of the most common ways to get infected?
A. HBs Ag
B. HBe Ag
C. Anti HBc Ab
D. all of the above

Back 75

4. A. HBe Ag-one of the most common modes of infection
way to remember: the whiner says: "everything happens to me again"

Front 76

The HBV indicates that the patient is about to recover from the the infection?
A. Anti HBs Ab
B. HBs Ag
C. Anti HBc Ab
D. Anti HBe Ab

Back 76

indicates pt is about to recover from infection
D. Anti HBe Ab
How to remember: Anti is against , When Everyone(e) is about to be against(anti) HB

Front 77

Which HBV is post- HBV vaccine or shows a hx of HBV?
A. Anti HBs Ab and HBs Ag
B. HBe Ag
C. Anti HBs Ab
D. A and C

Back 77

post HBV vaccine or with hx of HBV
Anti HBs Ab ( anti means antibody , hence "post")
way to remember: The only time the Anti HBs Ab is by itself is when it is Post -HBV or someone with a hx of HBV ;

Front 78

The first one to show up with a window of 1-2 weeks of infection , which is an early stage of infection with HBV is?
A. Anti HBs Ab
B HBe Ag
C. Anti HBc Ab
D Anti HBe Ab

Back 78

This is the first one with 1-2 wk infection window , this is an early stage of infection
C. Anti HBc Ab ( only one with a c)

Front 79

HBs Ag is the ?
A. the incubation, chronic, or cured/recovering stage of HBV
B. Incubation period of HBV
C. the positive confirmation that the patient has a chronic case
D. first to appear:initial 1-2 wks of infection

Back 79

HBs Ag is the
B. the incubation period of HBV

Front 80

HBV manifests differently for each patient but his type in the blood can indicate:
1. Chronic
2.Cured/Convalescent
3. History of HBV
4. Incubation
5. After the HBV vaccine( my friend )
Choices:
A. HBe Ag
B. Anti HBc Ab
C. Anti HBe Ab
D.Anti HBs Ab

Back 80

the incubation , chronic , or cured/recovery stage of HBV is
D. Anti HBs Ab
This only has one "s" and not two of them that confirm chronic Hep cases
( HBs Ag AND Anti HBs Ab together = CHRONIC)

Front 81

True of False
Hep B is contagious during incubation ( up to 6 months), Full blown Hep B , if chronic and during the convalescent stage?

Back 81

False all but convalescent stage

Front 82

Comparison Review :
Two types of Chronic kinds of Hep
Chronic Active:
ss: severe fatigue ie malaise, weight loss, anorexia and often jaundice
Chronic Persistent :
Asymptomatic( no symptoms) or has very few symptoms but CAN continue to infect others

Back 82

Comparison Review:
Two Types of Chronic kinds of Hep
Chronic Active:
ss/sx: severe fatigue ie malaise, weight loss, anorexia, and often jaundice

Front 83

What kind of chronic Hep does this describe?
Aysmptomatic or has very few ss but can continue to infect others.

Back 83

Aysmptomatic , very min ss but can cont to infect others
Chronic Persistant

Front 84

This Chronic Hep is described as: What is it called?
Progressive symptomatic dx that continues to damage the Liver. Ss/sx include Very bad fatigue( malaise) weight loss, anorexia, and often jaundice.

Back 84

Chronic Active

Description:
Progressive symptomatic cont to damage liver
ss/sx
severe fatigue( malaise) weight loss, anorexia and Often jaundice

Front 85

Review Our Immune system and how it reacts to pathogens
3 ways
Autogenous Infection
Cross Infections
Natural Barriers

Back 85

Autogenous Infections are infections caused by pathogens that the patient is already carrying
Cross infections: are caused byt pathogens gotten from another person or are in the environment
Natural Barriers: Skin and mucous membranes of the lungs, nose, mucus and saliva tears , urine and balanced acid of Vaginal secretions, stomach acid Urethra and rectum.

Front 86

What does HIV go after?

Back 86

HIv loves CD4 ( akaa: T4) lymphocyte as its host , this stops the cell -mediated response to antigens.

Front 87

Who can get HIV?

Back 87

Anyone who engages in unsafe sex practices or in work environments that are high risk like the medical field

Front 88

What is the risk for practioners who work with patients with HIV?

Back 88

Secondary infections like Hep, Herpes virus and Staph

Front 89

What kinds of tests are there for HIV?(2)

Back 89

1. HIV: The first lab test will be looking for antibodies.
2. There are also Rapid HIV tests that let you know in an hour

Front 90

What kinds of opportunistic infections with HIV? ( 4)

Back 90

1.esophageal candiasis( neoplastic disorder)
2.Cytomegalovirus
3.Kaposi's sarc
4.pneumocystis carinii pneumonia

Front 91

Initial infection is usually followed within 2-4 weeks by a febrile dx thats like mono or the flu. This stage is pretty quick and most people just blow it off . This describes what dx?
A. AIDS
B. HIV
C. HBV ( HEP B)
D . Hep C

Back 91

B. HIV
these people stay healthy for long time then they get sick with HIV

Front 92

This dx spreads by skin to skin contact and is easily spread from one person to another including in medical environments . What is this dx?

Back 92

MRSA Methicillin -Resistant Staphylococcus Aureus

Front 93

What is the protocol if you suspect your patient has the dx in previous question?

Back 93

refer the patient to an MD for treatment
If patient has this dx :
Handle materials as contaminated
Wash hands
Use gloves, lab coats and facemasks

Front 94

When a patient is first infected with HIV how long does it take for it to become AIDS?
A. 50-150 days
B. !5-60 days
C. 8-10 years
D. 20-90 days

Back 94

C . 8-10 years aftern initial infection

Front 95

What is the single most important thing to do if you suspect MRSA?

Back 95

Hand wash cuz MRSA is spread by skin to skin contact

Front 96

Re: CNT in General
How long should you wash your hands?

Back 96

10 seconds under running water , It is Best to use LIquid Soap

Front 97

When washing hands is it ok to touch the handle of the sink as long as you do it fast?

Back 97

No, Use the elbow or have someone else do it for you . or turn it on and off with a paper towel

Front 98

What are 4 choices to use if you do not have soap to wash with ?

Back 98

1.Wipe with Alcohol
2. Alcohol based hand rub
3.antiseptic towel
4.germicidal scrub

Front 99

When should you wash your hands when seeing patients? ( 6 )steps approx.

Back 99

1. Before and After acupuncture treatment
1.In between patients . Parago said before we 2.greet a new patient,3. after we interview and examine,4. Before needling 5., after needling and 6. before and after we take out the needles.

1.My school notes say: before and after an acu treatment
after contact with blood or body fluid
when treating immuno-compromised patients ie Chemo pt, dialysis, HIV
Use paper towels
Don't touch the sink or faucets and handles . Air dry if need be.

Front 100

If you have touched your face or helped a pt pull off their socks , but have washed your hands can you needle a point?

Back 100

No, you have to wash again either with antimicrobial soap or use the alcohol based hand cleanser.

Front 101

What is the recommendation for bleeding as far as gloves?

Back 101

Double Glove

Front 102

What is the biggest risk for a patient and acupuncturist?

Back 102

Contaminated needles

Front 103

If a patient has active TB what piece of equipment must you use?

Back 103

Wear a mask!

Front 104

What two points on the eye do we need to be sure that the depth is no more than .1c for first point and .5-1c?(2)

Back 104

Bl1-.1c
St 1-.5-1c ie:insert slowly,no thrusting,or rotating

Front 105

We should use ? for an immune compromised patient when cleaning an acu point? (2)

Back 105

Betadyne followed by an alchohol swab or benzyclonium.