AP Emergency Procedures & Response 3 — Questions and Answers
Question 1: A patient with a pacemaker presents for treatment. Which precaution is most critical?
- Avoid all needling above the waist
- Do not use electrical stimulation (e-stim) on the patient (Correct answer)
- Limit treatment to distal points only
- Use only intradermal needles
Correct answer: Do not use electrical stimulation (e-stim) on the patient
Electrical stimulation can interfere with pacemaker function and is absolutely contraindicated; manual needling with appropriate caution is generally acceptable.
Question 2: During cupping therapy, a patient develops a blister larger than 2 cm. What is the correct management?
- Puncture the blister, drain it, and apply antibiotic ointment with sterile dressing (Correct answer)
- Leave the blister intact and advise the patient to monitor at home
- Apply additional heat to reabsorb the fluid
- Perform needle drainage at LI 11 to clear heat
Correct answer: Puncture the blister, drain it, and apply antibiotic ointment with sterile dressing
Large blisters from cupping should be sterilely drained and covered to prevent infection while the site heals.
Question 3: A patient begins seizing during treatment. After ensuring airway safety and calling 911, what should NOT be done?
- Turn the patient to a lateral recovery position
- Remove nearby sharp objects
- Restrain the patient's limb movements forcefully (Correct answer)
- Time the duration of the seizure
Correct answer: Restrain the patient's limb movements forcefully
Forceful restraint during a seizure can cause fractures or dislocations; the focus should be on protecting the patient from injury without restricting movement.
Question 4: A patient with diabetes reports feeling shaky, sweaty, and confused during treatment. Blood glucose reads 48 mg/dL. What is the appropriate response?
- Finish the treatment quickly and have the patient eat afterward
- Immediately give 15-20g of fast-acting carbohydrate and recheck in 15 minutes (Correct answer)
- Administer insulin per the patient's prescription
- Apply needles to ST 36 and SP 6 to regulate blood sugar
Correct answer: Immediately give 15-20g of fast-acting carbohydrate and recheck in 15 minutes
A blood glucose of 48 mg/dL indicates hypoglycemia requiring immediate fast-acting glucose (15-15 rule) before any further treatment.
Question 5: Which of the following is a contraindication for moxibustion?
- Yang deficiency patterns
- Cold-damp bi syndrome
- Excess heat conditions (Correct answer)
- Kidney yang deficiency
Correct answer: Excess heat conditions
Moxibustion uses heat and is contraindicated in excess heat or fire conditions, as it would aggravate the pathology.
Question 6: A practitioner sustains a needlestick injury from a needle previously used on a patient with unknown HIV status. What is the recommended first step?
- Squeeze the wound to express blood, wash thoroughly with soap and water, then report to occupational health (Correct answer)
- Apply a tourniquet above the injury site
- Immediately start prophylactic antiretroviral therapy without further assessment
- Disinfect with bleach solution and continue working
Correct answer: Squeeze the wound to express blood, wash thoroughly with soap and water, then report to occupational health
Immediate first aid includes allowing some bleeding, thorough washing with soap and water, followed by prompt incident reporting and risk assessment for PEP consideration.
Question 7: A patient has an acute asthma attack during treatment with audible wheezing and use of accessory muscles. They have their rescue inhaler. What should the acupuncturist do FIRST?
- Needle LU 7 and KD 6 to open the Chong and Ren channels
- Have the patient use their rescue inhaler and assess response; call 911 if no improvement (Correct answer)
- Remove all needles and have the patient breathe into a paper bag
- Apply moxa to CV 17 and LU 1 to open the chest
Correct answer: Have the patient use their rescue inhaler and assess response; call 911 if no improvement
The patient's prescribed rescue bronchodilator is the first-line intervention; if there is no improvement or worsening, emergency services must be activated.
AP Emergency Procedures & Response 3
A patient with a pacemaker presents for treatment.
Which precaution is most critical?