Filiform needles should be selected according to patients' conditions and scalp site.The needles must have polished and straight bodies(shafts)without rusts or bends,solid handle and sharp tips without barbs.
Select locations according to different disease.The locations and indications of scalp acupuncture are presented in Annex A.
The sitting position is appropriate,or selects a position comfortable for patient and convenient for practitioner.
Be sure that the environment setting should be clean and no pollutant.
It is better to select the disposable filiform needles.Reusable needles should be processed with high pressure sterilization method according to international inspection standards(ISO 11737).
The location should be disinfected with 75% alcohol cotton or 1% iodophor ball in a circular motion from the center to the periphery,according to international inspection standards(ISO 11737).
Before operation the acupuncturist should wash hands with soapsuds,then disinfect with 75%alcohol cotton ball according to international inspection standards(ISO 11737).
Normally the needles are inserted obliquely with an angle of about15°~30°between the needle shaft and the skin,then the needle is inserted horizontally into the skin.
Insert the needle into the subgaleal region rapidly and parallel to the skin to reach certain depth.
After the needle is inserted into the layer beneath the galea aponeurotica,the needle should be insertedalong the skin;the depth of insertion depends on the patient's condition and the requirements of the prescription.
After the needle body enters the layer beneath the galea aponeurotic,the acupuncturist should immobilize the shoulder,elbow,and wrist joints and thumb to prevent the needle from moving.Bend the proximal and distal joints of index finger as semi-buckling state,and hold the needle handle with the palm side of the thumb and the radial surface of the index finger.Twist the needle by bending and stretching movement of the metacarpophalangeal joint of the index finger rapidly without stopping,at a frequency of200 times per minute,and last for at least1~3 minutes.
During the process of treatment,the needles are manipulated intermittently.To strengthen the stimulation and achieve better effect repetitively twirl the needles for about2~3 times.Each twirling may last 1~3 minutes.
In general needles are retained for 15~30 minutes,but retention for 2~24 hours may be used for severe or complicated cases.Prescribe the patients to do exercises during needle retention can enhance the therapeutic effect.Manipulation is not needed during the needle retention.
Withdraw the needle quickly and press the puncture hole with a dry sterilized cotton ball for a while to prevent bleeding.
Annex B presents methods of management for fainting,stuck needle,bent needle,broken needle or hematoma during or after treatment.