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3 Operation Steps and Requirements

3.1 Preparation

3.1.1 Needles

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.

3.1.2 Locations

Select locations according to different disease.The locations and indications of scalp acupuncture are presented in Annex A.

3.1.3 Patient' Body Position for Treatment

The sitting position is appropriate,or selects a position comfortable for patient and convenient for practitioner.

3.1.4 Environmental Setting for Treatment

Be sure that the environment setting should be clean and no pollutant.

3.1.5 Sterilization

3.1.5.1 Sterilization of Needles

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).

3.1.5.2 Disinfection of the Skin Selected for Acupuncture

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).

3.1.5.3 Personal Hygiene of the Acupuncturists

Before operation the acupuncturist should wash hands with soapsuds,then disinfect with 75%alcohol cotton ball according to international inspection standards(ISO 11737).

3.2 Need ling Methods

3.2.1 Angle of Insertion

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.

3.2.2 Fast Insertion

Insert the needle into the subgaleal region rapidly and parallel to the skin to reach certain depth.

3.2.3 Depth of Insertion

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.

3.2.4 Needle Manipulation

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.

3.2.5 Needle Retention

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.

3.2.6 Withdrawal of the Needle

Withdraw the needle quickly and press the puncture hole with a dry sterilized cotton ball for a while to prevent bleeding.

3.2.7 Management of Possible Accidents

Annex B presents methods of management for fainting,stuck needle,bent needle,broken needle or hematoma during or after treatment. bJJoV7ApQKXCsWsb7AkhkIGHepJGAO7gOPs0DUHAe79nonfkgKziP0RF2XjU2VBk

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