Dry Needling Safety Policy

 

Before Needling

• Before starting any dry needling intervention, the Licensed Healthcare Professional must receive signed informed consent from the patient or guardian acknowledging a clear understanding of the procedure and its associated risks(2)

• Wash hands thoroughly with soap and water, ensuring all surfaces of the hands including the fingernails are clean, and rinse under running water for 15 seconds(1,2,3)

• Always wear gloves with any risk of contacting blood(2,3)

• The patient must be fully supported in an appropriate position that allows for optimal access to the treatment area(1)

• Disinfect the area to be treated by swabbing it with a 70% ethyl or isopropyl alcohol wipe(1,3)

• Needles and all other equipment necessary for the procedure are to be kept in a clean, hard plastic container with a securable cover(2)

• All needles and guide tubes will remain in sterilized packaging and must only be opened in front of the patient on which the needle is to be used(1)

 

 

While Needling

• The area to be needled is to be identified through palpation

• Once the treatment area is identified, the needle should be removed from its sterile packaging and held within the guide tube by the handle of the needle to ensure the shaft of the needle remains sterilized and does not come in contact with the practitioner’s fingers(3)

• Only disposable, single use needles may be used(1,3)

• The practitioner must communicate with the patient after every needle insertion to ensure the patient does not experience an adverse reaction

• Once the needle has been withdrawn, it must be discarded in an easily accessible sharps container(1,2,3)

• Guide tubes must be discarded of in a trash receptacle after each use, or at the end of the treatment session if one guide tube is used for several needles on the same patient

• If, upon insertion or during treatment, the needle becomes bent, it must be immediately removed and discarded into a sharps container and a new sterile needle must be used to continue treatment(3)

• If, upon insertion or during treatment, the needle breaks, the patient must be instructed to remain calm as the exposed portion of the needle is extracted with forceps(3)

• If, upon extraction, the needle becomes stuck, the patient must be instructed to relax and the needle must be rotated in the opposite direction to which is was inserted(3)

• If, at any point, the patient faints or presents with symptoms of impending faintness, the needle should be immediately withdrawn and disposed of in a sharps container and position the patient flat on his or her back with the feet up and the head down to encourage blood flow to the brain(1)

• If, at any point, a needle punctures the glove of the practitioner, the needle must be immediately discarded into a sharps container, the practitioner must re-wash his or her hands, don a fresh pair of gloves, and continue treatment with a new sterile needle(2)

• If, at any point, a needle pierces the skin of the practitioner or any individual that is not the patient being treated, the employer must be informed immediately and the route of exposure, circumstance leading to exposure, and identification of the source individual must be documented(2)

• Any recipient of an accidental needle stick will be encouraged to allow the area to bleed freely and must thoroughly wash the area with disinfectant(2)

 

 

After Needling

• Examine the patient’s integumentary for bleeds and apply pressure to any found(1)

• Instruct the patient to rise slowly whenever he or she is ready

• Remain with the patient to ensure no fainting spells or other adverse side effects present

• Educate the patient on the areas treated and what effects can be expected following the treatment

• Ensure all needles have been properly disposed of in a sharps container(1,2,3)

• Ensure all guide tubes have been appropriately disposed of in a trash receptacle

• Remove gloves and discard into a trash receptacle(1,2,3)

• Wash hands thoroughly with soap and water, ensuring all surfaces of the hands including the fingernails are clean, and rinse under running water for 15 seconds(1,2,3)

 

 

Sharps Container

• Sharps containers must be red or otherwise indicated by a fluorescent orange label declaring “BIOHAZARD” in symbol or writing clearly affixed to the receptacle2

• The receptacle must be leak-proof on the sides and bottoms and impenetrable by the needle2

• All sharps containers must be demarcated with a “fill line”

• The sharps container must be replaced frequently with the content not allowed to amass past the “fill line”2

• A full sharps container must be securely closed when discarded in accordance with state and federal regulations

 

 

References:

 

1. South African Society of Physiotherapy. Dry Needling Physiotherapy Group Safety Protocol. DNPG. http://dryneedling.co.za/images/files/Safety%20 protocol%20%20final.pdf. Accessed February 20, 2015.

2. United States Department of Labor. Occupational Safety and Health Standards: Toxic and Hazardous Substances – Bloodborne pathogens. OSHA. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=10051&p_table=STANDARDS. Updated April 3, 2012. Accessed February 20, 2015.

3. World Health Organization. Guidelines on Basic Training and Safety in Acupuncture. WHO. http://whqlibdoc.who.int/hq/1999/WHO_EDM_TRM_99 .1.pdf. Updated 1999. Accessed February 20, 2015.