Tracheal injury

More special anatomical location of the trachea, acupuncture is not easy to damage. Trachea from the cartilage, and connective tissue composed of smooth muscle fibers, even thorn in general, do not cause serious consequences. However, improper operation, but also fire. Especially if both hurt the surrounding blood vessels, nerves, etc., can be greatly suppressed respiratory function, and even cause suffocation.


Tracheal injury because there are basically two kinds of the following:
An acupoint Reason: Because a substantial portion of the trachea obscured sternum, acupuncture can cause direct damage to the points limited. Among them, the most prone to sudden hole is the day of the accident. Days of the conflict points in the suprasternal fossa depression median (midpoint sternum on one inch), the left and right of the sternocleidomastoid muscle, deep sternohyoideus and sternal thyroid muscle. Jugular vein deep in the skin a little bow, and then deep thyroid vein, deep to the trachea. Down there in the sternum rear left innominate vein, the aortic arch, innominate artery and the left carotid artery. Show Tiantu point not only directly related to the trachea and the surrounding blood vessels is also very rich, and many of them are major blood vessels, a little careless, that could easily lead to accidents. In addition, acupuncture Futu also vulnerable to improper trachea or throat hurt.
Second, the operating reasons: mainly refers to the day in terms of conflict points. In this regard, the ancients already learned: “The days of conflict points, which cross under the needle straight down, no less (arrived) hand, that the gas wounding five internal organs” (“bronze acupoints acupuncture figure, volume IV”).
(A), needling thorn in the wrong direction and too deep. Trachea in the suprasternal fossa muscle covering shallow, too deep to piercing damage; deep puncture to the left, easily hurt lung tissue, especially in emphysema patients, more pneumothorax; along the trailing edge of the sternum down flat spines deep puncture, often harming aorta or innominate artery, causing heavy bleeding. Currently, some people advocate the needle when the first days of the conflict fifth flat spines, needle to pierce the pipe about 1 to 2 minutes, put the needle handle piercing needle obliquely below. Practice has proved that this method is not accurate, can often lead to laryngospasm.
(Two), way too heavy. Greatly revisit thrusting, violent action, can often lead to multiple injuries trachea and surrounding tissues.
(Three), the needle, the patient coughing or repeated actions such as swallowing, can cause severe muscle contraction, changing the direction and depth of needle loss and trachea.

Clinical manifestations

Because of the extent of damage and the scope is different, the different syndromes.
One, mild: mostly the simple tracheal injuries caused. Cough, chest pain, shortness of breath, cough spit sputum with bloodshot eyes and so on. Also due to stab throat, suffocating, hoarseness, subcutaneous emphysema embolism.
Second, severe: severe injuries to the trachea and surrounding blood vessels, nerves and other tissues. Chung vomiting phlegm, coughing, difficulty breathing, paleness, cold extremities, sweating, convulsions, unconsciousness. If not rescued, or even suffocation.


The key is to grasp point selection and operation.
First, the selection of points: points mark Tiantu point clearer, subject Dingzhun, otherwise it will affect the operation. Secondly, the non-cooperators (such as infants, the mentally ill and those who fear needles, etc.), or coughing, especially drama paroxysmal cough, should be suspended and other points selected days of the conflict can be reelected Xuanji nearby, the smell of mutton various points, or and all the way back acupoints acupoints and so on.
Second, the operation: According to the authors, and most physicians experience Tiantu point to bend the needle prick method is more secure, the method is: first of 15 ° angle with the horizontal flat spines, damaged after delivery needle slowly, such as felt tip to contradict hard object, namely the trachea. Slightly back 0.1 to 0.2 inch, horizontal stab downward change in the sternum between the trailing edge and the leading edge of the trachea, the needle slowly. To capture the direction of the needle, the available charge hand (left hand) Hold the needle body piercing about 1 to 1.5 inches, such as the gas being too obvious, can be used for lift and thrust a slight twisting, action should be gentle, until a satisfactory acupuncture. If sent to the needle during a tough sense of touch tip tissue, and patients feel pain; or needle, the needle tail appeared rhythmic beat, have shown that blood vessels have been met, it is expedient to retreat outside the needle slightly above phenomenon disappears.
Needle retention period, the patient is asked to swallow less, such as a sudden cough, emergency will retreat into the subcutaneous needle until coughing subsided, and then piercing the law, such as coughing, should go to choose another needle points.
Point injection, should adopt the 5th dental needle, a 45 ° angle with the horizontal piercing needle to the tip slowly arrived and sent to the trachea, slightly back from 0.1 to 0.2 inches, the injection of drugs, in order to avoid incorrect needle piercing the trachea , liquid injection, before Withdrawing look to see if there is air drawn into, which shall then inject a few drops slightly to observe the occurrence of cough and other phenomena. Thinner because of the hole muscle injected dose should not be too big, too strong irritant to avoid the application of the drug, such as the need to use should also be diluted.
Others, such as Futu hole, etc., although the same operation with the general point, but not deep puncture, the precautions and the same day of conflict points.

[Processing Method]

A mild injury: generally do not need special treatment, given the right amount antispasmodic cough medication with antibiotics to prevent infection. Higher number such as bleeding, supplemented hemostatic agent.
Two, severe damage: Damage heavy or multiple stab wounds, especially those associated with peripheral vascular, neurological or lung tissue damage, difficulty in breathing and a variety of complications, surgical treatment should be rapidly transferred. Severe breathing difficulties and for which secretion can not be excluded, and even more to be considered for tracheotomy.