During acupuncture treatment, the patient may feel faint. The needling procedure and the sensations it may cause should therefore be carefully explained before starting. For those about to receive acupuncture for the first time, treatment in a lying position with gentle manipulation is preferred. The complexion should be closely watched and the pulse frequently checked to detect any untoward reactions as early as possible. Particular care should be taken when needling points that may cause hypotension, e.g. LR 3 taichong.
Symptoms of impending faintness include feeling unwell, a sensation of giddiness, movement or swaying of surrounding objects, and weakness. An oppressive feeling in the chest, palpitations, nausea and sometimes vomiting may ensue. The complexion usually turns pale and the pulse is weak. In severe cases, there may be coldness of the extremities, cold sweats, a fall in blood pressure, and loss of consciousness. Such reactions are often due to nervousness, hunger, fatigue, extreme weakness of the patient, an unsuitable position, or too forceful manipulation.
If warning symptoms appear, remove the needles immediately and make the patient lie flat with the head down and the legs raised, as the symptoms are probably due to a transient, insufficient blood supply to the brain. Offer warm sweet drinks. The symptoms usually disappear after a short rest. In severe cases, first aid should be given and, when the patient is medically stable, the most appropriate of the following treatments may be applied:
• press GV 26 shuigou with the fingernail or puncture GV 26 shuigou, PC 9 zhongchong, GV 25 suliao, PC 6 neiguan and ST 36 zusanli; or
• apply moxibustion to GV 20 baihui, CV 6 qihai and CV 4 guanyuan.
The patient will usually respond rapidly to these measures, but if the symptoms persist, emergency medical assistance will be necessary.