Getting a New Point in the ER

Acupuncture study shows treatment offers relief

TUESDAY, April 23, 2002 (HealthDayNews) -- Acupuncture may seem out of place in a hospital's harried emergency room, since it requires the painstaking placement of needles all over the body.

However, the ancient Chinese practice -- along with traditional treatments -- can ease certain ER patients' pain and anxiety quickly, claims new research from a pioneer of the approach.

"Acupuncture is a very feasible treatment to use in the emergency department," says Dr. Martha Grout, a Phoenix doctor and acupuncturist. "It's a wonderful treatment to use in addition to standard Western medicine."

In 1997, Grout began treating emergency room patients at Phoenix Memorial Hospital with a combination of Western medicine and acupuncture for conditions that ranged from headache and backache pain to anxiety, depression and stress-related illnesses such as irritable bowel syndrome.

In a six-month study of acupuncture treatments used on more than 100 people who came to the hospital's ER in 1999 and 2000, Grout says she found the treatments not only helped eased pain and anxiety, but also sometimes eliminated the need for medication.

When that happens, she adds, "You can send the patients home clearheaded."

Her study, believed to be one of the first of its kind, will be published next month in Medical Acupuncture, the journal of the American Academy of Medical Acupuncture. Grout also just presented a workshop on acupuncture in the ER at the academy's annual meeting in Los Angeles this weekend.

She's not suggesting that acupuncture replace Western methods; only that it supplement them.

"There's nothing better than Western medicine to treat acute emergency problems," she says, but acupuncture's role shouldn't be overlooked.

Among her findings:

  • Of 16 patients who sought treatment for severe headache pain, 62 percent said they were either pain-free or had 80 percent pain relief after acupuncture.
  • Of the 77 patients who had fractures, sprains or strains, 30 percent reported being pain-free or almost so after acupuncture. The treatment was typically given after X-rays, but before applying casts, she says, when the pain was still severe.
  • Five of 12 patients who had pain from such conditions as toothaches, carpal tunnel syndrome or tennis elbow said the acupuncture took away the pain completely when pain medication hadn't worked.

"The relief is more than you could explain by placebo effect," Grout says.

Grout keeps her acupuncture equipment in the ER at all times, and she says she shifts back and forth between Western and Eastern medicine as a patient's condition demands.

However, she cautions, acupuncture is not for everyone. Needle-phobic patients typically decline the treatment, she says, even though the needles used for acupuncture are finer than those used for routine injections. And she does not use acupuncture on very agitated patients, citing safety concerns.

Only a handful of U.S. doctors use acupuncture in an ER setting, Grout says, but she predicts the number will grow as acupuncture and other complementary medicine techniques continue to gain acceptance among Western-trained doctors.

Not all ER doctors think the trend will catch on that quickly.

David Vukich, chairman of the Department of Emergency Medicine at the University of Florida, Jacksonville, and a spokesman for the American College of Emergency Physicians, says time is an issue.

He notes his colleagues' first reaction would probably be: "Gosh, that's just too slow for this setting." These days, he notes, ER doctors face "huge pressures" to work faster and smarter.

However, he adds, he doesn't rule out the value of acupuncture in the emergency department entirely. "Acceptance of acupuncture is growing," he says.

Dr. Jay Kaplan, vice president for emergency services for the Arizona region of Banner Health System, says ER doctors may warm up to the concept.

"I think it's a great idea, particularly for certain kinds of illness, such as headache," he says.

Acupuncture originated in China more than 2,000 years ago. Proponents theorize there are more than 2,000 acupuncture points on the human body, connected with pathways called meridians that conduct energy throughout the body. When the energy flow becomes blocked or unbalanced, acupuncture is believed to restore the balance.

"Think of the needle as tiny bridges that you put into the areas of blockage," Grout says. "The needle helps the energy move over the gap. You take out the needle, and the energy still flows."

In 1966, the U.S. Food and Drug Administration approved acupuncture needles, classified as medical devices, for used by licensed practitioners in general acupuncture use.

What To Do

The National Institutes of Health's National Center for Complementary and Alternative Medicine has a fact sheet on acupuncture.

For some frequently asked questions about acupuncture, go to the American Academy of Medical Acupuncture.

SOURCES: Martha Grout, M.D., emergency department physician and acupuncturist, Phoenix Memorial Hospital, Phoenix; David Vukich, M.D., professor, chairman, Department of Emergency Medicine, University of Florida, Jacksonville, and spokesman, American College of Emergency Physicians; Jay Kaplan, M.D., emergency and family physician, and vice president, Emergency Services, Arizona region, Banner Health System, Phoenix; April 20, 2002, presentation, American Academy of Medical Acupuncture annual meeting, Los Angeles
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