Abbott pioneers acupuncture in the ER
Abbott Northwestern Hospital is
reporting success using acupuncture in its emergency room to treat conditions
ranging from car accident injuries to migraines to kidney stones, and hoping to
prove that the traditional Chinese treatment can reduce doctors’ reliance on
addictive opioids to manage patients’ pain.
The Minneapolis hospital was the
first in the nation to staff its ER with an acupuncturist two years ago, as
part of a broader campaign to promote Eastern remedies as complements to
Western mainstream medicine.
After tracking 182 patients, it
reported this month that pain scores in those who received acupuncture alone
dropped by the same amount as those who also received analgesic painkillers.
“No matter what I’m treating them
for, many patients report feeling calmer, more relaxed, less anxious,” said
Adam Reinstein, the acupuncturist in Abbott’s ER.
Coordinating with doctors and nurses
on weekdays, Reinstein finds patients willing to receive acupuncture. He then
places needles strategically in their skin to provide overall pain relief and
relaxation, or to target pain in specific body parts.
The free service is designed to
supplement whatever other care patients receive, but Reinstein said there have
been cases when it pre-empted the need for prescription painkillers and
shortened patients’ ER stays. Now the goal is to measure just how much
acupuncture in and of itself makes a difference.
Acupuncture Specialist Adam
Reinstein met with cancer patient Julie Valley before giving her an acupuncture
treatment at the Abbott Northwestern emergency room, Monday, March 7, 2016 in Minneapolis,
MN. The hospital is reporting success posting an acupuncturist in its ER to
provide pain relief to patients.
The study published by Reinstein and
Jeffery Dusek of the Penny George Institute for Health and Healing this month
in the journal Pain Medicine found equivalent pain relief in patients who
received acupuncture alone, but also reductions in their anxiety. The
“observational” study had limits, though, including the chance that the
acupuncture recipients might have been more likely to recover faster in the
first place, and that there was no comparison group who only received
painkillers.
Now Dusek is pursuing a federal
grant for a more definitive study of 750 patients.
Proving acupuncture could sometimes replace
opioids would be meaningful because there is growing evidence that the drugs
are being overused and causing addictions and overdose deaths, said Dr. Chris
Kapsner, the medical director of Abbott’s ER.
Minnesota overdose deaths have risen
sixfold, according to state death records, a trend that has corresponded with
rising prescription rates.
“We’re cognizant that there is a
huge epidemic” of opioid overuse, Kapsner said, “and we’re doing our best not
to be part of the problem, but to be part of the solution.”
Five slender needles
Reinstein had already provided
acupuncture for a car accident victim last week when he knocked on the door of
Julia Valley’s ER room. The breast cancer patient from Bloomington reported
crushing pain and swelling in her left shoulder — a side effect of chemotherapy
treatments that caused veins to collapse and become clogged.
Awaiting painkillers, Valley gladly
agreed to acupuncture; the hospital’s research shows that nine of 10 such ER
patients agree to the treatment.
Reinstein selected the hand opposite
from Valley’s injured shoulder, cleansed it, and nimbly placed five needles
between her wrist and thumb.
“Is that it?” asked Valley, who was
anticipating stings. “Wow!”
“That’s it,” Reinstein replied. “We
try not to do anything that causes more pain.”
American views on acupuncture have
changed over the past 30 years, from deeming it quackery to embracing its place
in health care — even if its mechanisms are loosely understood. Studies
nationally have proved it effective at reducing nausea from chemotherapy and
addressing certain types of chronic pain.
Acupuncture is usually provided in
meditative outpatient clinics rather than emergency departments full of bright
lights, beeping alarms and anxious patients. Reinstein said the goal of ER
treatment is different as well: immediate relief rather than long-term recovery
or healing.
‘I can feel it!’
Acupuncture involves the shallow
insertion of needles to stimulate junctures in the body — often nerves, muscles
or connective tissues. Traditional whole-body teaching holds that “meridian”
lines along the body possess therapeutic value for specific organs; the line of
pressure points connected to the heart, for example, is said to extend from the
shoulders down the arms.
Reinstein said he is conservative
and targets “distal” edges of the body such as hands, ears or ankles — away
from injury sites — because ER patients aren’t always familiar with acupuncture
or are agitated.
Julia Valley recently received
acupuncture treatment for pain at the Abbott Northwestern. emergency room.
Valley, 34, was surprised by the
calm she felt after treatment. “I can feel it!” she exclaimed.
“A lot of patients fall asleep
during treatment,” Reinstein replied, “though not so much in the emergency
room.”
In addition to proving that
acupuncture relieves pain, Reinstein and colleagues hope to prove that it
reduces ER costs and that insurers should cover it.
Insurers such as Blue Cross and Blue
Shield of Minnesota generally cover acupuncture, but only for nausea related to
chemotherapy and surgery, or treatment of pain once traditional efforts have
failed.
Reinstein said placebo effects could
explain some of his results; simply listening to patients and attending to them
could reduce anxiety. It’s also unclear why some patients benefit and others
don’t.
But acupuncture has few side effects
— unless the needles aren’t clean or are pushed in too far — so ER doctors have
encouraged its use while awaiting data that proves its value, Reinstein said.
“It’s not about Western medicine”
vs. Eastern medicine, he said. “It’s not about the medication. It’s not about
acupuncture. It’s about, what can we do to make the patient feel better?”
