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    Clinical safety and escalation

    Every diagnostic tool on Medi-Chi runs the same safety check before it shows you anything. Findings fall into two tiers: results are either withheld and replaced with an urgent-care screen, or shown with an explained clinical caution.

    In an emergency

    Australia 000 · UK 999 · US/Canada 911 · EU 112 · New Zealand 111

    Mental-health crisis: Lifeline 13 11 14 (AU) · 988 (US) · 116 123 (UK/IE). Medi-Chi is clinical decision support, not a substitute for emergency assessment.

    Tier 1 — results blocked

    If any of these appear in your answers, your free-text notes, or in a generated result, the clinical output is hidden and you are routed straight to the urgent-care screen.

    • Crushing, tight or radiating chest pain

      Blocks results

      Chest pain like this can be a heart attack. Every minute counts, so we stop and send you to emergency care instead of showing a pattern.

      Possible acute coronary syndrome. Delay to reperfusion costs heart muscle, so no TCM pattern is offered.

      Next step: Call emergency services or go to your nearest emergency department now.

      Last updated 14 Feb 2026

    • Severe breathlessness or blue lips/fingers

      Blocks results

      If you can't get enough air, you need oxygen and a scan — not acupuncture. We hold the result and point you to urgent care.

      Hypoxia or acute respiratory failure needs oxygen and imaging, not needling.

      Next step: Call emergency services or go to your nearest emergency department now.

      Last updated 14 Feb 2026

    • Sudden weakness, facial droop, slurred speech or vision loss

      Blocks results

      These are stroke signs. Clot-busting treatment only works within a few hours, so nothing else is shown.

      Stroke is time-critical — thrombolysis windows are measured in hours.

      Next step: Call emergency services or go to your nearest emergency department now.

      Last updated 14 Feb 2026

    • Coughing or vomiting blood, or heavy uncontrolled bleeding

      Blocks results

      Bleeding you can't stop, or blood coming up, needs a hospital to find the source. The tool stops here.

      Haemorrhage requires urgent assessment for its source and volume loss.

      Next step: Call emergency services or go to your nearest emergency department now.

      Last updated 14 Feb 2026

    • Thoughts of self-harm or suicide

      Blocks results

      Your safety comes before any pattern. We show crisis-line numbers instead of a treatment plan.

      Risk of harm outranks any pattern differentiation; crisis support must come first.

      Next step: Contact a crisis line now — Lifeline 13 11 14 (AU), 988 (US), 116 123 (UK/IE) — or emergency services if you are unsafe right now.

      Last updated 2 May 2026

    • Swelling of tongue/throat, hives with breathing trouble

      Blocks results

      A severe allergic reaction needs an adrenaline injection within minutes. Nothing else is appropriate.

      Anaphylaxis needs adrenaline within minutes.

      Next step: Call emergency services or go to your nearest emergency department now.

      Last updated 14 Feb 2026

    • High fever with stiff neck, confusion or non-blanching rash

      Blocks results

      This combination can mean meningitis or blood poisoning, which get worse by the hour. Go straight to hospital.

      Meningococcal disease and sepsis progress within hours.

      Next step: Call emergency services or go to your nearest emergency department now.

      Last updated 14 Feb 2026

    • Sudden severe abdominal, head or testicular pain

      Blocks results

      Pain that hits suddenly and hard usually means something needs surgery or a scan today.

      Sudden severe pain suggests a surgical or vascular emergency (thunderclap headache, torsion, dissection, perforation).

      Next step: Call emergency services or go to your nearest emergency department now.

      Last updated 14 Feb 2026

    • Vaginal bleeding in pregnancy, or reduced fetal movements

      Blocks results

      Bleeding in pregnancy, or a baby moving less than usual, is an emergency for the maternity unit — not something to treat at home.

      Antepartum bleeding and reduced fetal movements are obstetric emergencies.

      Next step: Call emergency services or go to your nearest emergency department now.

      Last updated 2 May 2026

    Tier 2 — results flagged

    These do not stop a pattern differentiation, but they change what is safe to prescribe. The caution sits above the result so it is read first.

    • Currently pregnant or possibly pregnant

      Caution

      Some common points and herbs shouldn't be used during pregnancy, so the result appears with those cautions on top.

      Several commonly prescribed points (LI4 Hégǔ, SP6 Sānyīnjiāo, BL60, BL67, GB21) and many blood-moving herbs are contraindicated in pregnancy.

      Next step: Confirm gestation, remove contraindicated points and herbs, and co-manage with the treating obstetric team.

      Last updated 2 May 2026

    • Taking blood thinners (warfarin, apixaban, clopidogrel)

      Caution

      Blood thinners make bruising and bleeding under the skin more likely with needles, cups or gua sha, and some herbs make that stronger.

      Anticoagulation raises bruising and haematoma risk with needling, cupping and gua sha, and several blood-moving herbs potentiate it.

      Next step: Use fine needles and light technique, avoid cupping/gua sha over the area, and check herb–drug interactions before prescribing.

      Last updated 20 Mar 2026

    • Restricted or scheduled herb mentioned

      Caution

      This herb isn't legal to supply in Australia. The result is shown, but a compliant substitute has to be used instead.

      This substance is restricted or prohibited under the TGA in Australia and is not appropriate to recommend.

      Next step: Substitute a compliant alternative before issuing any handout or prescription.

      Last updated 11 June 2026

    • New lump, unexplained weight loss or night sweats

      Caution

      These signs need a GP to rule out something serious first. Treat the pattern alongside that work-up, not instead of it.

      Constitutional symptoms can indicate malignancy or chronic infection and need biomedical work-up alongside any TCM treatment.

      Next step: Refer for GP assessment and imaging or bloods before treating the pattern alone.

      Last updated 20 Mar 2026

    Clinical safety governance

    The safety engine is a single rule set shared by every diagnosis surface — the guided questionnaire, free-text symptom entry and AI output. Each rule carries trigger wording, a tier (block or caution), a plain-language explanation and a next step. Nothing is generated before the rules run, and the generated output is re-scanned afterwards.

    Current rule set

    Version 2026.08 · 13 rules · last change 11 June 2026.

    Update cadence

    Reviewed quarterly, plus an out-of-cycle review whenever a regulator publishes a change.

    • Quarterly scheduled review of every block and flag rule
    • TGA adds or reschedules a herb or substance
    • AHPRA updates advertising or scope-of-practice guidance
    • A user or practitioner reports a missed or over-eager red flag

    Who reviews it

    Reviewed by Derek Doran, registered acupuncturist (AHPRA CMR0002211465), against AHPRA scope-of-practice guidance and the TGA restricted-substance lists.

    How you are told about changes

    Rule changes are dated on this page and listed in the public changelog. Subscribed practitioners get an email when a block-level rule is added or removed; flag-level wording changes appear in the changelog only.

    Spotted a red flag we miss, or one that fires too often? Tell us and it goes into the next review.

    How the check runs

    1. Before you start. Guided questionnaires open with a tick-box safety screen.

    2. On your input. Free-text symptoms and case notes are scanned for red-flag wording before anything is generated or sent.

    3. On the output. Generated patterns, point selections and herb suggestions are re-scanned, so a restricted substance or contraindicated point is caught even if your input looked routine.

    Practitioners stay responsible for the final clinical decision. This layer is a backstop, not a triage service.