Clinical safety and escalation

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

  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.

• Severe breathlessness or blue lips/fingers

  Blocks results

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

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

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

  Blocks results

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

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

• Coughing or vomiting blood, or heavy uncontrolled bleeding

  Blocks results

  Haemorrhage requires urgent assessment for its source and volume loss.

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

• Thoughts of self-harm or suicide

  Blocks results

  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.

• Swelling of tongue/throat, hives with breathing trouble

  Blocks results

  Anaphylaxis needs adrenaline within minutes.

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

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

  Blocks results

  Meningococcal disease and sepsis progress within hours.

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

• Sudden severe abdominal, head or testicular pain

  Blocks results

  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.

• Vaginal bleeding in pregnancy, or reduced fetal movements

  Blocks results

  Antepartum bleeding and reduced fetal movements are obstetric emergencies.

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

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

  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.

• Taking blood thinners (warfarin, apixaban, clopidogrel)

  Caution

  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.

• Restricted or scheduled herb mentioned

  Caution

  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.

• New lump, unexplained weight loss or night sweats

  Caution

  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.