{"id":22,"date":"2018-09-10T15:03:19","date_gmt":"2018-09-10T15:03:19","guid":{"rendered":"http:\/\/acupuncturesociety.org.uk\/wp\/?page_id=22"},"modified":"2018-09-12T13:47:43","modified_gmt":"2018-09-12T13:47:43","slug":"code-of-safe-practice","status":"publish","type":"page","link":"https:\/\/www.acupuncturesociety.org.uk\/wp\/?page_id=22","title":{"rendered":"Code of Safe Practice"},"content":{"rendered":"<body><div>\n<h4>SAFE NEEDLE PUNCTURE<\/h4>\n<p><strong>All members of The Acupuncture Society must follow this code:<\/strong><br>\n  Only use pre-sterilised disposable needles. Always wipe the skin with non-allergenic  wipes prior to and after needling.<br>\n  Wear sterile vinyl or latex gloves if you have a skin disease, have sweaty fingers, cuts, abrasions, lesions<br>\n  or suffers from an infectious disease. Some needle types allow for aseptic puncture without the use guide tubes by holding the needle handle, whilst others require the use guide tubes. Never allow your fingers or anything else which is not sterile to touch the needle shank prior to insertion.<br>\n  For longer needles we recommend the use of guidetube or wearing sterile gloves. Needles must be used directly from the sterile pack and not placed on non-sterile surfaces prior to use.<\/p>\n<p> Where the point of an unused needle comes in contact with the skin, nail or any non sterile surface it<br>\n  must not be used, and be discarded in a yellow sharps container. All used needles must be placed in a yellow sharps container and disposed of correctly by incineration by an approved sharps service. Used cotton wool wipes and couch roll must be disposed of in an appropriate manner according to local authority regulations.<\/p>\n<p><strong>NEEDLE AND INSTRUMENT QUALITY CONTROL<\/strong><\/p>\n<p>All needles should be purchased  from a reputable medical supplier. Do not use the needles if you  have  any doubt of their quality,  such as, bent or broken needles, torn  sterile packaging etc. Ensure  any needle used is within its use by  date. Since May 2014 there has been a recognised International Standard for  needle quality which has been adopted as a British Standard by the British Standards Institute. The title  for this is sterile  acupuncture needles for single use and the Standard  Number is BS ISO 17218:2014.<\/p>\n<p><strong>Electro-acupuncture<\/strong> <br>\nAll electro-acupuncture equipment must be checked and serviced  by a registered electrician following the  Electricity at Work Regulations (1989). Documentation of its electrical safety  test  certificate should be retained. <\/p>\n<p><strong>Indwelling needles<\/strong> <br>\n  The Acupuncture Society recommend  against the use of indwelling semi-permanent needles and auricular acupuncture inserted devices because  the use of semi-permanent needles carries a greater risk of infection than  with regular acupuncture techniques  (Ernst &amp; White 1999).<\/p>\n<p><strong>Auricular Acupressure balls\/magnets\/seeds<\/strong> <br>\nThe use of acupressure balls, magnets or seeds in the ear is a technique that carries less risk than semi-permanent needles. We advise that acupressure  balls magnets or seeds should not be used until full  training has been completed in auricular acupuncture. <\/p>\n<p><strong>Withdrawal of auricular needles and ball\/seed\/magnets<\/strong><br>\n  We recommend using medical tweezers<br>\n  to grab and withdraw pasters for auricular balls\/seeds\/magnets and  needles, tweezers must be washed as instructed below between patients.<\/p>\n<p><strong>R<\/strong><strong>e-usable  equipment<\/strong> <br>\n  Re-usable equipment  such as glass or plastic cups,  probes and massage equipment  should be washed between  uses in hot water with detergent and stored in a clean dry place. If possible, washing of re-usable equipment  should be done in a dishwasher at high temperature<br clear=\"all\">\n<\/p>\n<div>\n<p><strong>Alcohol swabs<\/strong> <br>\n    Alcohol  swabs should always be available  should they be required  though their use is not mandatory (Cummings &amp; Reid 2004). <br>\n    They should always be used within their use by date. Visibly soiled or dirty skin or skin  which has recently had emollients applied can be  cleaned with 70% isopropanol or 0.5% chlorhexidine  or soap and water. <\/p>\n<p><strong>Cotton wool<\/strong> <br>\n    Cotton wool  balls are recommended to be used to control  a small bleed following the removal of the acupuncture needle. Cotton wool  balls must remain clean, but sterile cotton wool is not mandatory. They should be disposed of according to environmental health guidlines.<\/p>\n<p><strong>First aid kit<\/strong> <br>\n    All practices should have a fully stocked first aid kit. The first aid kit should be regularly  checked and restocked  and there should be an appointed person  to take charge of first aid  arrangements. There is no mandatory list  of items to put in a first aid  box. The contents  of any first aid kit should reflect the outcome of your  first-aid needs  assessment. The Health and Safety  Executive have  a suggested list  of contents, please see <br>\n    <a href=\"http:\/\/www.hse.gov.uk\/pubns\/indg214.pdf\">http:\/\/www.hse.gov.uk\/pubns\/indg214.pdf <\/a> for more  information. <\/p>\n<p><strong>Sharps container<\/strong> <br>\n    All sharps  containers  should be yellow with an orange lid and compliant with UN3291 and BS7320 standards. They should be kept locked away when not in use. Sharps containers  should be kept at a safe  height, in a stable place and adjacent  to the treatment couch  when in use. <\/p>\n<p><strong>T<\/strong><strong>r<\/strong><strong>eatment couch<\/strong> <br>\n    Each treatment  area should have a treatment couch.  All treatment couches should be height  adjustable and in good working order. The non- <br>\n    porous  upholstery should be free from  tears.  Treatment  couches should be covered with disposable paper couch roll which should be renewed after each patient. Material  couch covers  can be used and they should be changed  and laundered regularly,  however  we do not advise their use. <\/p>\n<\/div>\n<p><strong>Infection Prevention and Control <\/strong><\/p>\n<p><strong>Storage of sharps<\/strong> <br>\n  Under the Health and Safety at  Work Act 1974 Section 3 we  have  a duty to protect those people who are not in our employment, i.e. <br>\n  members of the public, guests,  patients, visitors,  contractors to  site; and so the method to lock away  potential hazardous objects is seen as a measure of protection. Therefore the Acupuncture Society recommend  best practice to be storing sharps of all types (including new boxes of needles, used sharps and sharps containers) in a lockable  cupboard or equivalent. \n<\/p>\n<p><strong>Steps to remain  \u201csharps safe\u201d:<\/strong> <br>\n  \u2022\u00a0\u00a0 \u00a0All  sharps containers  should be yellow with an orange lid and approved  under BS7320: 1990\/ UN 3291 <br>\n  \u2022\u00a0\u00a0 \u00a0Do  discard of any sharps directly  into the sharps container immediately after use  at the point of use. Close the aperture  to the <br>\n  sharps  container when carrying or if left unsupervised to  prevent spillage  or tampering <br>\n  \u2022\u00a0\u00a0 \u00a0Do  place the sharps container close to your working area  so you do not have to  travel with the sharps. <br>\n  \u2022\u00a0\u00a0 \u00a0Do carry  sharps containers  by the handle and do not hold them close to  the body <br>\n  \u2022\u00a0\u00a0 \u00a0Do  lock the container when its three-quarters full using the closing mechanism <br>\n  \u2022\u00a0\u00a0 \u00a0Do  label the sharps containers  with premises\/departmental address  prior to disposal <br>\n  \u2022\u00a0\u00a0 \u00a0Do  place any damaged sharps containers  inside a larger sharps container.  Lock and label prior to disposal. Do  not place this or <br>\n  anything sharp inside a hazardous  waste  bag as it may cause injury <br>\n  \u2022\u00a0\u00a0 \u00a0Do keep sharps  containers  in a locked room\/ cupboard when  not in use <br>\n  \u2022\u00a0\u00a0 \u00a0Do keep all sharps waste in a designated, secure area  until it is collected <br>\n  \u2022\u00a0\u00a0 \u00a0Do  dispose of disposable razors  in a sharps bin immediately  after use. Razors should never be re-sheathed  after use<br>\n  \u2022\u00a0\u00a0 \u00a0Do not place anything other than sharps in the sharps container <br>\n\u2022\u00a0\u00a0 \u00a0Do  not try to re-sheath any  used needles, should they be  supplied sheathed  <br>\n\u2022\u00a0\u00a0 \u00a0Do  not leave sharps lying around and do not try to retrieve  items from a  sharps container <br>\n\u2022\u00a0\u00a0 \u00a0Do  not try to press sharps down  in the container to make  more room <br>\n\u2022\u00a0\u00a0 \u00a0Do  not place sharps containers  on the floor, window sills or above shoulder height.  Use wall or trolley brackets, they  should be stored above knee level and below shoulder level <br>\n\u2022\u00a0\u00a0 \u00a0Do  not bend or break needles before discarding them <br>\n\u2022\u00a0\u00a0 \u00a0Do  not  re-use needles during or after any treatment session<br>\n\u2022\u00a0\u00a0 \u00a0Do  not use makeshift containers such as drinks cans, bottles or cardboard boxes as sharps disposal. They are not adequate for the purpose and may  find their way into domestic waste and present hazard to  refuse  workers and members of the public <br>\n\u2022\u00a0\u00a0 \u00a0Full  sharps containers  must be collected and disposed of by a licenced waste  management company<br clear=\"all\">\n<\/p>\n<div>\n<p><br clear=\"all\">\n<\/p>\n<\/div>\n<div>\n<p><strong>Clinical waste disposal <\/strong>HSE (n.d.)<br clear=\"all\">\n<\/p>\n<\/div>\n<p>All waste that has become  contaminated with blood or body fluids should be disposed of correctly  by a licensed waste  handler. <br>\n  Some local councils  may provide support with  clinical waste disposal. <\/p>\n<p><strong>Local Council Waste Collection Services<\/strong><\/p>\n<p><a href=\"https:\/\/www.gov.uk\/request-clinical-waste-collection\">https:\/\/www.gov.uk\/request-clinical-waste-collection<\/a><\/p>\n<p><strong>Cleaning<\/strong> <br>\n  All clinic areas  must be cleaned regularly and it is advised that a cleaning log is maintained to  demonstrate regular  cleaning. A policy should be in place to  dictate when certain clinic areas and equipment  should be <br>\n  cleaned and how  this cleaning should take place.<\/p>\n<p><strong>Blood borne virus<\/strong> <br>\nBBV\u2019s  are viruses that some people carry in their blood  and which may cause severe  disease in certain people and few  or no symptoms in others. The virus can  spread to another person, whether the carrier of the virus is ill or not. <\/p>\n<p><strong>The  main BBV\u2019s of concern are: <\/strong><br>\n  \u2022\u00a0\u00a0 \u00a0Hepatitis B Virus (HBV), hepatitis C virus (HCV) and hepatitis D virus, which all cause hepatitis, a disease of the liver <br>\n  \u2022\u00a0\u00a0 \u00a0Human immunodeficiency virus (HIV)  which causes acquired immune deficiency syndrome (AIDS), affecting the immune system <br>\n  of the body <br>\n  These viruses can  also be found in body fluids other than blood, for example, semen, vaginal  excretions and breast milk. Other body fluids or <br>\n  materials such as urine, faeces, saliva, sputum, sweat,  tears  and vomit carry a minimal  risk of BBV infection, unless they are contaminated with blood. Care  should still be taken as the presence of blood is not always obvious. <br>\n  (HSE 2011) <\/p>\n<p><strong>Immunisations<\/strong> <br>\nImmunisation (vaccination) is  available against Hepatitis B  Virus (HBV), but no other blood borne viruses. The need for a worker to  be immunised should be determined by  the risk assessment where appropriate. It should only  been seen as a supplement  to reinforce other control  measures. Employers should make vaccines available  free of charge to their employees if they are needed. It is recommended  that a vaccination record  is kept and a reminder of when it is next due. \n<\/p>\n<p>The Acupuncture Society  recommends   practitioners to be vaccinated  against HBV. <br>\n<br clear=\"all\"><\/p>\n<div>\n<p>\u00a0<\/p>\n<p><strong>See Health Authority Guidlines<\/strong><\/p>\n<p><a href=\"https:\/\/www.gov.uk\/government\/publications\/blood-borne-viruses-protection-of-health-care-workers\">https:\/\/www.gov.uk\/government\/publications\/blood-borne-viruses-protection-of-health-care-workers<\/a><\/p>\n<\/div>\n<p><br clear=\"all\"><\/p>\n<div>\n<p><strong>Decontamination procedures<\/strong> <br>\n    Under ideal laboratory conditions HIV can  remain infectious in dried blood and liquid blood for several  weeks  and HBV stays active for even longer. If materials become contaminated  with blood or other body fluids, there are several methods  available for decontamination. These  procedures are designed to  inactivate BBVs, mainly by using heat or chemical disinfection. You should have a local  code of practice for dealing with spillages and other forms  of contamination and  all staff should be familiar with it. <br>\n    HSE  (2011) <br clear=\"all\">\n<\/p>\n<\/div>\n<div>\n<p>\u2022\u00a0\u00a0 \u00a0Methods of decontamination are: <br>\n    \u2022\u00a0\u00a0 \u00a0Physical cleaning <br>\n    \u2022\u00a0\u00a0 \u00a0Ultrasonication <br>\n    \u2022\u00a0\u00a0 \u00a0Heat <br>\n    \u2022\u00a0\u00a0 \u00a0Autoclaving <br>\n    \u2022\u00a0\u00a0 \u00a0Thermal  washer disinfection <br>\n    \u2022\u00a0\u00a0 \u00a0Dry heat <br>\n    \u2022\u00a0\u00a0 \u00a0Chemical disinfection <\/p>\n<p><strong>Sharps injury<\/strong> <br>\n    This section is taken from  HSE (2013a) Health and Safety  <\/p>\n<p><strong>Sharps training<\/strong> <br>\n    Employers  are required to train  their employees on the use of sharps,  the <br>\n    training  provided  to employees must cover: <br>\n    \u2022\u00a0\u00a0 \u00a0The correct  use of safer sharps (if appropriate) <br>\n    \u2022\u00a0\u00a0 \u00a0Safe  use and disposal of medical sharps <br>\n    \u2022\u00a0\u00a0 \u00a0What to  do in the event of a sharps injury <br>\n    \u2022\u00a0\u00a0 \u00a0The  employer\u2019s arrangements  for health surveillance and other <br>\n    procedures <br>\n    All Acupuncture Society members must ensure that they have recieved proper training in safe use and management of sharps prior to Joining\n  <\/p>\n<p><strong>Sharps injury: notifying manager<\/strong> <br>\n    An employee who receives a sharps injury at work  must notify their employeras soon as is practicable. The employer will need to ensure <br>\n    they have  sufficiently robust arrangements  to allow employees to  notify them in a timely manner, including where the employee works out-of-office  or away from the employer\u2019s  premises. \n  <\/p>\n<p>  <br clear=\"all\"><\/p>\n<div>\n<p><strong>R<\/strong><strong>ecording  and investigating a sharps  injury<\/strong> <br>\n      Employers  must make a record  of the sharps injury when they  are notified of it, whoever provides that  notification. They must investigate the circumstances and causes of the incident  and take any action required. <br>\n      The injured  person is required to provide sufficient information to their employer to  allow them to carry out this investigation. The extent  of the investigation should be proportionate to the potential severity of the sharps injury. The purpose of the investigation should  be to establish whether the  employer\u2019s existing risk  control measures  are adequate. It should look at underlying and root causes as well as the immediate  factors that  led to the individual injury. Any lessons to be learnt should be  applied across the organisation (as  appropriate), not just in the location of the injury. \n  <\/p>\n<p>In the case of an injury where there may  have  been exposure to a blood-borne  virus or other significant infection, the <br>\n      investigation may  also involve establishing the infection status of the source patient (where it is possible to identify the  individual).<br>\nIf this information is  known, it should be handled following usual patient confidentiality procedures.<\/p>\n<p>If it is promptly shared with the medical professional who is treating the injured  person, it can greatly assist  with ensuring they receive  the right treatment or that  they do not take unnecessary prophylaxis  or anti-viral treatments. <\/p>\n<p><strong>T<\/strong><strong>r<\/strong><strong>eatment and follow-up  of a sharps injury<\/strong> <br>\n      The employer must  ensure that, when notified of any incident  in which an employee has been injured by a sharp that has or may have exposed  them to a blood-borne virus, the employee: <br>\n      \u2022\u00a0\u00a0 \u00a0Has  immediate access to medical advice <br>\n      \u2022\u00a0\u00a0 \u00a0Has  been offered post-exposure  prophylaxis and any  other medical treatment,  as advised by a doctor <br>\n      \u2022\u00a0\u00a0 \u00a0The  employer has considered whether  counselling would be appropriate for  the employee<br>\n      Even if the employee  works  out-of-hours or off the employer\u2019s premises,  the employer should<br>\nhave robust systems  in place to enable employees  to receive treatment  in a timely manner.      \n    <\/p>\n<\/div>\n<p>  <br clear=\"all\"><\/p>\n<p><strong>RIDDOR<\/strong> <br>\n    RIDDOR stands  for \u201cReporting of Injuries,  Diseases and Dangerous <br>\n    Occurrences  Regulations\u201d. There  are certain incidents that require <br>\n    reporting by RIDDOR, a list of such incidents can be found  on the \u201ctypes <br>\n    of reportable incidents\u201d page of the RIDDOR  website, please follow the <br>\n    link for  further information. <\/p>\n<p><a href=\"http:\/\/www.hse.gov.uk\/riddor\/reportable-incidents.htm\">http:\/\/www.hse.gov.uk\/riddor\/reportable-incidents.htm<\/a>  <br>\n    HSE (n.d.) <br clear=\"all\">\n<\/p>\n<p>  (Instruments in Healthcare Regulations 2013 Guidance for employers  and employees. Health and Safety  Executive). <br clear=\"all\">\n<\/p><\/div>\n<h4>\n  PERSONAL HYGIENE<\/h4>\n<p>Hands and finger nails must be scrubbed clean with antibacterial soaps between each patient, where sterile gloves are not used. Paper<br>\n  masks must be used when in close contact with patients and whilst administering moxibustion. Use<br>\n  sterilised  disposable gloves during needle insertion and withdrawal. Disposable hand towels are recommended. Medical non alergy examination gloves must be worn<br>\n  when coming into contact with skin disease. Refrain from smoking or consuming food in the treatment area.<\/p>\n<p>  Needlestick injuries should be logged and a blood test taken, if the needle had penetrated the dermal<br>\n  layers see above<\/p>\n<h4>\n  PATIENT CHECK LIST TO BE FILLED IN PRIOR TO TREATMENT<\/h4>\n<p>Practitioners must ask patients to fill in this or a similar check list before administering treatments:<\/p>\n<p>  If you suffer from any of the conditions listed below or other conditions which have not been included<br>\n  that you feel are relevant, please inform us prior to treatments so that we can assess your suitability for<br>\n  such treatment.<br>\n  Where there is any doubt please consult your GP.<br>\n  \u2013 A recent operation<br>\n  \u2013 An untreated medical condition<br>\n  \u2013 Severe bone or joint disorders (Rheumatoid\/Osteo arthritis, osteoporosis)<br>\n  \u2013 Cardiovascular disorders (high blood pressure, heart \/ circulatory desease, thrombosis)<br>\n  \u2013 Diabetes<br>\n  \u2013 Endocrine disorders<br>\n  \u2013 Epilepsy<br>\n  \u2013 Drug addiction or recent use of recreational and\/or prescribed drugs and or exessive alcohol<br>\n  consumption<br>\n  \u2013 Medication<br>\n  \u2013 Pregnancy (or post natal within the last 6 months)<br>\n  \u2013 Severe skin disorders<br>\n  \u2013 Severe mental illness<br>\n  \u2013 Spinal injuries<br>\n  \u2013 Prone to fainting<br>\n  \u2013 If you suffer from infectious deseases like hepatitis B or HIV<br>\n  You must also have eaten within 2 hours prior to treatment (please inform practitioner if you haven\u2019t)<br>\n  \u2013 Is there anything else we should know about your health?<\/p>\n<h4>\n  HERBAL MEDICINE<\/h4>\n<p>The EU laws concerning Herbal medicine came into force in April 2011, which only apply to patent<br>\n  medicines and preparations made up in factories for thirds parties.<br>\n  Those practitioners and retail outlets who are trading in patent medicines will be able to apply for a<br>\n  licence to continue to supply these patent or factory prepared formulations from the HPC (see the written<br>\n  ministerial statement below published 16 February 2011).<br>\n  UK legislation due in early 2013 is likely to require registration of Herbal Practitioners with the HPC,<br>\n  it\u2019s anticipated that this will greatly increase our acceptance within the orthodox medical community.<br>\n  There will be a consultion process begining in late 2012 leading to legislation expected in 2013, there<br>\n  will be grandparenting arrangements for all those qualified prior to the legislation becoming active. Until<br>\n  the White Paper is published it is not yet clear what exactly it will contain, but its expected to follow<br>\n  simillar processes that occured when previous aspirant therapies attained registration to the HPC in the<br>\n  past. The Acupuncture Society is seeking to attain automatic grandparenting for all its Herbal Members.<\/p>\n<p>  Follow this link to the hpc website page on herbal regulation <a href=\"http:\/\/www.hpc-uk.org\/aboutregistration\/%0Aaspirantgroups\/aspirantgroups\/\">http:\/\/www.hpc-uk.org\/aboutregistration\/<br>\n    aspirantgroups\/aspirantgroups\/<\/a><\/p>\n<p>  Herbalist\u2019s must not use endangered species animal and mineral substances in their formulae nor use<br>\n  patient medicines nor ask third parties to prepare them or their insurance may be void.\n<\/p>\n<h4>\n  <u>List of Banned Herbs and legal implications of new EU herbal regulation<\/u><br>\n<\/h4>\n<p>\u00a0<\/p>\n<p><strong>A: RESTRICTED UNDER THE CONVENTION ON INTERNATIONAL TRADE IN ENDANGERED SPECIES<br>\n  (CITES)<br>\n  <\/strong>Herbs which are endangered in the wild are restricted but may be traded with the appropriate CITES<br>\n  certification. In the case of Appendix I this is normally only permitted for scientific purposes if at all.<br>\n  Suppliers can trade in herbs listed in Appendix II but only when obtained from an authenticated cultivated<br>\n  supply.<br>\n  An example of this is XI YANG SHEN which is available from farmed sources.<\/p>\n<p>  <strong>APPENDIX I<\/strong><br>\n  HU GU (Os tigris)<br>\n  SHE XIANG (Secreto Moschus)<br>\n  XI JIAO (Cornu Rhinoceri)<br>\n  XIONG DAN (Vesica Fellea Ursi)<br>\n  BAO GU (Os Leopardis)<br>\n  DAI MAO (Carapax Ertmochelydis)<br>\n  MU XIANG (Saussurea lappa) NOTE: Vladimira species are permitted as a substitute herb.<\/p>\n<p>  <strong>APPENDIX II<\/strong><br>\n  CHUAN SHAN JIA (Squama Mantis Pentadactylae)<br>\n  HOU ZAO (Calculus Macacae)<br>\n  LING YANG JIAO (Cornu Antelopis)<br>\n  GUI BAN (Chinemys reevesii)<br>\n  SHI HU (Dendrobium species)<br>\n  BAI JI (Bletilla striata)<br>\n  TIAN MA (Gastrodia elata)<br>\n  GOU JI (Cibotium barometz)<br>\n  LU HUI (Aloe ferox)<br>\n  XIAO YE LIAN (Podophyllum emodii)<br>\n  ROU CONG RONG (Cistanches deserticola)<br>\n  XI YANG SHEN (Panax quinquefolius) NOTE: Only applies to the whole and sliced root.<br>\n  HU HUANG LIAN (Picrorrhiza kurroa)<\/p>\n<p>  <strong>B: RESTRICTIONS UNDER STATUTORY INSTRUMENTS<\/strong><\/p>\n<p>  SI 2130 1997<br>\n  These herbs were listed as an in addition to those listed in the Medicines Act 1968 as being potent and<br>\n  hence in need of dosage regulation. In some cases they are forbidden at any level of internal dosage.<\/p>\n<p>  MD= Maximum single dose MDD=Maximum Daily Dose<\/p>\n<p>  FU ZI\/CAO WU (Aconitum species) NOTE: Permitted to use externally at a dose of 1.3% or below. Internal<br>\n  use prohibited.<br>\n  SHI LIU PI (Punica granitum). Internal use prohibited.<br>\n  BING LANG (Areca catechu) Pharmacy use only.<br>\n  DA FU PI (Areca catechu) Pharmacy use only<br>\n  MA HUANG (Ephedra sinica). MDD: 1800 mg. MD: 600 mg.<br>\n  YANG JIN HUA (Datura stramonium). MDD: 150 mg. MD: 50 mg.<br>\n  YANG JIN HUA (Datura stramonium). MDD: 150 mg. MD: 50 mg.<br>\n  DIAN QIE CAO (Atropa belladona). MDD: 150 mg. MD: 50 mg.<br>\n  TIAN XIAN ZI (Hyocyamus niger). MDD: 300 mg. MD: 100 mg.<\/p>\n<p>  NOTE: SI 2130 also applies to other herbs not employed in Chinese medicine.<br>\n  S1 1841 2002<br>\n  This ban relates to all Aristolochia species and also includes herbs which have been confused with Aristolochic<br>\n  species due to poor quality assurance.<\/p>\n<p>  The sale, supply and importation of the following is banned:<br>\n  MU TONG (Aristolochia manshuriensis). NOTE: this ban also applies to Akebia quinata, Akebia trifoliata,<br>\n  Clematis montana and Clematis armandii.<br>\n  FANG JI (Aristolochia fangji). NOTE: this ban also applies to Stephania tetrandra, Cocculus laurifolius,<br>\n  Cocculus orbiculatus and Cocculus Trilobus<br>\n  MA DOU LING (Aristolochia contorta, Aristolochia debilis)<br>\n  TIAN XIAN TENG (Aristolochia contorta, Aristolochia debilis)<br>\n  QING MU XIANG (Aristolochia debilis)<\/p>\n<p>  SI 548 2008<br>\n  All species of Senecio are prohibited for internal use due to the presence of toxic pyrrolizidine alkaloids<br>\n  (PA). This mainly applies to the use of Senecio<br>\n  scandens QIAN LI GUANG<\/p>\n<p>  <strong>C: VOLUNTARY RESTRICTION<\/strong> Due the presence of Aristolochic Acid in Asarum species there is a voluntary ban on the use of:<br>\n  XI XIN (Asarum species)<\/p>\n<p>  <strong>D: RESTRICTIONS UNDER THE MEDICINES ACT<\/strong> 1968<br>\n  Under Section 12(1) of the 1968 Medicines Act 1968, herbal remedies which are administered after a<br>\n  one-to-one consultation with a practitioner do not require a medicines licence (marketing authorisation).<br>\n  This legislation was enacted before traditional medicines from non-European cultures, which use<br>\n  non-plant substances, had any significant presence in the UK.<br>\n  Since the term \u2018herbal remedies\u2019 refers to plant materials, the MHRA has stated in its guidance on medicines<br>\n  law that the use of mineral and animal substances, which do not have a marketing authorisation,<br>\n  is illegal.<\/p>\n<p>  Section 12(1) is currently under review and the RCHM is working to re-establish the use of animal and<br>\n  mineral products. It is also expected that this redefinition of what constitutes a \u2018herb\u2019 will be clarified in<br>\n  European and UK legislation in the near future to include non-plant medicines.<\/p>\n<p>  In the meantime, members are warned that the use of these products may result in legal action by the<br>\n  MHRA and absence of insurance cover in the case of a claim. Hence all animal and mineral products<br>\n  should not be used until otherwise informed.<\/p>\n<p>  Whatever the outcome of this process, the following must never be used in any form:<br>\n  ZHU SHA (Mercuric sulphide) Cinnabar<br>\n  QING FEN (Mercuric chloride) Calomel<br>\n  HONG FEN (Mercuric oxide) Realgar<br>\n  HEI XI Lead<\/p>\n<p>  <strong>PRESCRIPTION ONLY MEDICINES (POM)<\/strong><br>\n  It is strictly prohibited to include any drug which is made available only through prescription by a registered<br>\n  medical doctor.<br>\n  This includes the following:<br>\n  YING SU KE (Papaver somnifera)<br>\n  MA QIAN ZI (Strychnos nux vomica)<br>\n  STEROIDS Including external use in creams such as PI YAN PING or 999 SKIN CREAMS.<br>\n  <br>\n  FU ZI Internal use<\/p>\n<p>  <strong>E: PATENT FORMULAE<\/strong><br>\n  It should be noted that several patent formulae traditionally contain some of the above restricted herbs<br>\n  and toxic minerals, and recently some have been found to contain drugs. These include the following,<br>\n  which may present a health risk if used as a patent:<\/p>\n<p>  NIU HUANG JIE DU PIAN (May contain arsenic)<br>\n  TIAN WANG BU XIN DAN (May contain mercuric salts)<\/p>\n<p>  It is the responsibility of the practitioner to ensure that all patent formulae are obtained from \u2018bonafide\u2019<br>\n  suppliers. In practice this means that all ingredients are listed and none of the above are included in the<br>\n  formula.\n<\/p>\n<h4>\n  TREATMENT PROHIBITIONS<\/h4>\n<p>Patients should not be treated if they have consumed alcohol or combinations of alcohol, prescribed or<br>\n  recreational drugs or if they haven\u2019t eaten two to three hours prior to treatment. They should have also<br>\n  taken their prescribed medicine to the prescribed dose prior to treatment. Patients should be treated<br>\n  whilst they are lying on the treatment couch and not whilst sitting on a chair as this will reduce the risk<br>\n  of syncope.\n<\/p>\n<h4>\n  PROHIBITED TREATMENTS<\/h4>\n<p>Abortion.Pregnancy related symptoms against the advice of a midwife or a medical doctor. Controlled<br>\n  infectious disease which require hospitalization in isolation. Treatment for cancer and other serious<br>\n  diseases like diabetes, high cholesterol, blood pressure, thyroid or any other conditions requiring medication<br>\n  must not be offered as a replacement to conventional medical treatment.\n<\/p>\n<h4>\n  ORIENTAL MASSAGE SAFE PRACTICE STANDARDS (INCLUDING TUINA, THAI, ACUPRESSURE<br>\n  AND CHINESE MASSAGE)<\/h4>\n<p>An Oriental Massage Practitioner members will be able to demonstrate that they:<\/p>\n<p>  1. know and comply with their Professional the Acupuncture Society\u2019s Code of Professional<br>\n  Conduct and Ethics.<br>\n  2. keep clear and appropriate records.<br>\n  3. understand cautionary techniques, and conditions requiring special consideration.<br>\n  4. can offer appropriate lifestyle recommendations.<br>\n  5. follow an accurate and appropriate assessment procedure.<br>\n  6. use appropriate and accurate techniques.<br>\n  7. can demonstrate reflective practice.<br>\n  9. are working within the scope of practice of thier training.<br>\n  10. have certificate or diploma qualification recognised by the Acupucture Society.<br>\n  11. carry upto date professional indemnity\/ public liability insurance cover.<br>\n  12. have a minimum of anatomy and physiology qualification equivalent to the national standards of<br>\n  level 3.<br>\n  13. hold a currant a first aid certificate.<br>\n  14. can refer clients to a more approriate practitioner or a doctor when out of thier scope of practice.<br>\n  15. can refer clients to their GP if any symptoms presented are not understood, are potentially<br>\n  dangerous or may require further investigation or medical treatment.<br>\n  16. have undertaken the required annual CPD course hours and submitted them on the Society\u2019s log.\n<\/p>\n<\/div>\n<\/body>","protected":false},"excerpt":{"rendered":"<p>SAFE NEEDLE PUNCTURE All members of The Acupuncture Society must follow this code: Only use pre-sterilised disposable needles. Always wipe &hellip; <\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-22","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.acupuncturesociety.org.uk\/wp\/index.php?rest_route=\/wp\/v2\/pages\/22"}],"collection":[{"href":"https:\/\/www.acupuncturesociety.org.uk\/wp\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.acupuncturesociety.org.uk\/wp\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.acupuncturesociety.org.uk\/wp\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.acupuncturesociety.org.uk\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=22"}],"version-history":[{"count":2,"href":"https:\/\/www.acupuncturesociety.org.uk\/wp\/index.php?rest_route=\/wp\/v2\/pages\/22\/revisions"}],"predecessor-version":[{"id":192,"href":"https:\/\/www.acupuncturesociety.org.uk\/wp\/index.php?rest_route=\/wp\/v2\/pages\/22\/revisions\/192"}],"wp:attachment":[{"href":"https:\/\/www.acupuncturesociety.org.uk\/wp\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=22"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}