top of page

Did you know?

Updated: Dec 31, 2021

Did you know that your acupuncturist, trained at an accredited school, has to learn human anatomy, biomedical diseases, medications and side effects and also red flags?

Red flags are signs and symptoms which would either require immediate assistance or referral to a hospital or GP for further investigation.

There have been two occasions in the past two years where this has already helped me and my family

  • My Dad, about 18 months ago, had a terrible headache. He was struggling with sensitivity to light and it had been a couple of days with absolutely no let-up. His age and his stiff neck had me packing him off to A&E. Six hours later and he was diagnosed with severe pneumonia.

  • My Nan, who has polymyalgia rheumatica, just this week has had an unrelenting headache and visual disturbances. I told her she needed to ring her GP, or an ambulance immediately. My worry was that this could be temporal arteritis and if not immediately treated can lead to loss of sight.

Today's blog is going to take a look at the most severe of red flags because it really highlighted, to me, how we should all be more aware of our bodies and seek medical advice at any signs which cause you concern.

You are not wasting anyone's time by checking something out.

If you have any questions at all please get in touch.

Love from Andrea


*It should be noted that all of these red flags, in this blog, are considered urgent medical attention. You should ring 999 immediately. Trust your instincts. If something doesn't feel right get it checked.

There are of course lots of other red flags, which your acupuncturist must be aware of, and that would require a referral either as high priority (be seen the same day) or a non-urgent referral which requires attending an appointment at your GP *

All these references are taken from a book called The Acupuncturists Guide to Conventional Medicine by Clare Stephenson.


Let us start at the top of the body


  • rapidly worsening breathlessness, increased heart rate, reluctance to talk, need to sit upright, cyanosis (possible diagnosis is severe asthma and at least two of these symptoms should be present)

  • breathless with malaise (possible diagnosis is lower respiratory infection)

  • severe breathlessness, chest pain worse for breathing in and collapse if very severe (possible diagnosis is pneumothorax)

  • harsh noisy breathing on both in and out-breath. will want to sit upright and not talk (possible obstruction to upper airway)

  • disabling breathlessness with watery cough (possible acute heart failure)

  • see also chest pain


  • cough, fever, malaise, breathless, increased heart rate, reluctance to talk, need to sit upright, cyanosis (possible diagnosis is pneumonia)

  • see also breathless


  • collapse with no pulse (cardiac arrest)

  • loss of consciousness (possible diagnosis of stroke, brain infection, intoxication, metabolic disease)

  • rapid deterioration of consciousness, irregular breathing and pinpoint pupils (intracranial pressure)

  • convulsions, loss of consciousness, emptying of bladder or bowels (epileptic seizure)

  • agitation, sweating, dilated pupils, confusion, loss of consciousness/coma (hypoglycemia)

  • see also chest and abdominal pain


  • dizziness, fainting, confusion. rapid pulse, low blood pressure, cold & clammy extremities (shock)

  • vertigo for the first time in someone over the age of 45 (stroke)

  • see also collapse


  • severe headache that develops over hours or days with fever, vomiting, neck stiffness and bruising and non-blanching rash (acute meningitis or encephalitis)

  • severe headache that comes out of the blue. may want to lie down, vomit, neck stiffness and dislike of bright lights (intracranial haemorrhage)

  • high blood pressure, worsening headaches, blurred vision, chest pain (malignant hypertension)

  • headache, abdominal pain, visual disturbance, nausea, vomiting and oedema in mid/late pregnancy (pre-eclampsia)

  • severe one-sided headache over the temple in an elderly person, or someone with polymyalgia rheumatica. Blurring or sight loss are very serious signs (possible temporal arteritis)

Face & eyes

  • progressive swelling of the soft tissues of the face and neck with an itchy throat and wheezing (angioedema and or urticaria)

  • painful, red and swollen eyes and eyelid (orbital cellulitis)

  • sudden onset of painless blurring or loss of sight in one or both eyes. can also be accompanied by a one-sided headache (possible temporal arteritis)

  • intensely painful and red eyes (possible iritis, choroiditis, acute glaucoma, corneal ulcer or keratitis)

  • loss of speech or ability to speak clearly (stroke)

  • loss of vision, unsteadiness, confusion, loss of memory, loss of sensation or muscle weakness (possible stroke or multiple sclerosis)


  • grossly enlarged tonsil with patient feeling unwell, feverish and foul-smelling breath (quinsy)

  • Acute onset of purpuric rash, possibly accompanied by headache, vomiting and fever (meningococcal septicemia)

  • see also headache, bruising, children


What about the middle?


  • severe abdominal pain with collapse, fever. offensive vaginal discharge (pelvic inflammatory disease)

  • right hypochondriac pain that is very intense and comes in waves. maybe associated with fever, vomiting and jaundice (acute abdomen)

  • acute abdomen pain with severe central abdominal back and back pain, vomiting and dehydration (acute pancreatitis)

  • any abdominal pain in pregnancy

  • acute abdominal or back pain with collapse, features of shock (low blood pressure and rapid pulse) (ruptured aortic aneurysm)

  • abdomen pain which radiates to the groin or scrotum (acute testicular pain)

  • acute pain in flanks radiating around to pubic areas. comes in waves. maybe vomiting, agitation and collapse (obstructed kidney stone)


  • chest pain with breathing in, breathlessness, cyanosis, collapse and blood in spit (pulmonary embolism)

  • sustained intense chest pain associated with fear. palpitations and breathlessness may also appear. may vomit or develop cold sweat. In the elderly, there may be no pain (unstable angina or heart attack)

  • sharp central chest pain that is worse for leaning forward and lying down. fever, palpitations and breathlessness are more serious features (complicated pericarditis)

  • sudden tearing chest pain with radiation to back. faintness, low blood pressure, rapid pulse may also be present (dissecting aortic aneurysm)

Weight Loss

  • a short history of thirst, weight loss and excessive urination which is rapidly progressive in severity (type 1 diabetes or poorly controlled type 2)

  • increased pigmentation of the skin, weight loss, muscle wasting, tiredness, loss of libido, low blood pressure, diarrhoea and vomiting, confusion, collapse (Addison's disease)


  • diarrhoea and vomiting associated with features of dehydration

  • projectile vomiting for more than two days (24 hours in children or elderly)

  • vomiting fresh blood or altered blood (may look like dark gravel or coffee grounds)

  • see also headache, weight loss and abdominal pain




  • very rapid pulse (over 100 beats per minute) (supraventricular tachycardia or atrial fibrillation)

  • very slow pulse (40-50 beats per minute) (complete heart block)

  • diastolic hypertension >120mmHg with symptoms including recent worsening headaches, blurred vision, chest pain (malignant hypertension)


  • bruising and non-blanching rash with severe malaise (meningococcal septicemia)

  • purpura or bruising rash (non-blanching) (bleeding disorder or vasculitis)

  • see also headache and anaemia

Bones, joints & muscles

  • suddenly the extremely pale, painful, mottled and cold limb (limb infarction)

  • prolonged pain and stiffness of the muscles of the hips and shoulders. associated with malaise and depression. May also have one-sided headaches and visual disturbances (temporal arteritis refer urgently if one-sided headache and visual disturbance)

  • pain in the calf, swollen or discoloured leg or breathlessness with chest pain or blood in the sputum (thromboembolism)

  • any sudden or gradual onset of muscle weakness that might be affecting the muscles of respiration


  • blood loss with dizziness, fainting and confusion. rapid pulse, cold & clammy extremities (shock)

  • blood loss in urine or vomit or stools or pregnancy or after childbirth or with no sign of stopping


  • severe progressive anaemia with recurrent progressive infections, bruising or bleeding (bone marrow failure)

  • see also bruising

Anxiety or agitation

  • agitation, sweating, dilated pupils, confusion and coma (hypoglycemia)

  • hallucinations, delusions, together with deteriorating self-care and personality change (schizophrenia and suicide risk if behaviour is posing a risk to themselves or others)

  • increasing agitations, grandiosity, the pressure of speech and sleeplessness with delusional thought (bipolar disorder and should be urgently referred to if the behaviour is posing a risk to themselves or others)

  • delusional or paranoid ideas after childbirth (postnatal psychosis)



As with any of the signs and symptoms above, if something doesn't feel right then trust your instinct and call for assistance. You will never regret taking that step.

  • chest infection, allergic reaction, cough

  • dehydration - dry mouth and skin, loss of skin firmness, sunken fontanel

  • febrile convulsions

  • severe diarrhoea and vomiting

  • unusual drowsiness


Did you also know we complete first aid training? We are legally required to update it every three years. At the bottom, you will find my certificate of first aid training.

In this course I learnt:

  • The breathing unresponsive casualty and the Recovery Position;

  • The non-breathing unresponsive casualty, including Resuscitation and use of an Automatic External Defibrillator (AED);

  • Bleeding control, Burns and the Management of a Shocked patient;

  • Management of the Choking patient and some common causes of Asphyxia

  • Recognition and Management of a variety of medical conditions including Fits, Seizures and Strokes.


Do you know any first aid? In case you haven't completed anything formal (which I honestly highly recommend) then here are two pointers:

1. Do you know the location of a defibrillator in Hertfordshire? You can click here and you can see where they are in your town. If someone collapses and you ring 999 the telephone operator will talk you through what you need to do before the emergency services arrive.

  • The Bull in Gosmore has just raised money to have one in their pub.

  • If you are in Letchworth Garden City there is a public one just outside the Heritage Foundation Offices on Broadway.

2. There is an app called Citizen Aid which you can download. It is a step by step guide in what to do in an emergency, for example, if someone is not breathing, or they are bleeding, or have burns.

134 views0 comments


bottom of page