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Risks of acupuncture range from stray needles to pneumothorax, finds study

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e6060 (Published 07 September 2012) Cite this as: BMJ 2012;345:e6060
  1. Zosia Kmietowicz
  1. 1London

About 100 patients a year in England and Wales experience adverse events after acupuncture delivered by the NHS, ranging from having needles left on their body to pneumothorax, a study has found.1

Although most incidents aren’t harmful, it is likely that the total figure is an underestimate because of under-reporting, say the researchers. They recommend a number of practices that can improve the safety of acupuncture.

The researchers searched the database of the national reporting and learning system run by the National Patient Safety Agency for adverse events after acupuncture reported between January 2009 and December 2011. They found 325 incidents that met their inclusion criteria. The most common incident was retained needles (100 incidents), followed by dizziness (99), loss of consciousness or unresponsiveness (63), falls (12), bruising or soreness (7), and pneumothorax (5). There were 39 “other” incidents.

The incidents where needles were retained included 59 cases where patients found needles on their way home and 41 where patients were treated for longer than planned. In some cases patients were left with needles in place while staff went on their lunch break or even went home. In one case a patient was found with needles in place more than 30 minutes after staff had left the department at the end of the day.

Whoever reports safety incidents must classify them according to the level of harm they cause. Most incidents (310 (95%)) that resulted from acupuncture were classified as no or low harm, 14 (4%) as moderate harm, and one case of pneumothorax as severe. But the harm may have been overstated or understated, say the researchers. Although 29 patients needed to be assessed by ambulance crews, only one incident was classified as causing severe harm.

Edzard Ernst, emeritus professor at the University of Exeter and one of the authors, said, “The investigation shows for the first time that acupuncture, as employed within the NHS, is not devoid of risks. The adverse events disclosed in this study tend to be mild and rare, but there is good reason to suspect that, due to under-reporting, the real size of the problem is substantially larger.”

Practitioners of acupuncture and clinic managers can ensure safer delivery of the treatment by, among other things, ensuring that emergency procedures are available, maintaining equipment, timing the length of treatment, and counting needles in and out, recommend the researchers.

Notes

Cite this as: BMJ 2012;345:e6060

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