Safety protocols for Gua sha (press-stroking) and Baguan (cupping)

Gua sha (press-stroking) and Baguan (cupping) are therapeutic procedures of traditional East Asian medicine (TEAM) that are also practiced in integrative clinical as well as domestic or familial settings. They may be defined as instrument assisted mechanical stimulation of the body surface that intentionally creates therapeutic petechiae and ecchymosis representing extravasation of blood in the subcutis. Blood and 'other potentially infectious material' (OPIM) can sometimes be drawn through the surface of the skin leading to potential contamination of instruments and to risk of bloodborne pathogen exposure. Neither the literature nor the current national standards of the acupuncture profession sufficiently address safety standards for Gua sha and Baguan. This paper presents the nature of the potential risks and applies current hospital safety standards as proposed protocols for Gua sha and Baguan.