While aesthetics is a relatively low risk branch of medicine, it is important to have a clinic protocol in place in the unlikely event of a medical emergency.
In this day and age there seems to be an injectables clinic on every corner and in every shopping mall. It’s easy to lose sight of the fact that these treatments are medical procedures and should be performed in medical spaces, by medical professionals. As such professionals, we have a responsibility to our patients to ensure we have a protocol in place in the event a ‘Medical Emergency’ does occur. As ‘Medical Professionals’ we must be able to immediately institute what can be simple, but life saving interventions.
Yes, it may be more than a few years since we were at medical school or nursing school, but we should be able to draw on the basic life saving skills that we learnt there, as well as follow a straightforward protocol that has been put in place well in advance of any such occurrence.
So, what are the simple medical emergencies that we should be prepared for – and be able to handle in our cosmetic practices? This is my list of the most common occurrences:
1. Anaphylaxis
2. Asthma
3. Cardiac arrest
4. Epileptic seizure
5. Hypoglycaemia
6. Stroke
7. Syncope
8. Simple eye injuries
The next question to ask ourselves is what do I need to deal with these emergencies? I have divided the list into three broad categories: equipment, drugs and knowledge. The equipment every clinic should have includes a basic kit which contains: a stethoscope, a 1L bag of normal saline, a volumatic spacer and a blood pressure machine. For those clinics wanting a more advanced kit, you could add a bag valve mask, a selection of airway adjuncts (oropharyngeal, nasopharyngeal airways), an oxygen cylinder, a pulse oximeter, the ability to obtain IV access, a blood glucose monitor and an automated de brillation device. It is worth the expense to have these basic items on hand.
When it comes to drugs, all doctors have access to the PBS government funded ‘doctors bag’ prescription, where they can obtain for free an extensive list of emergency drugs. I would suggest each clinic stocking at the very least: adrenaline, aspirin, glucagon, glyceryl trinitrate, midazolam and a short acting beta agonist such as salbutamol.
Armed with these drugs and the basic medical equipment listed above, plus the knowledge of basic life support procedures, a couple of airway manoeuvres along with knowing how to place someone in the recovery position, we are ready to save lives and avert the emergency.
Obviously, I am not suggesting you manage the whole case on your own in your clinic; but to initiate life saving treatment while you wait for the ambulance to arrive will save precious time – and possibly loss of life.
As an Emergency Physician and a Cosmetic Physician I have developed a course, in association with Monash University, The Alfred Emergency and Trauma Center, and the Dermatology Institute of Victoria so that we can refresh our core medical knowledge with regards to common medical emergencies, allowing us to create a safer medical space in which we practice our craft.
The next course will be held Monday 7th October and you can register here. AMP
