As consumer demand for non-invasive aesthetic procedures rises across the country, the number of complications is also growing at an alarming rate. During 2022, Save Face, a UK register of accredited cosmetic practitioners, received a shocking 2,824 complaints relating to dermal fillers and Botox treatments. This is a significant increase from 2,436 in 2021 and 2,083 in 2020. 

While the rise of complications is due to unqualified ‘professionals’ administering aesthetic procedures, complications can still occur regardless of an aesthetician’s experience. In an industry where higher standards and stricter regulations are desperately needed, it’s imperative for clinics to establish effective emergency protocols to keep patients safe.

Types of Emergencies in Aesthetic Medicine

Aesthetic procedure complications can range from minor and transient to severe and potentially life-threatening. Whatever the severity, emergency protocols in aesthetics are vital to ensure patient safety in aesthetic procedures. Some of the most common aesthetic medicine emergencies include infections, allergic reactions, nodules, syncope, and vascular occlusion. 

Clinics should have strict safety protocols in place for every potential complication, especially those that are more serious. For example, one of the most severe complications includes vascular occlusion (VO), which refers to a blockage in the blood vessels. This is a very serious condition that requires immediate medical treatment. Left untreated, VO can cause cell and tissue death (necrosis), organ damage/failure, visual loss, heart attack, stroke, and in some cases, death. 

In some cases, it may be possible to resolve VO with conservative measures, such as massage, tapping or applying heat to the treated area. If this fails, however, hyaluronidase injections should be administered repeatedly, usually every 15-20 minutes until the issue is resolved. For rarer complications caused by VO such as sudden visual loss, practitioners should organise an immediate transfer to an appropriate medical unit.

Developing Emergency Protocols

Developing emergency protocols will equip practitioners with the knowledge required for handling emergencies in aesthetic clinics. Practitioners should familiarise themselves with protocols covering every potential complication, including anaphylaxis, visual loss, vascular occlusion, and other acute reactions like infections or allergic responses. These protocols are outlined by reliable industry bodies, such as the Aesthetic Complications Expert Group (ACE Group) and Complications in Medical Aesthetic Collaborative (CMAC). 

To ensure emergency preparedness in cosmetic clinics, robust protocols should outline clear instructions around identifying, assessing, and managing complications. These guidelines should also clearly state the roles and responsibilities of clinic staff.

Key considerations of an emergency protocol may include keeping:

Up-to-date and easily accessible emergency contact information

In the event of a serious complication where a transfer or additional medical help is required, it’s important to make sure emergency contact information is up-to-date and easily accessible. This includes contact information for emergency medical services, nearby hospitals, and specialist providers who can assist with complication management.

Well-organised emergency equipment

Ensure that the clinic has a well-organised stock of essential medical supplies and equipment, such as epinephrine auto-injectors, oxygen therapy devices, and emergency medications. Each emergency kit should include a detailed list of contents with expiry dates attached. Clinic owners should check these kits monthly, to ensure all items are within their expiry dates and keep an eye on stock. 

In the event of a medical emergency, it’s best practice to keep both digital and printed copies of the protocols readily available in the clinic. Establishing a referral process for urgent situations is also vital for ensuring patient safety. Most importantly, safety protocols should be reviewed and updated annually to ensure they remain current and effective.

Training and Drills

Training for aesthetic emergencies and implementing drills is one of the most crucial factors in crisis management. Not only will this build confidence and competence, but it will also enable practitioners to handle emergencies swiftly and effectively. 

Clinic owners should organise regular training sessions and simulations that cover a wide range of scenarios to ensure every complication is covered. Both online and in-person training is required to ensure clinic staff understand how to recognise and respond to aesthetic complications. 

Practitioners should also consider enrolling in specialised courses and training programmes to help them better manage complications and keep up-to-date with the latest safety protocols in cosmetic surgery. 

Communication During Emergencies

Safety protocols in cosmetic surgery should also cover patient communication. From a patient’s perspective, experiencing a complication can be distressing, to say the least. This is why clear and effective communication with both the wider clinician team and the patient is vital. 

When a complication arises, using too much medical jargon can overwhelm the patient, so make sure you’re explaining the situation in a clear and calm manner. Explain the next steps and course of action clearly and concisely to put the patient at ease and alleviate any anxiety they may be feeling. 

Rather than making any immediate decisions, practitioners should consult with colleagues and external specialists to decide the best course of action. Making your colleagues aware of the situation will also ensure there are other professionals ready to support and provide assistance should the situation escalate. 

Legal and Ethical Considerations

Crisis management in aesthetics requires both clinic owners and aesthetic practitioners to follow the legal standards of care. This involves obtaining informed consent from the patient, maintaining patient confidentiality, keeping comprehensive documentation of the situation, and reporting incidents to the relevant authorities. 

Having well-prepared emergency protocols and keeping accurate written records can protect you and your patients legally and ethically. For example, if legal action were taken against you or the practice, having robust protocols in place would help prevent any dispute about what may or may not have happened in the emergency situation. Plus, these protocols play a crucial role in prioritising patient safety in all aesthetic procedures undertaken in the clinic. 

Equipment and Supplies

As mentioned above, having a well-equipped, organised and up-to-date emergency medical kit is essential. Conduct regular checks to ensure all the essential equipment is included, such as epinephrine auto-injectors, oxygen, first aid kits, and emergency medications. These checks also help to ensure supplies are up-to-date, functional, and readily available. 

Example Emergency

If a patient were to experience vascular occlusion, having a robust protocol in place for this particular scenario can help minimise the risks and save lives. While rare, VO can result in loss of vision, heart attack, stroke, and even death. This is why having easily accessible and comprehensive emergency protocols tailored to different scenarios is critical.  

FAQs

What are emergency protocols in aesthetic medicine?

This is a comprehensive plan containing instructions to be followed in the event of an emergency related to aesthetic procedures, such as dermal fillers or botox. 

What is an aesthetic emergency kit used for?

An emergency medical kit contains essential medicines and medical items to deal with complications from common aesthetic procedures.

What are complications in aesthetics?

Complications in aesthetic medicine can vary from mild and common to rare and severe. For example, some of the most common complications in dermal filler treatments include bruising, tenderness, and redness while other more serious complications can include infections and necrosis (tissue death).

Keeping your clinic emergency-ready

Having comprehensive emergency protocols in place is essential to ensuring aesthetic procedure safety. As a clinic owner, it’s your responsibility to ensure all staff are equipped to handle any aesthetic emergency. As such, make sure you’re regularly reviewing and updating the clinic’s emergency protocols and providing ongoing complications training to enhance preparedness and safety.