Journal of Clinical and Aesthetic Dermatology

APR 2018

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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61 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY April 2018 • Volume 11 • Number 4 T H E E M E R G E N C Y K I T A n A e s t h e t i c Co m p l i ca t i o n s E x p e r t G ro u p Co n s e n s u s Pa p e r W elcome to the JCAD Aesthetic Complications Guidelines by The Aesthetic Complications Expert (ACE) Group. The ACE Group developed a series of evidence-based, peer-reviewed guidelines that cover complications that can occur in nonsurgical aesthetic practices. The objective of this series is to help dermatologists and other physicians performing aesthetic procedures identify and manage these potential complications. Each guideline was been produced after a vast literature review by leading experts in the United Kingdom. We hope these guidelines help raise standards within the medical industry and ensure early diagnosis and appropriate management of complications, ultimately improving outcomes for our patients. This month's guideline: ACE emergency kit v1.2 by Martyn King, MD JCAD A E S T H E T I C CO M P L I C AT I O N S G U I D E L I N E S INTRODUC TION Just like any other area of medicine, aesthetic practice requires a set of skills and resources to first identify and then manage potential complications. The Aesthetic Complications Expert (ACE) Group has produced a series of guidelines on how to manage some of the most common, as well as the most serious, problems that might occur, all of which are academic if you do not have the right tools at your disposal. BACKGROUND An emergency kit is essential for anyone performing aesthetic treatments as in the event of a medical emergency, there is not enough time to prescribe and order the drugs required to treat it. Although this is not a problem for doctors and dentists, this is an obstacle to nurses performing aesthetic treatments who are not able to hold stock drugs. The British Association of Cosmetic Nurses are currently lobbying to have this restriction removed to allow safer practice; however, in the meantime, nurses only have the option of prescribing these drugs on a named patient basis or working in collaboration with a doctor or dentist who can hold these medicines as stock drugs. The basic emergency kit should contain the items listed in Table 1. According to Regulation 238 of the Human Medicine Regulations 2012, anybody can inject adrenaline and other drugs listed in Schedule 19 of the Regulations for the purpose of saving a life without breaking any laws; however, this does not get around the issue of how to obtain these drugs in the first place. In the future, the ACE Group would like to facilitate a register of clinics who stock emergency drugs that may be accessed in the case of an emergency by nurses who are unable to stock these drugs. We'd also like to facilitate a register of experienced practitioners who might be able to give advice to others when diagnosis or treatment decisions are in doubt. TABLE 1. Aesthetic Complications Group emergency kit Adrenaline 1:1000 1mL 2 ampules Hyaluronidase 1500 units 2 ampules Water For Injection 10mL 2 ampules Aspirin 75mg 4 Topical Glyceryl Trinitrate 30g Normal Saline Steripod Eye Wash 2 x 10mL Resuscitation Mask Adult x 1 2ml Luer-lok Syringe 2 10ml Luer-lok Syringe 2 1ml Graduated Syringe 3 23G Blue Needles (25-30mm) 4 27G Grey Needles 2 30G Yellow Needles 2

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