Complication management for non-surgical cosmetic procedures

This standard coexists alongside, SKANSC1 Implement and maintain safe and hygienic effective working practices during elective non-surgical cosmetic procedures SKANSC2: Consult, assess, plan and prepare for elective non-surgical cosmetic procedures and all treatments in the non-surgical cosmetic procedures suite. This standard is for aesthetic practitioners to manage non-surgical procedure complications.  You will also be required to do a post procedure evaluation and reflection for continuous improvement. Users of this standard will need to ensure that their practices reflect up-to-date information, policies, procedures, regulations and manufacturer instructions. You will need to identify, assess and implement control methods in relation to yourself, the working environment including tools, equipment and products, the individual and area to be treated, prior to the non-surgical cosmetic procedure being performed. The aesthetic practitioner must have a First Aid at Work qualification or equivalent and be able to carry out the functions within SFHCHS36: Provide Basic life support and have access to life support equipment as identified in the complication management and/or emergency plan.

1. ensure there are protocols in place to deal with the range of emergencies/complications
2. check the suitability and effectiveness of systems and protocols required to prevent and deal with emergencies associated with non-surgical cosmetic procedures
3. analyse the need for methods of monitoring post non surgical cosmetic procedures communication and providing post instructions to individuals

4. Identify signs and symptoms of the potential risks and complications with non-surgical cosmetic procedures and refer to the emergency plan including:-

   • 4.1 undertake observations, physical examinations and oral questioning to complete an assessment to determine a potential complication.
   • 4.2 categorise risk in order to select appropriate risk management protocols.

5. manage the risks and complications associated with non-surgical cosmetic procedures including:-

   • 5.1 analyse the options available in the event of an adverse reaction post non-surgical cosmetic procedure
   • 5.2 recommend strategies for dealing with common side effects of non-surgical cosmetic procedures

6. manage emergencies when carrying out a non-surgical cosmetic procedure

7. ensure continuous monitoring of the individual during and immediately after the non-surgical cosmetic procedure.
8. complete the individual's non-surgical cosmetic procedure records and store in accordance with data legislation

9. in the event of an adverse reaction or incident, take prompt corrective action as set out within the emergency plan to include:

   • 9.1 seek and implement immediate medical intervention from the identified healthcare professional trained to deal with complications as set out in the emergency plan

10. Report and record using the agreed reporting systems/mechanisms

11. review risks and complications protocols and documentation through reflective practice and audit
12. Provide all relevant information and instructions when handing over care to another professional

1. anatomy and physiology relevant to this standard
2. signs and symptoms of short-term, medium-term and long-term complications arising from non-surgical cosmetic procedures
3. the types of complications that may arise and the action to take
4. The range of healthcare professionals available and the complications they are trained to deal with
5. how to reduce risk and complications associated with non-surgical cosmetic procedures through individual selection and assessment through consultation, assessment and medical history
6. safe working practices to limit risk
7. prescribed and non-prescribed drug, herbal and supplement interactions with cosmetic treatments and emergency medications
8. pre-existing medical (physical, social and mental health) conditions that could increase risk and complications and affect administration of emergency medications and interventions
9. information and aftercare advice constructed to minimise risk and complications
10. how to manage the risks and complications associated with non-surgical cosmetic procedures
11. why you must comply with ethical practice and work within the health and safety responsibilities in line with legislation
12. the importance of collaboration with competent professionals to support effective and safe working practices
13. how to manage emergencies when performing non-surgical cosmetic procedures
14. the protocols and action to take in the event of a medical emergency that presents a risk to life.
15. the protocols and action to take in the event of a medical emergency that does not present a risk to life
16. the importance of obtaining and following instructions from the identified healthcare professional in the event of an adverse reaction
17. the importance of referring and reporting the complication to a healthcare professional, supplier and manufacturer
18. how and when to seek further advice and support outside the practitioner's remit
19. the importance of discussing, reflecting, evaluating and recording the outcomes with the regulated healthcare professional to inform further action and future procedures
20. your responsibility and the reporting procedures for suspected malpractice
21. the importance of adhering to the emergency plan in the event of an adverse reaction
22. the legislative, insurance and organisational requirements for taking and storing visual media of the individual's treatment area
23. the legislative and regulatory requirements of completing and storing the individual's non-surgical cosmetic procedure records
24. the systems and processes that support quality assurance and non-surgical cosmetic procedure improvements
25. the importance of monitoring the health and wellbeing of the individual

Risks and complications
Immediate medical intervention requiring urgent attention

1. Anaphylaxis – severe allergic reaction – acute systemic toxicity
2. Vascular occlusion/Compression occlusion
3. Severe unremitting pain
4. Difficulty speaking or swallowing
5. Respiratory distress
6. Arterial puncture
7. Severe abnormal Oedema/swelling
8. Severe burn
9. Severe cuts
10. Severe infection - systemic/topical
11. Severe Haematoma
12. Migraine/severe headache
13. Severe Nausea/sickness
14. Necrosis
15. Compromised capillary refill
16. Blindness - Bi lateral and unilateral
17. Immediate and delayed visual disturbances/double vision
18. Vasovagal response
19. Severe injury to eyes

Immediate intervention
20. Mild bleeding
21. Moderate to mild swelling
22. Moderate to mild allergic reactions
23. Moderate to mild burn
24. Moderate to mild Infection
25. Abscess formation
26. Cuts and abrasions
27. Delayed wound healing response
28. Onset delayed auto immune
29. Inflammation
30. Hives
31. Nerve damage
32. Hypersensitivity
33. Headache
34. Biofilm formation
35. Mild feeling of nausea
36. Flu-like symptoms or respiratory infection
37. Erythema/irritation/tenderness of tissues
38. Dry eyes/mouth
39. Temporary and moderate symptoms or impairment to periocular or perioral areas
40. Changes in skin texture/appearance in adjacent areas
41. Pruritus - Mild itchy skin
42. Needle stick injuries

Cosmetic Complications Requiring Action
43. Sub-optimal cosmetic outcome/Asymmetry
44. Contour irregularities
45. Worsening of cosmetic appearance
46. Non-responder /short lived duration
47. Migration of product
48. Scarring
49. Bruising - Transitory or definite
50. Prolonged/chronic oedema
51. Nodule/ Granuloma formation
52. Tyndall effect - Dyspigmentation
53. Hyper/hypo pigmentation
54. Telangiectasia/neovascularisation
55. Transitory or definite change of skin colour – hemosiderin
56. Transitory or definite skin textural changes
57. Transitory or definite formation of skin disorder
58. Muscle atrophy
59. Petechiae - Small blood blisters
 
Instructions

1. the individual and aesthetic practitioner's legal rights and responsibilities
2. immediate and ongoing support and advice
3. complication management and/or emergency plan
4. post procedure expectations and associated time frames
5. pre and post procedure instructions and care
6. restrictions and associated risks
7. future procedures
8. complaints procedure or concerns protocol

Adverse reaction
An adverse reaction is an 'unexpected' reaction or outcome following a service, i.e. fainting
Contra action
A contra-action is an 'expected' reaction or outcome following a service, i.e. erythema
Emergency plan
An emergency plan is a structured set of procedures and guidelines designed to be implemented in response to unexpected and potentially dangerous situations or events. The primary purpose of an emergency plan is to ensure the safety and well-being of individuals.
Evidence-based practice
Evidence-based practice is based on the best available, current, valid and relevant evidence.
First aid
First aid can refer to first aid at work qualifications or equivalent and first aid mental health awareness.
Infection Prevention and control measures
Refers to evidence-based practices and procedures that, when applied consistently in treatment settings, can prevent or reduce the risk of transmission of microorganisms
Microbial contamination
Microbiological contamination refers to the presence of unwanted microbes such as bacteria, fungi, viruses and spores.
Protocol
A protocol is a standard procedure to ensure best practice and compliance when providing services, i.e. follow manufacturer's instructions.
Risks and complications
An unanticipated problem that arises following, and is a result of, a procedure or treatment.
Universal precautions and standard precautions
Universal precautions are relevant if the practitioner is exposed to blood and/or some bodily fluid. It is the responsibility of the practitioner to implement infection prevention and control measures to prevent exposure to blood borne pathogens or Other Potentially Infectious Materials (OPIM). Standard precautions are the basic level of infection control that should be used at all times within the working environment, such as hand hygiene, personal protective equipment, prevention of needle stick and injuries from sharps, risk assessment, respiratory hygiene and cough etiquette, environmental cleaning and waste disposal.

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