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Safety Protocols

Here are a number of useful safety protocols for plastic surgeons, from the ASAPS Patient Safety Committee.  Reproduced with the kind permission of Lorne Rosenfield, MD, Chair, ASAPS Patient Safety Committee.

Preoperative Decolonization Protocol
Plastic surgeons should adopt active MRSA surveillance and actively implement proven methods of preventing post-op MRSA infections.  In addition to basic hand washing and standard infection control precautions, routine use of chlorhexidine showers and topical mupirocin are effective tools for MRSA decolonization and preventing post-op MRSA infections.
author: Lorne Rosenfield, MD

Managing the Chronic Pain Cosmetic Patient & Prevention of Opioid Overdosing
Every aesthetic surgeon will eventually be faced with a chronic pain patient on opioids. Managing these patients is different from one’s regular cosmetic patient. These patients present with a unique set of risk factors that can be safely maneuvered.
authors: Gary Culbertson, MD, Lorne Rosenfield, MD

LipidRescue™ – Treatment Algorithm For Local Anesthetic Systemic Toxicity (L.A.S.T.)
Local Anesthetic Systemic Toxicity (L.A.S.T.) can occur with any local/regional anesthetic nerve blocks, with the most common causative agent being Marcaine™ (bupivacaine). Both dosing errors and inadvertent intravascular injection can lead to L.A.S.T and cardiac emergencies. The method of LipidRescue™ has been proven effective as an “antidote.”
author: Sam M Sukkar, MD

“Common Sense” Guide for Venous Thromboembolism Prophylaxis in Aesthetic Plastic Surgery
Even though physicians are well aware of VTE, cases are still common after surgeries. The inclusion of all categories of plastic surgeries in scientific research doesn’t differentiate the risk factors. The use of a “Common Sense” system to evaluate the risk of the aesthetic patient separates the risk factors into three groups, signaling each group with a color indicating the attention level that should be given for each risk factor.
author: Jaime Anger, MD, Lorne Rosenfield, MD

Filler Crash Kit
Complications from facial fillers include changes in vision, signs of stroke & soft tissue loss. The issue of filler embolization causing circulatory compromise fortunately is rare & can be a preventable event. Livedo Retcularis can be treated if done expeditiously.
author: James Fernau, MD

Benzodiazepine and Opioid Rescue
In the case of benzodiazepine or opioid overdose with an unresponsive patient and/or patient respiratory depression, immediately follow this rescue protocol.
author: James Fernau, MD