@aestheticsgroup
@aestheticsjournaluk
Aesthetics
aestheticsjournal.com
ACE Group Emergency Helpline call handlers5
Sharon King, aesthetic nurse prescriber
Linda Mather, aesthetic nurse prescriber
Dr Martyn King, aesthetic practitioner
Dr Lee Walker, aesthetic practitioner
Spotlight On Emergency Helpline of the complication and the state of the practitioner. Mather has written an article on p.63 about the psychological impact of causing a serious complication on the practitioner, as well as a dissertation for her Master’s. She says often practitioners will need support through this time, which she is happy to give. King and Mather encourage members to contact their call handler again should they need any further assistance. “Sometimes the practitioner just needs to call back for advice on the best antibiotics to use in that circumstance, or skincare recommendations afterwards,” says King.
Things to bear in mind Dr Cormac Convery, aesthetic practitioner
Gillian Murray, prescribing pharmacist
Calling the helpline Practitioners need to be ACE Group members in order to access the helpline. There is one number that will call through to seven call handlers, each with significant experience in managing aesthetic complications. Mather says, “One call handler will pick up the call and will usually hear a panicked practitioner at the end of the line saying they need help. We will firstly ask them to remain calm and take a breath because we need a concise and clear story of what’s happened. It can be really traumatic for the practitioner when something like this happens, but staying calm is really important.” Mather says that the call handler will then ask the practitioner to give their name and their phone number in case the call is cut off. The practitioner should then go through what has happened in as much detail as possible. The call handler might ask when the procedure was carried out, the product used, how much, the injection technique and entry points, what concerns the patient is presenting with, what you saw and how the patient was feeling. For suspected vascular events, the call handler will also ask what the capillary refill time was before you started injecting and what it is now. Mather notes, “Don’t forget your hygiene standards in a vascular emergency. Wear gloves when you are pressing for capillary refill – I have seen numerous practitioners pressing on a patient’s newly injected lips with dirty finger nails!” King adds, “Following this, we will then ask to look at the patient via a video call through something like FaceTime or WhatsApp. The practitioner can show us
Emma Davies, aesthetic nurse prescriber
what is going on and we might ask them to send us photographs if the video quality isn’t very good. We will also ask for the patient’s name and use that while addressing them so that we can make them feel as comfortable as possible through this process.” King and Mather advise practitioners to consider image and video quality, taking note of the lighting and angles, as well as your internet connection. “Really think about the call handler trying to interpret what you are looking at to help them provide the best advice to you,” Mather says, adding, “Again, always stick to strict hygiene practices; I actually had one person take a picture of a patient sitting on the toilet, which is not ok.” The call handler will then provide advice on what the practitioner should do to manage the situation. King highlights that the advice given is always related to evidence-based medicine and the ACE Guidelines that have been collated and published,4 as well as the call handler’s own experience. “At this time, we will either leave the call and let the practitioner implement our advice, or perhaps we might stay on the call and consult with them for the whole treatment, watching while they inject the hyaluronidase, for example,” King says, adding, “Sometimes it’s a matter of advising them to refer on to a specialist, such as an ophthalmologist for visual impairment or a plastic surgeon for wound management, as has happened in one particular case, or perhaps it’s just a bruise; in which case, we are no longer needed.”
Following the call
King and Mather encourage practitioners to ring during normal business hours if possible; however, they acknowledge that they have taken calls outside of this for genuine emergencies. Callers should be respectful of the call handler, and know that any breaches of professional standards could result in the call handler reporting them to the practitioner’s professional body. Patient consent must be obtained before sharing the patient’s information with the ACE Group. For example, Mather says, “My paperwork says that the patient consents to having their photos taken and stored safely, as well as that I may need to share the photos in the case of an emergency with a third party, so it should be in writing before the complication occurs.” Data sent electronically must also adhere to GDPR.2
Complication education King and Mather both say that if practitioners are treating patients, it’s not a matter of ‘if’ they will cause a complication one day, but ‘when’ and they need to be ready and prepared for this possible eventuality. In the ideal world, they say that practitioners would be so educated and prepared that there would be no need for the Emergency Helpline. However, even the best practitioners may seek guidance from their peers and the helpline is there to help direct practitioners to use the appropriate pathways. REFERENCES 1. Aesthetics journal, ACE Group launches emergency helpline, December 2018. <https://aestheticsjournal.com/news/ ace-group-launches-emergency-helpline> 2. ACE Group Emergency Helpline Policy. <https://acegroup. online/policies/emergency-helpline-policy/> 3. News Special: Lip Filler Complications, Aesthetics January 2019, News Special: Lip Filler Complications <https://aestheticsjournal. com/feature/news-special-lip-filler-complications> 4. ACE Group Publications <https://aestheticsjournal.com/feature/ news-special-lip-filler-complications> 5. ACE Group board member profiles <https://acegroup.online/ about/>
Usually the call handler will follow up with the practitioner, depending on the severity Aesthetics | June 2020
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