Every day, your staff and patients walk in and out of your medical facility expecting to never be in harm's way in respect to their personal safety. As a medical practitioner or provider of medical services, you probably feel the same way. In a recent edition of Modern Aesthetics®, Jay Shorr and Mara Shorr reviewed eight steps to take in your practice to help ensure proper safety measures are in place.

1. Create proper traffic signage in your parking lot to ensure proper flow and direction. Make sure each individual space is large enough for various size vehicles to park to minimize physical damage to patient's vehicles and visibility to oncoming vehicles. Eliminate and remove blind obstacles which may impair one's ability to see oncoming traffic.

2. If your facility has an entranceway that is subjected to inclement weather, have the ground and stairs coated with paint that has a sand base, or have strips of sandpaper on the steps to prevent a slip, trip, or fall.

3. Make sure your stairways and corners of your parking are well lit. You might even consider security cameras in your entrance/exit and corners of your building for internal security measures. Also remember to change the settings of your exterior lighting when daylight savings time is over.

4. Install well lit and identifiable exit signs at each exit and turn in your hallway with arrows pointing to the nearest exit. Test on a regular basis to ensure batteries in the signs are properly charged.

5. Install emergency lights (dual spot lights) that will come on when the power fails. Test regularly and mark the date on the battery. These batteries are inexpensive and should be changed on an annual or semi-annual basis. Do not wait for them to fail. It may just be too late at that point.

6. Similar to your home, change the batteries twice a year in your smoke alarms (the beginning and end of daylight savings time).

7. If you have outlets that have broken or missing covers, replace them. If a power cord is frayed, do not tape them but replace them. Remember that an exposed wire is still full of current no matter how low the voltage is.

8. Make safety everyone's responsibility and when any potential hazard is seen, remove it immediately. Clean up any/all debris in any area when it is first noticed to prevent the hazard.

For the full article, read “Safety in the Medical Workplace,” by Jay A. Shorr BA, MBM-C, MAACS-AH, CAC I-V, III, which ran in the July/August 2014 issue of Modern Aesthetics® magazine. Visit www.modernaesthetics.com to read the full article. Jay Shorr is the founder and managing partner of The Best Medical Business Solutions. He can be reached at info@thebestmbs.com

Injectable Anatomy: How to Avoid Complications when Injecting

Susan Weinkle, MD, FAAD discussed the importance of injectable anatomy in a recent DermTube.com interview. Beyond just understanding facial anatomy, understanding how deep and at what angle to inject in various areas of the face is vital to avoiding serious complications.

“I've been injecting fillers since 1980 when collagen was developed, but now we're injecting fillers in far difffernt planes than we ever did. We used to just efface fine lines, superficial injections, but now we're going deeply—deep into the temple, the forehead. And understanding the depth of the important vessels is important to avoid catastrophic events,” says Dr. Weinkle

Watch the full video at dermtube.com. Search Key: Injectable Anatomy

What To Do When a Patient Posts a Negative Online Review

Alex Thiersch, JD spoke at the recent NewDerm Live meeting, which was held in September at the
W Hollywood, CA, and offered suggestions to help physicians assure they don't run afoul of the law.

“A doctor's main kind of visceral response to a negative review on Yelp is to respond to that patient and to let the online world know that this was a mistake or this doesn't truly reflect their practice. Unfortunately, many lawyers interpret HIPAA and other patient privacy laws as preventing a doctor from responding in anyway to any type of patient who posts something online. So doctors have to be very, very careful when they engage or they respond to patients online because what you're essentially doing is you are acknowledging that that patient treated at your facility, which can be a breach of patient privacy,” cautions Mr. Thiersch.

For more, visit www.newdermmd.com.

Avoiding HA Filler Complications

Although there are several case reports of facial skin ischemia/necrosis caused by hyaluronic acid filler injections, researchers noted that no systematic study of the clinical outcomes of a series of cases with this complication has been reported. A recent study looked at 20 consecutive patients who developed impending nasal skin necrosis as a primary concern, after nose and/or nasolabial fold augmentation with hyaluronic acid fillers. Researchers retrospectively reviewed the clinical outcomes and the risk factors for this complication using case-control analysis. Seven patients (35 percent) developed full skin necrosis, and 13 patients (65 percent) recovered fully after combination treatment with hyaluronidase.

Although the two groups had similar age, sex, filler injection sites, and treatment for the complication, 85 percent of the patients in the full skin necrosis group were late presenters who did not receive the combination treatment with hyaluronidase within two days after the vascular complication first appeared. Fifteen percent of the patients in the full recovery group were late presenters. The author concluded that the key for preventing the skin ischemia from progressing to necrosis is to identify and treat the ischemia as early as possible and that early (<2 days) combination treatment with hyaluronidase is associated with the full resolution of the complication.

Plast Reconstr Surg. 2015 Oct;136(4):434e-41e.