#5 Monitor compliance
Implement and monitor compliance of the practice’s policies and procedures to mitigate hazards.
Practices that use lasers, intense pulsed light and radiofrequency devices need to determine that their policies and procedures not only reflect national consensus and evidence based practices (ANSI) but also state regulations and manufacturer procedural recommendations found in device manuals, Owens says.
Policies and procedures need to address direct laser beam hazards, such as ocular injuries and skin burns, along with non-beam hazards, which include laser-generated smoke/plume, electrical and fire hazards according to Owens.
Compliance includes having the appropriate signage on doors; taking steps to keep potential dangers within the treatment area; and using appropriate protective measures, including eye protection.
“There are some lasers that can create superficial tissue injuries, only, like the carbon dioxide or erbium lasers-utilized for facial resurfacing. With accidental ocular exposure, they can cause corneal damage or burns to the patient,” Owens says. “However, other visible or invisible laser wavelengths, which represent the majority of lasers utilized in cosmetic dermatology, can transmit to the retinal tissue in back of the eye with the sequelae of temporary or permanent eye damage—even blindness.”
Ocular safety measures include designated laser safety eyewear that correlates to the appropriate laser wavelength and optical density for awake patients and staff. Occlusive laser eyewear needs to be applied for procedures performed on the face.
Protective eyewear for laser treatment on the eyelids and peripheral ocular adnexa should never be performed without metal corneal scleral shields. Eye protection for radiofrequency electrical energy-based devices, on the other hand, should always be plastic per manufacturer’s recommendations, according to Owens.