Emergency Response and Anaphylaxis Protocol

The Emergency Response and Anaphylaxis Protocol at California Hair and Skin Institute applies to all physicians, nurses, technicians, medical assistants, and administrative personnel.

Emergency Response Team

The Medical Director provides clinical leadership. Clinical staff are responsible for emergency recognition, medication preparation, patient monitoring, and documentation. Administrative staff activate EMS, direct responders, notify emergency contacts, and assist with documentation.

Emergency Equipment Requirements

The emergency cart contains airway equipment, oxygen delivery systems, suction equipment, blood pressure monitor, pulse oximeter, glucometer, emergency medications, IV supplies, and lipid emulsion for treatment of local anesthetic systemic toxicity.

Emergency Cart Inspection

Emergency carts are inspected monthly and after each use. Documentation includes medication expiration dates, oxygen levels, equipment functionality, and inventory status.

Anaphylaxis Protocol

Recognize urticaria, facial swelling, tongue swelling, wheezing, hypotension, dizziness, and respiratory distress. Stop the procedure, activate emergency response, call 911, administer oxygen, monitor vital signs, and administer epinephrine according to accepted medical standards. Additional medications may include antihistamines, corticosteroids, and bronchodilators as clinically indicated.

Vasovagal Syncope Protocol

Recognize lightheadedness, nausea, diaphoresis, pallor, bradycardia, and brief loss of consciousness. Stop the procedure, place the patient supine with legs elevated, monitor vital signs, and activate EMS if symptoms persist.

Local Anesthetic Systemic Toxicity Protocol

Recognize tinnitus, metallic taste, circumoral numbness, confusion, seizures, arrhythmias, or cardiovascular collapse. Stop anesthetic administration, activate EMS, maintain airway support, administer oxygen, and initiate lipid emulsion therapy according to accepted guidelines.

Cardiac Emergency Protocol

For chest pain, shortness of breath, syncope, or suspected myocardial infarction, activate EMS immediately, administer oxygen, monitor vital signs, and provide aspirin when clinically appropriate.

Hypoglycemia Protocol

Treat conscious patients with oral glucose. Unconscious patients require EMS activation and advanced medical evaluation.

Seizure Protocol

Protect the patient from injury, maintain airway safety, avoid restraint, monitor vital signs, and activate EMS for prolonged or recurrent seizures.

EMS Activation Procedures

Call 911 for anaphylaxis, myocardial infarction, stroke symptoms, respiratory distress, seizures, loss of consciousness, local anesthetic systemic toxicity, or any unstable patient. Provide clinic location, patient condition, interventions performed, and callback information.

Staff Training Requirements

All clinical personnel maintain current BLS certification and complete annual emergency response, bloodborne pathogen, and anaphylaxis training. ACLS certification is recommended for providers.

Incident Reporting

All emergencies are documented including event description, staff involved, medications administered, vital signs, EMS involvement, and patient outcome.

Quality Assurance Review

All emergency events undergo Medical Director review including root cause analysis, staff performance evaluation, equipment review, documentation review, and corrective action planning.

Quality Metrics

Track emergency response times, crash cart readiness, medication availability, training compliance, incident frequency, and equipment inspection compliance.