Archive for April, 2020
Please note that this BMLA advice and guidance is produced for practitioners undertaking elective laser procedures. As this is a fluid situation, the guidance may change in the next few days. These guidelines have been adapted from the British Association of Dermatologists, British Association of Dermatologic Surgeons and British Association of Maxillofacial Surgeon’s guidance.
Most laser procedures are classed as routine or elective procedures. Whilst these won’t be classed as frontline or essential procedures, patient and staff safety is paramount when such procedures are undertaken.
The BMLA recommends that the following guidance is implemented:
- Consider cancelling all elective laser procedures.
- Practitioners undertaking laser procedures during the COVID-19 pandemic should clearly state why the procedure could not be deferred and clinical need for the laser procedure.
- Current government recommendations state that all non-essential travel and contact should be avoided. As such, routine maintenance of equipment and visits from laser protection advisors should be avoided unless absolutely necessary. This decision should be informed by a risk assessment with all other possibilities, such as video conferencing and deferral of equipment use, being eliminated.
Personal Protective Equipment – PPE
- The limited supplies of PPE mean that any patient who does not need to come to hospital or clinic should not.
- All patients should be treated as potentially COVID-19 positive.
- Most laser procedures are aerosol-generating. Laser plume may contain carcinogens, bioaerosols, viruses, blood fragments, and bacteria depending on the type of the procedure. They also contain carbon monoxide, polyaromatic hydrocarbons, and various toxic gases and vapours. Plumes may contain chemicals such as formaldehyde, hydrogen cyanide, acrolein, and benzene.
- For all laser procedures deem to be producing laser plume, FFP3 masks, eye screens, full sleeve, disposable fluid-repellent surgical gowns and gloves should be worn by all practitioners present during the procedure.
- Smoke extractor systems, in addition to laser masks, are the most effective way to minimise risk, as standard surgical masks alone are not sufficient to act as the primary method of particle filtration.
- Only the absolute minimum number of healthcare professionals required for the procedure should be present.
- For high-risk or known COVID-19 patients or invasive procedures, NHS England guidelines should be followed and where possible, laser procedures should be abandoned or postponed.
- This will remain the case until the current trajectory of COVID-19 has flattened.