While the chances of it happening are slim, a laceration, physical trauma, or complication from a past cosmetic surgery procedure can happen at any time. In a moment when hospitals are grappling with depleted supplies and the spread of the coronavirus disease (COVID-19), patients might be concerned about whether or not the emergency room is their best option in the face of an unexpected aesthetic emergency. While limiting contact through social distancing is recommended, getting proper help is still possible and encouraged.
To understand the most effective methods for getting medical assistance during this time, The AEDITION spoke with two board certified providers about what to do if urgent care is needed.
Is the Emergency Room the Best Option?
When it comes to non-aesthetic health emergencies, the ER remains the best place to seek care — especially in critical situations. But, for patients who are experiencing complications in the aftermath of a cosmetic or plastic surgery procedure, it may be best to reach out to your plastic surgeon first.
“I would encourage people to stay away from the ER because of the many sick COVID-19 patients. That being said, the first thing the patient should do is call their plastic surgeon,” explains Kevin Tehrani, MD, a board certified plastic and reconstructive surgeon and founder of New York’s Aristocrat Plastic Surgery & MedAesthetics. “Most plastic surgery practices will still be open for follow-up appointments and any emergencies that may have arrived as a result of their procedure.”
The reasoning behind staying away from a hospital in this critical time is due to social responsibility on all fronts. “During a pandemic, most people will want to stay as far away from a hospital as possible, to reduce potential exposure to COVID-19 patients and also to avoid the inevitable long wait times because these places are overburdened,” explains Beverly Hills-based board certified facial plastic and reconstructive surgeon Jonathan Cabin, MD. “In addition, many socially-minded patients may want to avoid hospitals to prevent extra patient burden when they are dealing with an onslaught of very sick patients.”
Post-op complications aren’t the only aesthetic concern that might need tending to right now. When dealing with lacerations (i.e. cuts that go through the skin and, sometimes, the muscle), Dr. Cabin explains that “there is a lot of skill that goes into not only closing up a laceration, but doing so in a way that leads to optimal healing and minimal scarring.” While many level one and level two trauma centers have plastic and reconstructive surgeons on call who can treat you, not every hospital does.
If you have a relationship with a board certified plastic surgeon and the laceration occurs during normal business hours, you can certainly reach out and see if they would be able to treat you. But, if you don’t or the trauma occurs in the middle of the night, going to the emergency room remains a viable option.
If the ER Is the Only Option
Of course, in the event of an emergency when rapid attention is required, the ER is a must. “In any true post-operative emergency – for example, sudden extensive bleeding – the best thing is to go straight to the nearest ER,” Dr. Cabin says. In an effort to get the best care and limit potential exposure to COVID-19, he recommends patients call ahead to the ER to let them know you are coming. And don’t forget to keep your plastic surgeon in the loop, too. “You should also try to alert your surgeon as to what is going on so that they can be involved in your care,” he says. “This is always the best option.”
Dealing With a Post-Op Emergency
In matters of health, safety and affirmative action are vital. Dr. Tehrani advises that patients call their plastic surgeon “as soon as the trauma happens to see if they can temporarily treat themselves without leaving the house at all.”
When experiencing a plastic surgery emergency during a pandemic, taking extra precautions is not just important for the patient but for the caretakers as well. If an in-person appointment is necessary, the suggested course of action is for patients to call ahead and make an appointment. “We will do a pre-screen over the phone to ensure no one is infected prior to coming into our office,” Dr. Tehrani explains. “We also advise patients to not come into the office if they are sick.”
Those who show no symptoms and are able to travel to the office should remember to sanitize prior to the visit. “Patients should be taking all the preventative measures before coming into our office such as washing their hands, practicing social distancing, and staying at home,” Dr. Tehrani says. “As soon as the patient is seen, we advise them to wash their hands and sanitize — we have hand sanitizers in every room of our facility — and go straight home.”
Dealing With an Aesthetic Emergency
While not related to a post-op crisis, lacerations are still considered an aesthetic emergency that are best cared for by a plastic and reconstructive surgeon. “Lacerations are rarely life-threatening but are, nonetheless, considered urgent because, when not treated within a certain timeframe (usually six to eight hours), there is a higher risk of infection, scarring, and – in certain locations like with the face – functional issues,” Dr. Cabin explains. “That being said, certain lacerations also involve damage to vital blood vessels, nerves, cartilage, or bone, and thus may be considered true emergencies for other reasons.”
As mentioned above, patients who have an existing relationship with a plastic surgeon can reach out to the practice directly. “Patients have the option to call a plastic surgeon, who can potentially see them in the office,” Dr. Cabin says. “Some plastic surgeons — myself included — will also offer house calls for patients who can’t or don’t want to leave their home.”
And if you don’t have a surgeon on speed dial? “Call any doctor you know and trust and ask them if they can refer you to a plastic surgeon they respect,” he suggests. “If this isn’t possible, patients can also try calling into their local emergency room or urgent care, explaining the situation, and asking for a referral.”
What to Do If You Need to Leave the House
If the situation does require a trip to the ER or a plastic surgeon’s office, here’s how to keep yourself safe and well:
- Only Bring One Person: “Try to come with, at most, one friend or family member to limit the number of people and decrease chances of viral exposure,” Dr. Cabin says, adding a person exhibiting any signs of illness (think: fever, cough, aches, breathing trouble) should only be treated in an emergency room.
- Use Protective Gear: “If you have a mask at home, it is best to put it on before seeing the doctor to protect the doctor from potential COVID-19 infection,” Dr. Cabin explains. If you do not have a mask and cannot safely locate one, he says the doctor will likely be able to provide one.
- Medicate Mindfully: If you have a laceration, avoid taking taking any aspirin or NSAIDS (i.e. Advil, ibuprofen, Motrin) for pain prior to seeking medical attention, as they can cause excessive bleeding. “If you are in pain, take Tylenol,” Dr. Cabin recommends.
- Clean the Wound: To ensure minimal damage is done before your visit, cover the laceration with a clean bandage ASAP. If it is a deeper cut with a lot of bleeding, Dr. Cabin says to “hold pressure with a pressure bandage or with your hand.”
Staying Healthy After Your Visit
Along with keeping everything sanitary and practicing social distancing, recovery needs to be done in accordance with doctor’s orders. When recovering in the midst of a widespread virus, it is possible to do so with limited outside interaction. “Every patient is given careful, typed instructions and all supplies needed for care,” Dr. Cabin explains. “So, they are not required to go to the pharmacy unnecessarily.” If a patient feels that they’re experiencing symptoms of COVID-19 or have tested positive, “it is important to let the doctor know so that they can take precautions after this exposure,” he says.
“Patients should know that many plastic surgeons, including myself, are here to help,” Dr. Tehrani says. “Many of our offices are still open because we are seeing follow-up patients and, therefore, have the resources to help healthy patients with their emergency aesthetic needs.”
When dealing with an aesthetic emergency, quick thinking and rapid action are vital to prevent further damage. Taking the necessary precautions during a pandemic can be beneficial not just for the patient but for healthcare providers as well. So, while going to the ER remains a viable option, it may be avoidable in favor of a trip to the plastic surgeon — assuming you call ahead.
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