Laser & Energy Device Emergencies

04

M.A.M.I.  —  Clinical Resources

Laser & Energy Device Emergencies

Protocol LA-01  ·  Reviewed 13 July 2026  ·  Next review July 2027

Energy devices fail rarely, and quickly.

Find the scenario, then work down it. Every emergency here begins the same way, and the first three actions are the same regardless of what has gone wrong.

Before anything else

The first three actions, every time

  1. 01Stop emissionStandby. Foot pedal off. Key out. Do not simply lift the handpiece.
  2. 02Secure the roomNobody enters. Eyewear stays on until the device is confirmed safe.
  3. 03Assess the patientAirway, breathing, pain, vision. Then the injury.
01

Scenarios

Find yours · Work down it

01

Laser skin burn — thermal

Immediate

  1. Stop emission. Standby, key out.
  2. Remove the handpiece from the skin.
  3. Cool under cool running water for 20 minutes. A cool compress only if running water is not possible. Not ice.
  4. Remove jewellery from the area, unless it is stuck.
  5. Cover with a light non-adherent dressing, or clean, dry, non-fluffy material.
  6. Assess pain, blistering, depth and surface area.

Escalate

Call 000 for severe pain, a large surface area, facial or airway involvement, a full-thickness burn, or an unwell patient. Arrange urgent medical review for any significant burn, and seek burns unit advice via your local pathway.

Document

Device, settings (fluence, pulse duration, spot size, passes, cooling), photographs with consent, body map, first aid given, and the follow-up plan.

02

Ocular exposure — patient or staff

Immediate

  1. Stop the laser. Secure the room. Nobody enters.
  2. Do not allow the eye to be rubbed.
  3. Remove contact lenses only if safe and easy to do so.
  4. If there has been chemical exposure, irrigate with saline or water.
  5. Keep the person calm. Assess for pain, photophobia, blurred vision, floaters or a scotoma.
  6. If trauma is suspected, apply an eye shield with no pressure on the globe.

Escalate

Urgent same-day ophthalmology or emergency department assessment for any symptom, and for any direct or near-direct exposure even if asymptomatic. Retinal injury can be painless. Call 000 for severe injury.

Document

Circumstances of exposure, the device and wavelength, the eyewear in use and its optical density, symptoms, and the referral outcome. Quarantine the device and the eyewear until both have been reviewed.

03

IPL flash exposure

Immediate

  1. Stop treatment.
  2. Check eyewear fit, and whether it was worn correctly throughout.
  3. Assess for afterimages, glare, or any change in vision.
  4. If there is any symptom, manage as an ocular exposure — scenario 02.

Escalate

Refer to ophthalmology or the emergency department for any ocular symptom. Do not reassure and rebook.

Document

The incident, the eyewear used, and the corrective action taken.

04

Fire — drape, hair, or room

Immediate

  1. Stop the laser or RF device.
  2. Activate the fire response. Remove burning material from the patient if it is safe to do so.
  3. Extinguish small drape fires with water or saline.
  4. Use the extinguisher if required.
  5. Evacuate if the fire is not immediately controlled. Do not fight it.

Escalate

Call 000 for any fire beyond immediate control, and for any smoke inhalation, facial burn, or airway involvement — even if the patient appears well.

Document

Incident report. Equipment service review. Review the use of alcohol-based preparations and oxygen in the treatment room.

05

RF thermal burn or hot spot

Immediate

  1. Stop RF energy.
  2. Remove the applicator and cool the area.
  3. Assess the skin and dress if required.
  4. Do not continue treatment in that area, or with that applicator.

Escalate

Arrange medical review for blistering, significant pain, or any skin breakdown.

Document

Device settings, applicator condition, grounding and skin-contact quality, coupling medium, and the follow-up plan.

Immediate escalation

Call 000 for any of these

  • Airway involvement, facial burn, or smoke inhalation
  • Any fire beyond immediate control
  • Full-thickness burn, or a large surface area
  • Severe uncontrolled pain
  • Sudden vision loss
  • Any patient who is unwell, collapsed, or deteriorating
02

After any incident

The part that is usually skipped

  1. Quarantine the device

    Take it out of service. Label it. Do not use it on the next patient "to check whether it happens again".

  2. Quarantine the eyewear

    Where the eye was involved, the eyewear is evidence. Check its optical density against the device wavelength, and its condition — scratches, crazing, age.

  3. Preserve the settings

    Photograph the screen before anyone powers the device down or changes a parameter.

  4. Complete an incident report

    Same day, while the detail is accurate.

  5. Arrange a service review

    Manufacturer or authorised service agent. Do not return the device to use on a verbal assurance.

  6. Be open with the patient

    Explain what happened, what is being done, and what the follow-up will be. Arrange the review yourself rather than leaving it to them.

  7. Notify

    Consider your obligations — your indemnity insurer, your state radiation regulator where applicable, the TGA where a device has malfunctioned, and your practice's own governance process.

Scope and limitations

This protocol is an educational resource for practitioners operating cosmetic energy devices. It is a guide only. It does not replace clinical judgement, your clinic's own emergency and laser safety procedures, the device manufacturer's instructions for use, nationally accredited first aid certification (HLTAID011 Provide First Aid), or the radiation safety requirements applicable in your state or territory. Requirements for the licensing and use of lasers and intense light sources differ between Australian jurisdictions — confirm what applies to you.

Sources

  • AS/NZS 4173 — Safe use of lasers and intense light sources in health care.
  • ARPANSA — radiation protection guidance for lasers and intense light sources.
  • ANZCOR Guideline 9.1.3 — Burns.
  • The manufacturer's instructions for use for each device in service.

Where this document differs from the manufacturer's instructions or from the requirements of your state regulator, those requirements prevail.

Clinical review. Reviewed by Dr Larissa Miller, Cosmetic Physician, on 13 July 2026. Next scheduled review July 2027. Protocols are reviewed at least annually and after any incident.

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