/policies/,/policies/clinical/,/policies/clinical/uwmf-clinical/,/policies/clinical/uwmf-clinical/uwmf-wide/,/policies/clinical/uwmf-clinical/uwmf-wide/clinical-policies-and-procedures/,/policies/clinical/uwmf-clinical/uwmf-wide/clinical-policies-and-procedures/transformations/,

/policies/clinical/uwmf-clinical/uwmf-wide/clinical-policies-and-procedures/transformations/102137.policy

201506175

page

100

UWHC,UWMF,

Policies,Clinical,UWMF Clinical,UWMF-wide,Clinical Policies and Procedures,Transformations

Palomar Vectus Hair Removal Laser Policy (102.137)

Palomar Vectus Hair Removal Laser Policy (102.137) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Transformations

102.137

1
UW HEALTH-CLINICAL POLICY AND PROCEDURE


TITLE: Palomar Vectus Hair Removal Laser Policy

Effective Date: 9/30/2014 Approval: See Authorization
Supersedes Policy Date: Contact: Stephanie Faucher, APNP

Reviewed



PURPOSE:

The purpose of this policy is to protect UW Health employees and patients from harmful
exposures to radiation. This policy is also intended to permit only authorized personnel
to operate and care for the Palomar Vectus laser.

DEFINITIONS:

Authorized personnel: laser operators who have been trained in the safe use and
general operation of the Palomar Vectus Hair laser.

GENERAL INFORMATION:

The Palomar Vectus is for removal of hair on patients of all skin types. The energy is
deeply absorbed by both melanin and hemoglobin.

EQUIPMENT/SUPPLIES:

1. Palomar Vectus laser
2. Skintel Reader
3. LuxLotion
4. Safety goggles for patient and staff
5. Gloves
6. Plume Evacuator
7. Sani-cloth Plus
8. Patient treatment supplies (towels, ice pack, gauze)
9. Laser must be plugged into appropriate power outlet

DOCUMENTATION:
1. A written consent for each patient should be completed, signed and scanned into
the electronic medical record.

2
2. A completed progress note should include the parameters used in the procedure
and how the procedure was tolerated by the patient.
STANDARD OPERATING PROCEDURE:

1. A pre-procedure consult is performed by medical staff prior to scheduling laser hair
removal. (Attachments A & B are used for laser hair removal)
2. Review and confirm orders.
3. Complete the pre-procedure part of the laser safety checklist posted in laser room.
(Attachment C)
4. Verify that the laser is plugged into the designated electrical outlet. Ensure that the
main circuit breaker on the lower rear panel is in the “ON” position.
5. The smoke evacuator must be on AT ALL TIMES during the procedure. Its suction
hose nozzle must be kept within 2 inches of the procedure site. If the smoke
evacuator fails, laser treatments must be stopped until such repairs are made.

IN AN EMERGENCY, depressing the red LASER STOP button
on the control panel can shut down the laser system.

In addition to the smoke evacuator, the Honeywell air filter should be turned on at the
Transformations site.
6. Place the laser into STANDBY mode after use. Remember to clean the tip of the
smoke evacuator nozzle after each treatment.
7. Patients are provided with the post care handout at the time of the initial consult and
are reviewed at time of discharge. (Attachment D)
8. Upon exiting laser room, remove the sign and goggles that indicate a treatment is
taking place.
9. Clean and inspect the smoke evacuator per manufacturer’s instructions. Smoke filters
are considered bio-hazardous, so universal precautions must be utilized when
changing/disposing filters. A gauge on the top of the unit indicates when this should
be done. Smoke evacuator tubing may be discarded in the trash. The entire “Buffalo”
filter and tubing are to be discarded in a red biohazard bag. The HEPA filter in the
Honeywell air filter is changed per the manufacturer’s recommendation by facilities.

SKINTEL READER:

1. The Skintel Reader is one of several tools a practitioner may use to assist in
determining a client’s starting test spot fluence.
2. Test spots should always be administered before every treatment, on each client and
at every visit.
3. The White and Black calibration standard, inside the access door on the Palomar
Vectus system, are used to calibrate the Skintel Reader to ensure consistency of
Melanin Index values.
4. Turn on the Skintel Melanin Reader and select “Use Skintel” option on the Vectus
screen.

3
5. Clean the skin where the Skintel will be used. Skin must be free of dirt, makeup,
moisturizers and powders.
6. Apply a thin coat of LuxLotion to the selected test spot surface area.
7. Take the Skintel Reader measurement within the treatment area that has the darkest
uniform skin color. Avoid areas that have active sun exposure within the past 4
weeks, tattoos, moderate to dense hair, darkly pigmented lesions and highly dense
vascular lesions.
8. Place the Skintel Reader window in full contact with the skin. The “Contact”
indicator will turn green, there will be an audible beep, and the measurements will be
automatically taken.
9. The Skintel Reader requires a minimum of three and a maximum of ten separate
readings of the client’s skin to determine an automatically-averaged Melanin Index
from the anticipated test spot area.
10. After each measurement, remove the Skintel Reader window from the skin. To take
another measurement, place the window directly back on the skin for the next reading
and repeat until all desired readings are taken.
11. After at least three Skintel Reader measurements have been completed, the
“Transmit” indicator will turn yellow. Press the gray button on the Skintel Reader for
one to two seconds, then release to Transmit the MI Value to the Vectus system. The
average MI value will be displayed.
12. Always re-administer test spots at every visit and always if client’s sun exposure has
changed since last treatment.
13. The Skintel Reader requires factory calibration at 6 months and 12 months in the first
year, and annually thereafter.
VECTUS SYSTEM OPERATION:

1. Adjust parameters as necessary and press “Ready” when desired parameters are set.
2. Press the enable button on the Handpiece until it glows blue, indicating that the
trigger is active and can be used to pulse the Handpiece.
3. Apply a thin coating of LuxLotion to planned treatment area.
4. Treat area applying firm, constant pressure.
5. 5-15% overlap is recommended depending on the spot size used.
6. When treating around the mouth, consider placing rolled up wet gauze between the
lips and teeth to protect the teeth from discomfort.
7. Avoid operating or treating within the orbital rim.
8. Use Handpiece to pre-cool area to be treated, and then glide the Handpiece in the
same direction for subsequent pulses.
9. Ensure the cooling portion of the Handpiece remains in contact with the skin at all
times during treatment.

4
10. Continually observe the skin during treatment and assess whether to decrease fluence
or increase pulse width.
11. CoolRoller may be used for added comfort during and after treatment.
12. Use EPA-approved germicidal wipe to clean Handpiece between every client.
EXCLUSIONARY CRITERIA:

1. History of seizures
2. Pregnancy
3. Undiagnosed lesions
4. Waxing, tweezing, epilation
5. Immunosuppression
6. Active infections
7. Blood thinners, coagulation issues
8. Open lesions
9. Active tan (within 4-6 weeks of treatment)
CAUTIONARY CRITERA:

1. History of Herpes infection, patient must use prophylactic treatment.
2. History of vitiligo, eczema, psoriasis, allergic dermatitis, autoimmune diseases, any
disease affecting collagen including Ehlers-Danlos syndrome, and scleroderma may
affect response to treatment.
3. Use of exfoliants or retinoids within 2 weeks.
4. Hormonal conditions and polycystic ovarian syndrome may have unpredictable
results.
5. Wait 2 weeks after Botox injections for the Vectus may increase diffusion of Botox.
6. Change in medical history.
SAFETY PRECAUTIONS:

1. Never look directly at the light coming from the light-emitting end of the Handpiece
as this may cause eye injury.
2. Never direct the laser at anything other than the targeted treatment area.
3. Never point the Handpiece so that it discharges into air or free space.
4. Follow Handpiece treatment instructions for treatments and when performing test
spots.
5. A message will appear on touch screen if chiller fluid reservoir is too low. Monitor
fluid level at the inside of the fill port panel. Use only Palomar chiller fluid. Use of
any other fluid may contaminate the system and void the warranty.
6. The fluid coolant filters should be changed every 3-6 months.
7. Air filters should be inspected and cleaned with a vacuum every 3-6 months.

5
8. The System Flow Maintenance Procedure is step by step on the touch screen.
9. The Palomar Vectus system must undergo an annual electronic preventive
maintenance between 11
th
and 13
th
month.
POSSIBLE SIDE EFFECTS:

1. Pain, bruising, peeling, rash, prolonged itching, redness, ingrown hairs, irritation,
crusting, swelling and infection.
2. Burning, blistering, blanching and scarring.
3. Scabbing, broken capillaries, bronzing, and acne or herpetic breakouts.
4. Pigmented changes including hypopigmentation or hyperpigmentation lasting 1-6
months or longer or possibly permanently.
5. Removal of lightening freckles or other pigmented lesions. Freckles and other
pigmented lesions may temporarily or permanently disappear in treated areas.
6. Risk of lightening or darkening of vascular lesions.
7. Scarring, blood clots, skin loss, hematomas and allergic reaction to medications or
materials used during the procedure.
8. A high risk of paradoxical hair growth in people of Middle Eastern and
Mediterranean descent and those who have an ill-defined hair line with no obvious
transition of the hairline to the face.
9. Patients with pacemakers, because of the electromagnetic interference from the laser,
must consult with their doctor before treatment begins.
10. The laser beam is capable of igniting combustible materials. Such materials shall be
wet down or removed from the laser beam path/area. No alcohol or alcohol-
containing preparations or solutions will be used in or near the laser impact site.
When alcohol is used to clean and disinfect any part of the handpiece, it must be
allowed to dry before the laser is pulsed.
NOTE: If the laser fiber breaks, a sudden flash or flame may occur.
DISCONTINUE PULSING IMMEDIATELY.
Always keep a small basin of water near the patient and a fire extinguisher available,
for use on the laser, if needed.
11. Report any laser deficiencies immediately to your manager. The operator is
responsible to lockout the laser and remove the key to prevent further operation. DO
NOT OPEN LASER PANELS OR ATTEMPT TO REPAIR LASER EQUIPMENT.
Exposure to harmful levels of radiation and electricity may occur when laser panels are
opened. In the event of cord damage, contact facilities for obtain a lock out plug.






6
REFERENCES:
Palomar Vectus Operator’s Manual and Treatment Guide

AUTHOR:
Stephanie Faucher APN

AUTHORIZATION:

________________________________________________________________________
Medical Director, Transformations Date