Preparedness of aesthetic medicine professionals for emergency scenarios: the SIMED–AGORÀ cross-sectional study
Keywords:
training , emergency, patient safety, aesthetic medicine, BLSD, ACLSAbstract
Background: Emergency management in aesthetic medicine is a fundamental component of patient safety. Despite the increasing demand for outpatient aesthetic procedures, the literature provides limited evidence on the actual preparedness of aesthetic physicians in managing acute medical emergencies not directly related to procedures1. This study aimed to evaluate the knowledge and competence level of aesthetic medicine professionals in handling emergencies and urgent-care scenarios, with the goal of identifying potential areas for educational improvement.
Methods: A 22-item questionnaire (7 demographic and 15 clinical questions) was developed within the SIMED–AGORÀ project. Fifty-six aesthetic physicians participated. A competence threshold of 12/15 (80%) correct answers was predefined. Data were analyzed using STATA 18 software; comparisons between professional areas were performed with one-way ANOVA followed by Tukey’s post-hoc test, and categorical variables were analyzed using χ² tests.
Results: The mean age of participants was 35.8 years (SD 7.4), and 42.8% had completed a postgraduate master’s in aesthetic medicine. Eighty-nine percent had attended BLSD courses, and 30% had completed ACLS training. The mean total score was 10.6 (SD 2.5). Physicians with ACLS training were significantly more likely to reach the competence threshold (OR 3.6; 95% CI 1.2–11.8; p = 0.03). Significant differences emerged among professional areas (F(5,50)=10.62; p < 0.001), with higher scores in the emergency–urgent-care group. Overall, 80.4% expressed interest in specific training on emergencies in the aesthetic-medicine setting.
Conclusions: Aesthetic physicians demonstrated satisfactory basic competence, but important gaps persist in pharmacologic management and systemic emergency response. Integrating specific intermediate training modules—bridging BLSD and ACLS—could improve preparedness and enhance both safety and quality of care in aesthetic medicine.
References
1. Mia R, Horton G, Venter Z. Introduction to the management of intravascular filler injection, including support for Intra-Vascular Combination Management (IVCM). Aesthetic Med. 2024; 10(4):e2024026.
2. Agosti V, Stefanini G. Granulomatous reaction to hyaluronic acid dermal filler: clinical and histological features. Aesthetic Med. 2024;10(1):e2024002.
3. Di Gregorio S, Damiani G. Safety and efficacy of filler injections in patients with immune-mediated inflammatory diseases. Aesthetic Med. 2025;11(2):16995.
4. Salti G, Tateo A, Cassuto D, et al. Hyaluronic acid hybrid cooperative complexes nearing 10 years of use: update on safety assessment based on post-marketing surveillance data. J Cosmet Dermatol. 2025; 24(7):e70197.
5. Cavallini M, Antonioli B, Gazzola R, et al. Hyaluronidases for treating complications by hyaluronic acid dermal fillers: evaluation of the effects on cell cultures and human skin. Eur J Plast Surg. 2013; 36:477-484.
6. Kato K, Inoue E. An anaphylactic reaction after simultaneous injection of hyaluronic acid fillers and human collagen. J Cosmet Laser Ther. 2022; 24(1-5):60-62.
7. Hazen PG, Daoud S, Hazen BP, et al. Medical emergencies in the dermatology office: incidence and options for crisis preparedness. Cutis. 2014; 93(5):251-255.
8. Kaya Erdogan H, Sahin Tekin M, Agaoglu E, et al. Emergency complications during dermatological, surgical, or cosmetic procedures: a cross-sectional study among dermatologists. J Cosmet Dermatol. 2024; 23(12):4102-4109.
9. Obata K, Naito H, Yakushiji H, et al. Incidence and characteristics of medical emergencies related to dental treatment: a retrospective single-center study. Acute Med Surg. 2021; 8(1):e651.
10. Smereka J, Aluchna M, Aluchna A, Szarpak L. Preparedness and attitudes towards medical emergencies in the dental office among Polish dentists. Int Dent J. 2019; 69(4):321-328.
11. Vaughan M, Park A, Sholapurkar A, Esterman A. Medical emergencies in dental practice: management requirements and international practitioner proficiency. A scoping review. Aust Dent J. 2018; 63(4):455-466.
12. Solla D, Magri Piccinini A, Gambolò L. Aesthetic medicine and basic life support: should it be a mandatory training? Aesthetic Med. 2024; 10(3):e2024016.
13. Spadotto L, Giaquinta S, Di Fronzo P, Gambolò L. Emergency management in the aesthetic medicine practice: a questionnaire to define the future of training in Italy. Aesthetic Med. 2025; 11(3):16674.
14. Stirparo G, Andreassi A, Sechi GM, Signorelli C. Spring, it’s time to ROSC. J Prev Med Hyg. 2023; 64(1):E87-E91.
15. Stirparo G, Di Fronzo P, Solla D, Bottignole D, Gambolò L. Are Italian newly licensed nurses ready? A study on self-perceived clinical autonomy in critical care scenarios. Healthcare (Basel). 2024; 12(8):809.
16. Cucino A, Babini G, Scapigliati A, Ristagno G. Assessment of cardiopulmonary resuscitation quality among healthcare providers: a randomized experimental study of the Italian Resuscitation Council. J Clin Med. 2024; 13(18):5476.
17. Wik L, Kramer-Johansen J, Myklebust H, et al. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA. 2005; 293(3):299-304.
18. Stirparo G, Kacerik E, Andreassi A, et al. Emergency department waiting time in the post-pandemic era: new organizational models, a challenge for the future. Acta Biomed. 2023; 94(S3):e2023122.
19. Margara A, Arrigoni F, Bartoletti E, et al. Ethics in aesthetic practice: results from a survey of medical doctors attending aesthetic medicine programs in Italy. Philos Ethics Humanit Med. 2025; 20(1):12.
20. Zargaran D, Zargaran A, Terranova T, et al. Profiling UK injectable aesthetic practitioners: a national cohort analysis. J Plast Reconstr Aesthet Surg. 2023; 86:150-154.
21. Tini G, Ameri P, Buzzatti G, et al. Diversity of cardiologic issues in a contemporary cohort of women with breast cancer. Front Cardiovasc Med. 2021; 8:654728.
22. Nashat H, Masding A, Krishnathasan K, et al. Pregnancy outcomes in women with the highest cardiovascular risk (mWHO class IV): a single-centre study. Int J Cardiol. 2025; 441:133774.
23. Solla D, Bottignole D, Di Fronzo P, et al. The importance of guidelines’ knowledge for the perceived self-autonomy among newly licensed doctors. Euromediterr Biomed J. 2025; 18:153-156.
24. Mondosanità. Simulatori in medicina estetica. Available at: https://mondosanita.it/medicina-estetica-innovazione-tecnologica-per-garantire-interventi-sicuri-ed-efficaci/. Accessed October 12, 2025.
25. Lungu AJ, Swinkels W, Claesen L, Tu P, Egger J, Chen X. A review on the applications of virtual reality, augmented reality and mixed reality in surgical simulation: an extension to different kinds of surgery. Expert Rev Med Devices. 2021; 18(1):47-62.
26. Di Fronzo P, Gaetti G, Marcassa D, et al. The impact of ACLS training in the management of cardiac arrest: a narrative review. Epidemiologia. 2025; 6(4):61.
27. Becker L, Eisenberg M, Fahrenbruch C, Cobb L. Cardiac arrest in medical and dental practices: implications for automated external defibrillators. Arch Intern Med. 2001; 161(12):1509-1512.
28. Jevon P. Resuscitation in the dental practice. Br Dent J. 2016; 220(5):261-263.
29. Owczarczyk-Saczonek A, De Boulle K. Hyaluronic acid fillers and ASIA syndrome: case studies. Clin Cosmet Investig Dermatol. 2023; 16:2763-2771.
30. Reinikainen M, Hedman A, Pelkonen O, Ruokonen E. Cardiac arrest after interscalene brachial plexus block with ropivacaine and lidocaine. Acta Anaesthesiol Scand. 2003; 47:904-906.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Giuseppe Stirparo, Antonio Vinci, Marta D'Angelo, Lorenzo Spadotto, Dorian Bardhi, Francesca Arrigoni, Stefania Belletti, Maurizio Cavallini, Marco Papagni, Nazzareno Fagoni
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
