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NEWS & INFORMATION
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Source To Surgery - February 1994, Vol. 2 Issue I
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Latex Precautions in the Operating Theatre
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Linda L. Gehring, RN, MS; Kevin J. Kelly, MD
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A step-wise approach in the hospital and peri-operative setting to care for the latex sensitive
patient is necessary. At the Children's Hospital Wisconsin, USA, a multidisciplinary task force
was established to develop a policy and procedure for the detection, care and education of
the latex sensitive patient. Manufacturers of all equipment used in the hospital were contacted
using a standard letter requesting details of the content of latex protein in each product.
A database of all latex and non-latex products was developed. This list is upgraded every
three months and distributed to each department to allow staff access to non-latex devices.
Review of glove usage and purchasing of low-allergen gloves is included in the evaluation of
products used.
LATEX ALLERGY PRECAUTIONS
The primary principle in management of allergy is to avoid the offending antigen by
limiting environmental contact with products that contain the allergen. Communication, documentation and coordination of all
personnel are essential to avoid a potential problem through inadvertent contact with latex allergen. This task is often
assumed by the nurse who coordinates the activity and movement of patients through the perioperative period.
Guidelines for ancillary departments that have contact with latex sensitive patients need to be developed. Each department should devise an educational plan to familiarize the staff with latex allergies
and precautions.
Interdisciplinary quality assessment system should be established to review all suspected reactions to natural rubber latex and to monitor the effectiveness of latex avoidance procedures.
Patients with suspected latex sensitization are referred to their physician for evaluation. Patients who have developed systemic symptoms or anaphylaxis should always carry emergency injectable
adrenaline medication.
Following precautionary guidelines that are tailored to the individual needs of an institution will protect latex sensitive patients from possible untoward reactions.
However, it is virtually impossible to avoid exposure to latex protein completely, as adequate substitute materials may not be available and the ubiquitous presence of rubber products derived from latex is
unavoidable.
Basic steps in the development of latex allergy guidelines
- Form a multidisciplinary latex allergy committee that includes staff from all
disciplines (e.g., medicine, surgery, anaesthesia, allergy, nursing, hospital
administration, pharmacy, central sterilization processing, central supply, employee health, quality assessment)
- Develop a uniform policy to handle the latex sensitive patient in the preoperative, operative and post-anaesthesia care areas
- Develop standard questions to be asked of all patients, which are aimed at detecting undiagnosed or confirmed latex allergy
- Obtain details of the latex content of all products used in the operating theater (and hospital) in writing from manufacturers or distributors; set up a uniform system to update and disseminate this information on a scheduled basis
- Develop latex-free emergency equipment
- Develop educational materials for staff and patients
- Monitor the quality of the procedure for handling latex sensitive patients and
establish a review process for all suspected reactions
- Educate personnel about the personal risks of latex allergy
- Make recommendations for the purchase of low-allergen latex gloves to minimize
exposure of the health care professional and patient to allergen
FURTHER READING
- Buback ME, Reed CE, Fransway AF et aL Allergic reactions to latex among
health care workers. Mayo Clin Proc 1992; 67: 1075-9.
- Sussman G, Tarlo S, Dolovich J. The spectrum of IgE-mediated responses
to latex. JAMA 1991; 265: 2844-7.
- Turjanmaa KD. Incidence of immediate allergy to latex gloves in hospital
personnel. Contact Dennatitis 1987; 17: 270-5.
- Young MA, Meyers M, McCullr ch LD, Brown W. Latex allergy, a guideline
for perioperative nurses. AORN Joumal 1992; 56: 488-502.
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