Latex Allergy Management

Purpose

Types of latex allergy

High risk groups

• Patients who have undergone repeated bladder catheterisation. This most commonly occurs in patients with spina bifida or neural tube defects.
• Healthcare workers.
• Patients with an occupational exposure to latex.
• Patients who have undergone multiple surgical procedures.
• Patients with a history of atopy or food allergy particularly to fruits such as avocados, bananas and kiwi fruit.

History

• People who have experienced swelling, itching or other symptoms following contact with rubber products e.g. dental, rectal or pelvic exam.

• Swelling of lips or tongue after blowing up a balloon
• After using a diaphragm or condom
• Whilst wearing stretchy or spandex underclothing

Assessment / Investigations

• Question for latex allergy in all high risk groups.
• If possible refer patients at high risk for preoperative testing.
• Patients with known or suspected history of anaphylaxis to latex should be treated as having a latex allergy.
• All patients with known or suspected latex allergy should be referred to the anaesthetic department preoperatively or on admission to the hospital or birthing suites.
• A therapeutic plan should be developed for each latex allergy patient to prevent their exposure to latex during their hospital stay.

Management

Identification

• Patients with known or suspected latex allergy (type 1 hypersensitivity) should wear an appropriate allergy alert bracelet and an allergy alert should be entered in their history.

Avoidance of latex exposure:

• NO powdered latex gloves should be used in any part of the hospital.
• Latex free gloves should be available in all clinical areas of the hospital and used for ALL latex sensitive patients.

Additional precautions for patients with type 1 hypersensitivity:

• Patients’s room, birth suite, operating theatre, ED cubicle should have latex products removed from it and substituted with latex free alternatives.
  
  
• The latex status of products on imprest at the Women's can be obtained from the Royal Children's Hospital Material Resources website (shared site). Refer to: Stock Catalogue RWH & RMH (Excel). Many products used at the Women's e.g. syringes, IV lines are now latex free.
  
  

• A latex officer should be nominated by each department to prepare a list of essential equipment that is safe to be used for latex sensitive patients. This could be kept as a list or latex free box.

• Operating Suite and or booking office should be notified of any patients with latex allergy admitted for surgery or to Birthing suites. At the Women's latex allergy should be noted in the ORMIS information system.
• Where possible Latex allergy patients undergoing elective procedures in the operating room should be booked as the first case on the list. This will allow adequate time to prepare the OR.
• The operating theatre must have signs attached to all entrances to ensure latex safe area.
• Operating theatre table mattress and arm boards must be completely covered with linen.
• Only when the operating room is prepared is the patient to be sent for.
• Patients should wear balaclavas with ties not elastic hats or other elastic containing disposable clothing.
• Latex free product list must be consulted to ensure all equipment used for surgery and anaesthesia is latex free.
• Patient should either be recovered in theatre or an area of PACU that can be prepared as a latex free area.
• On return to the ward the PACU nurse must ensure that ward staff are aware of the patient’s latex allergy and that they are returning to an appropriate latex free environment.

Prophylaxis

Treatment

References

• 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: Part 10.6: Anaphylaxis