Download Latex Sensitivity Precautions Policy

Policy:
A.
All patients will be assessed for latex sensitivity upon admission
to___________________________________.
B.
Latex sensitivity protocol shall be initialed and followed when a sensitivity is suspected,
reported by patient/ family member or previously documented in patient records.
C.
Healthcare workers may initiate “Latex Sensitivity Precautions” to protect patients from
known exposure to latex products whenever sensitivity is suspected.
D.
Patients with a known or suspected latex sensitivity shall be closely monitored for signs
and symptoms of an allergic reaction throughout treatment.
E.
All procedures shall be scheduled as early in the day as possible.
F.
Materials Management shall coordinate an ongoing process of obtaining and
documenting latex content of medical products.
G.
The following are examples of products which may contain latex:
1.
Blood pressure cuffs
2.
Stethoscopes
3.
Disposable gloves
4.
Oral and nasal airways
5.
Endotracheal tubes
6.
Tourniquets
7.
IV tubing and IV catheters
8.
Syringes
9.
Electrode pads
10.
Anesthesia masks
11.
Catheters
12.
NG tubes
13.
Wound drains
14.
Injection ports
15.
Rubber tops of mulitdose vials
16.
Dental dams
17.
Gloves
18.
Surgical masks
19.
Goggles
20.
Respirators
21.
Rubber aprons
22.
Rubber bands
23.
Erasers
24.
Balloons
H.
A latex free cart with product listings and latex free supplies shall be kept available for
use in patient care areas in the ED, surgery and in-patient care areas.
I.
A system of flagging all patient charts with a known history of latex sensitivity will be
coordinated through the Infection Control office electronically and with sensitivity
stickers.
J.
_______________________________will encourage the use of synthetic gloves for
non-sterile glove use, and purchase powder-free non-sterile gloves when latex gloves
are needed.
K.
_________________________shall not allow latex balloons on site in an effort to
minimize unnecessary and inadvertent exposure of latex to patients, families, visitors
and healthcare providers who have a latex sensitivity. Mylar balloons would be an
acceptable alternative.
Equipment:
A.
Latex free products/product cart
B.
Alert ID band
C.
Medical warning label for patient chart indicating “Latex Precautions”
D.
“Latex Sensitivity Precautions” signs
Procedure:
A.
Assess patient for latex sensitivity during assessment.
1.
Ask about sensitivity to latex or rubber sensitivity upon admission. Refer to
Attachment 1: Latex Allergy Questionnaire
a. Any symptoms when handling rubber products, balloons, Band-Aids, etc.
b. Any symptoms when in contact with rubber exam or surgical gloves
c. History of sensitivity to tropical fruits such as kiwi, papaya, bananas,
avocados, chestnuts
d. History of asthma, eczema or previous allergic reactions.
2.
Ask about characteristics of reaction
a. Irritant Contact Dermatitis
(1) Not necessarily an allergic reaction to latex, but to glove powder
(2) Erythema and pruritus localized to area of contact
(3) Occurs immediately
(4) Resolves in several hours
b. Allergic Contact Dermatitis - Type IV (cell mediated, delayed-type
hypersensitivity)
(1) Allergic response to chemical additives, not latex itself
(2) Includes erythema, pruritus, urticaria, flushing, edema, coughing and
conjunctivitises
(3) Can occur 1 – 48 hours after contact with source
(4) Can last for several days
c. Latex Sensitivity - Type I (IgE mediated, immediate-type hypersensitivity) a
systemic allergic reaction
(1) Includes urticaria angioedema, conjunctivitis, dyspnea, pharangral
edema, arrhythmias and anaphylaxis.
(2) Symptoms are immediate and may be moderate to life threatening in
intensity.
(3) Needs immediate intervention
d. Note that no predictable pattern exists for the progression of reactions;
anaphylaxis may occur at any time.
3.
Obtain history of sensitivity to latex from old chart
4.
5.
6.
Review “Allergy” field on patient’s Face Sheet for a Latex Sensitivity ‘flag’,
indicating a past history of latex sensitivity.
Identify patient as being in a high-risk group for a latex sensitivity
a. Patients with myelomeningocele (spina bifida), myelodysplasia, congenital
urologic abnormalities, or any other condition requiring frequent, long-term
bladder and bowel management using latex catheters and latex tip enemas.
b. Patients who have undergone multiple surgical procedures.
c. Patients with occupational exposure, such as those involved in the
manufacture of latex products.
d. Healthcare personnel and others who wear latex gloves.
Place Alert band on patient and label it “Latex Sensitivity”.
B.
Notify physician of history of latex sensitivity or being in a high-risk group for “Latex
Sensitivity Precautions”. Contact surgeon and anesthetist for any surgery or procedure if
latex sensitivity concerns arise during patient assessment.
C.
Prepare patient room
1.
Place patient in private room, if available, to avoid accidental latex exposure from
roommate.
2.
Remove or cover any latex containing products
a. Remove all latex gloves
b. Remove blood pressure cuffs or cover with cast padding
3.
Replace products containing latex with latex-free alternatives. See Attachment 2:
Common Products with Latex and Latex-Free Alternatives or Methods of Contact
Avoidance
4.
Apply “Latex Sensitivity Precautions” sign to door and above bed. See
Attachment 3: Latex Sensitivity Precautions.
5.
Place latex free cart outside patient room.
a. Latex-free cart/supplies goes with patient to other departments
b. Cart will be re-stocked daily by unit.
c. Upon discharge, cart is cleaned and restocked. Store in 2-Center Supply
Room. Refer to Attachment 4: Latex Sensitivity Cart Supply List.
6.
Fill out cart usage survey and send to Infection Control. Refer to Attachment 5:
Latex Cart Usage Survey.
a. Allows for tracking frequency and number of latex allergic patients
b. Allows means to flag charts for subsequent admissions
D.
Notify ancillary departments of latex sensitivity as appropriate
1.
Pharmacy
2.
Laboratory
3.
Surgery/PAR
4.
Housekeeping
5.
Infection Control
E.
Document latex sensitivity
1.
Document sensitivity on nursing assessment form
2.
Place “Latex Allergy” sticker on front of patient chart
3.
Note on Kardex
F.
Utilize latex free products from cart throughout hospital stay. Double check products
prior to use. If unsure of latex content of product, contact Materials Management or use
alternate product.
1.
2.
Purchase agreements will include a request for information regarding latex
content.
Purchasing will request and document information regarding latex content of
patient care supplies/equipment on an ongoing basis.
a.
The product inventory master screen will have a designated entry field for
latex content: L = known latex in product; N = No latex in product; and U =
Information not available.
b.
Materials may be contacted to relay known information regarding latex
content from the product inventory master screen or may be contacted to
assist in obtaining information from the product manufacturer by calling
x6131.
G.
Provide medications without latex contamination
1.
Remove rubber stoppers with pliers or hemostat prior to aspirating any
medications from a vial.
2.
Do not shake medications prior to use.
3.
Contact Pharmacy to prepare syringes when multiple doses of IV medications
that need to have rubber stoppers removed prior to aspirating are needed (i.e.,
heparin for flushes, insulin, or Solu-Medrol).
4.
Avoid multidose vials.
5.
Contact Pharmacy for clarification of latex-containing vials and IV piggybacks.
H.
Continuously monitor patient for any symptoms of sensitivity. Notify physician
immediately if reaction is observed.
1.
Skin rash or hives
2.
Itching, watery eyes
3.
Swelling or redness of skin
4.
Wheezing
5.
Chest tightness
6.
Anaphylactic shock
H.
Educate patient about widespread use of latex. Refer to Attachment 6: Natural Latex
Rubber Allergy Information for Allergic Patients.
I.
Encourage patient to notify all future health care providers, labs and clinics before they
make a visit to ensure availability and use of latex free products.
J.
Encourage patient to wear a Medic-Alert bracelet for emergency situations.
Documentation:
A.
Latex sensitivity cart usage survey
B.
Nurses notes
C.
Kardex
Key Words for Cross-References:
A.
Latex allergy
B.
Latex sensitivity
C.
Natural Rubber Latex allergy
Reference(s):
A.
Medical Surgical Unit Policy and Procedure Manual (Reference 138.10 –138.20)
Medical Consultants Network, Inc., 2000
B.
C.
D.
Lippincott Manual of Nursing Practice, 7th Edition Lippincott, Williams & Wilkins
Publishers, 2001, page 920
University of Colorado Hospital Policy & Procedure: Care of Latex Sensitive Patient
http://medweb.uncolorado.edu/PnPDoes/CareAssess_c/C203 1100.htm
Medical Consultants Network, Policy & Procedure Manual, Medical/Surgical Unit,
Reference #1337
Attachment(s):
A.
Attachment 1: Latex Allergy Questionnaire
B.
Attachment 2: Common Products with Latex and Latex-Free Alternatives or Methods of
Contact Avoidance
C.
Attachment 3: Latex Sensitivity Precautions Door Sign
D.
Attachment 4: Latex Sensitivity Cart Supply List
E.
Attachment 5: Latex Sensitivity Cart Usage Survey
F.
Attachment 6: Natural Rubber Latex Allergy Information for Allergic Patients
Originator(s):
Signature(s):