Abdul Kadir, Ph D Deputy Chief Executive Officer. Malaysian Rubber Export Promotion Council

Transcription

1 Know your medical gloves for better protection and patient care Abdul Kadir, Ph D Deputy Chief Executive Officer Malaysian Rubber Export Promotion Council

2 Outline What are medical gloves? How gloves prevent contamination Glove material comparisons Hazards of vinyl gloves Latex protein allergy Standard Malaysian Glove (SMG)

3 What are medical gloves? Medical gloves are disposable gloves used during medical procedures

4 Medical gloves are single-use items Decontamination and reprocessing for reuse should be avoided

5 Main types of medical gloves Examination Use in: Medical examinations Surgical Use for conducting surgical procedures Diagnostic & therapeutic procedures Handling of contaminated medical materials

6 How gloves prevent infection Gloves prevent contamination of the hands of healthcare personnel when touching blood, body fluids, secretions, mucous membranes, and nonintact skin Gloves reduce the likelihood that microorganisms present on the hands of healthcare personnel will be transmitted to patients Failure to change gloves between patient contacts is an infection control hazard

7 Wearing gloves does not replace the need for hand rubbing and washing

8 Gloves can be: Powdered or powder-free Sterile or non-sterile Examination gloves Surgical gloves Powdered or powder-free Powdered or powder-free Sterile Non-sterile Sterile Powdered gloves are coated with corn starch Powder-free gloves are chlorinated or have a synthetic coating

9 Invasive insertion Treating immunecompromised individuals Use of sterile exam gloves End stage renal disease treatment Sterile dressing changes

10 FDA potential warning on powdered gloves Warning: Powdered gloves may lead to foreign body reactions and the formation of granulomas in patients. In addition, the powder used on gloves may contribute to the development of irritant dermatitis and Type IV allergy, and on latex gloves may serve as a carrier for airborne natural latex leading to sensitization of glove users.

11 Glove materials Material Examination Surgical Natural rubber Nitrile Vinyl Polyurethane Polyisoprene Polychlorprene Styrene butadiene Styrene-ethylene-butylene-styrene

12 General properties of gloves made from different materials Durability Puncture & tear resistance Comfort and fit Flexibility Tactile sensitivity Grip Natural rubber Nitrile Vinyl

13 Detection of holes in gloves Introduce 1000 cm 3 water into the glove Observe for leaks immediately If the glove does not leak immediately, make a second observation after 2 to 4 minutes

14 Simulated use conditions Manipulation Repetition 1. Attach and remove a capped needle to a Luer-Lok syringe 2. Connect and disconnect a Luer-Lok syringe to intravenous tubing 30 times 8 times 3. Manipulate a stopcock 8 times 4. Wrapping, taping and unwrapping a blunt object 2 times

15 Percentage failure of gloves subject to water leak test Glove material New After use Natural rubber Nitrile Vinyl Failure of vinyl gloves after simulated use increased by 520% Rego A and Roley L, American Journal of Infection Control, Volume 27, Number 5, 1999.

16 Limited use of vinyl gloves Vinyl gloves are appropriate only for short-term tasks that involve minimum stress on the gloves and low risk of exposure to blood and other infectious materials

17 DEHP in vinyl gloves Used as a plasticizer in vinyl gloves Causes abnormal development of the male fetus Is a potential endocrine disruptor Shown to cause irregular rhythms of cardiac cells in culture ms/perp%200708s4_plasticizers.cfm

18 Sanctions against DEHP US Department of Health and Human Services (DHHS) and Environmental Protection Agency (EPA) label DEHP as potential carcinogen and reproduction toxin Many countries have banned DEHP in children s toys Japan and the European Union have banned DEHP in food service gloves DEHP is banned in California s Safe Drinking Water and Toxic Enactment Act of 1986

19 Latex protein allergy Natural rubber latex (NRL) contains proteins Some of the proteins are allergens Sensitization to NRL is caused by direct contact Prevalence of latex allergy in the general public is 1% and in healthcare workers from 0.6% to 10%

20 Symptoms of latex protein allergy Local or systemic urticaria Hay fever-like symptoms Abdominal cramps Difficulty in breathing Rapid heart rate Drop in blood pressure Anaphylactic shock

21 Solution to allergy problem NR Nitrile

22 Standard Malaysian Glove Scheme A voluntary certification scheme for latex examination gloves Establishes requirements for: Freedom from holes Physical properties Protein content Powder content POWDER-FREE POWDERED Operated by the Malaysian Rubber Board, an ISO/IEC Guide 65 body, authorized by Standards Malaysia Assurance that SMG gloves comply with the requirements of the SMG specification

23 SMG meets American and European standards for physical properties SMG Type Type I Type II Standard American European

24 SMG powder content requirements (mg/glove) Powder-free 2 Powdered 150

25 SMG protein content requirements ( g/dm 2 ) Powder-free 50 Powdered 200

26 Practical considerations in glove use Change glove if The integrity of a glove is compromised and complemented with hand hygiene Use double gloves if There is a need to take precautions against HBV, HCV and HIV for long surgical procedures (>30 minutes) Performing procedures in contact with large amounts of blood and other body fluids Undertaking high risk orthopaedic procedures

27 Conclusion Gloves prevent contamination and the spread of infection by providing an effective barrier against microorganisms There are many different types of gloves and selecting the right ones for use will result in better infection control and protection of the healthcare personnel

28 Thank you More information on medical gloves is available at the following websites: