SARASOTA MEMORIAL HEALTH CARE SYSTEM CORPORATE POLICY TITLE: LATEX ALLERGY POLICY #: EFFECTIVE DATE: REVIEWED/REVISED DATE: POLICY TYPE: 5/28/97 08/25/17 Clinical 1 of 5 Non-Clinical Job Title of Responsible Owner: Director, Education, Professional Development, and Research PURPOSE: POLICY STATEMENT: EXCEPTIONS: To promote a safe health care environment for latex-sensitive or latex-allergic patients and health care workers. It is the policy of Sarasota Memorial Health Care System (SMHCS) to promote a safe health care environment for latexsensitive or latex-allergic patients and health care workers. None DEFINITIONS: 1. Allergic contact dermatitis: (Type IV cell-mediated/delayed hypersensitivity): An allergic response generally localized to the contact area and attributable primarily to chemicals used in the latex manufacturing process. This is usually not latex allergy. 2. Irritant contact dermatitis: A non-allergic cutaneous response to an irritant caused by a chemical or physical exposure. 3. Latex: The milky cytosol tree sap acquired by tapping the commercial rubber tree, Hevea brasiliensis that is grown on large plantations in Africa and central Asia. Also known as natural rubber latex (NRL). 4. Latex allergy: (Type I lge-mediated/immediate hypersensitivity response): A systemic or local allergic response to various latex proteins to which the individual has been sensitized. 5. Latex-safe environment: An environment in which every reasonable effort has been made to remove or contain latex sources.
2 of 5 6. Sensitization: The development of immunological memory in response to exposure to an antigen. 7. Type I Allergic Reaction: A true latex allergy that can be life-threatening. Reactions vary based on type of latex protein and degree of individual sensitivity, including local and systemic. Symptoms include hives, generalized edema, itching, rash, wheezing, bronchospasm, difficulty breathing, laryngeal edema, diarrhea, nausea, hypotension, tachycardia, and respiratory and cardiac arrest (Perry & Potter, 2014). PROCEDURE: 1. Patient Assessment: a. Staff conducting the pre-admission or admission interview and assessment will evaluate and identify patients at risk for latex allergy and will list it as an allergy in the electronic medical record. Patient s at risk for latex allergies could include the following: 1) Known latex allergy. 2) History of allergic reaction to rubber gloves or balloons. 3) History of unexplained anaphylactic reaction during surgery, urinary catheterization, and rectal or vaginal exams. 4) All patients with spina bifida. 5) Patients identified at higher risk than the general population due to history of multiple GU procedures, frequent surgeries, known asthma, multiple food allergies, eczema and any previous allergic reactions. 6) People with multiple food allergies especially mangos, bananas, avocados, kiwi, papayas, chestnuts, grapes, and tropical fruits. 2. Management of patients: a. It is very important that communication occurs among health care workers regarding the patient s latex allergy status so they are cared for in a latexsafe environment. b. Latex Allergy management includes: 1) Order a latex allergy supply caddy from Central Distribution to be placed on the entrance door to the patient s room.
3 of 5 2) Label outside of patient s chart with a LATEX ALLERGY sticker (available in caddy). 3) Attach LATEX ALLERGY PRECAUTIONS notice to the door of the patients room (available in caddy). If the patient is in a semi-private room, place the sign above the patient s head of bed. 4) Place a green LATEX ALLERGY armband on the patient s wrist (available in caddy). 5) Surgery: When caring for patients in Perioperative Services, refer to department policy 139.0243 for specific care needs to follow in Surgery. 6) If patient does experience an allergic response: a) Stop treatment and remove irritating agent, if possible. Contact attending physician immediately. b) Monitor for anaphylactic reaction. c) Have emergency IV fluids and drugs for treatment immediately available. 7) Balloons should not be allowed in the patient rooms. 3. Employee Health Issues: a. Employees who may have latex sensitivity or allergy should be assessed by Employee Health Services. 1) If the employee has irritation due to factors other than latex, management may include changing soap or scrub solutions, changing gloves, or improving hand care. 2) If the employee is suspect for a latex allergy, they may be directed to see their primary physician for testing or a consultation by a dermatologist or allergist may be appropriate. b. Latex-allergic individuals with positive histories and/or skin tests should be counseled about the risk of working in environments with high latex use. They should use only non-latex gloves and avoid all products containing latex. They should wear appropriate allergic identification and always carry an epinephrine auto-injector device. c. Non-latex gloves, both sterile and non-sterile, will be available in the practice setting for latex allergic individuals.
4 of 5 4. Latex Avoidance And Education: a. High-risk patients should be informed that hospitals can be made latex-safe, but not totally latex-free. The risk of reaction still persists. b. Patient education should include information about the care and precautions that should be taken to prevent latex exposure and a first aid protocol in the event a severe reaction should arise. c. By touching any latex object, the health care workers can transmit the allergen by hand to the patient. Hand hygiene practices will be followed to prevent latex allergens from being transmitted on the hands of health care workers. RESPONSIBILITY: REFERENCES: It is the responsibility of the department/unit directors and managers to ensure that this policy is implemented and followed. Medline Plus. U.S. National Library of Medicine. 8600 Rockville Pike. Bethesda: MD. Retrieved: 8/16/12 SMH Surgery Department Policy. Latex Allergy Protocol for Surgical Patients. (139.0243). SMH: Author. Perry & Potter. (2018). Clinical Nursing Skills & Techniques. (9 th edition). (p. 266). Mosby. St. Louis: MO. Lippincott. (2015). Lippincott s Nursing Procedures-(Seventh edition). (pp. 481-482). Lippincott Williams & Wilkins. Philadelphia: PA. REVIEWING AUTHOR(S): Michelle Perala, Manager, Employee Health Sheryl McIntyre, Supervisor, Central Distribution Jeffrey Stamper, Central Distribution ATTACHMENT(S): None
5 of 5 APPROVALS: Signatures indicate approval of the new or reviewed/revised policy. Committees/Sections/Departments: Date Clinical Practice Council 8/3/17 Director/Responsible Owner: Jean Lucas, ACNO 8/7/17 Vice President/Executive Director: Connie Andersen, VP/Chief Nursing Officer 8/8/17 Chief of Medical Operations: (if clinical policy or appropriate) Chief of Staff: (if clinical policy or appropriate) Medical Executive Committee: (if clinical and review requested by CMO and COS) Chief Executive Officer: David Verinder, CEO 8/14/17