To outline the management of patients which are high risk for
latex allergy and/or allergic to latex/rubber products.
Latex sensitivity is an acquired sensitized response to the
latex protein antigen. The milky sap of the rubber tree
Hevea Brasilinies (rubber tree) produces 99% of the latex
used today. Latex sensitivity was first reported in 1979 and
has become a major concern due to the frequent exposure with
implementation of universal precautions. Increased use and
awareness have caused reports of adverse reactions to
increase dramatically. The first treatment goal is
prevention through utilization of products that have the
lowest protein allergen content or that contain no latex.
Once sensitization has occurred the avoidance of latex
AT RISK POPULATIONS AND/OR RISK FACTORS:
Patients known to have increased risk for latex sensitivity
reactions are those with a history of:
-Multiple surgeries where latex products were used,
particularly during childhood.
-Long term urinary catheterization with latex products.
-Myelomeningocele, myelodysplasia (spina bifida), and
other diagnoses requiring frequent catheterizations.
-Long term latex exposure in the work setting.
-History of anaphylactic reactions during surgical or
dental procedures for unknown reasons.
-Allergy to tropical fruits, kiwi, bananas, chestnuts
and poinsettia plants.
-Strong history of asthma, seasonal rhinitis, drug or
-History of contact urticaria.
Patients in above categories are at highest risk for the
development of latex sensitivity. Those who have experienced
localized (contact) reactions to latex are the highest risk
for developing systemic (anaphylactic) response with further
THREE DISTINCT REACTIONS TO LATEX ALLERGY
Irritant contact dermatitis: This is a non-allergic reaction
that results in a dry, red, cracked or crusted skin rash on
the hands. It is usually caused by sweating or rubbing under
the latex product, by detergent, by soap, by antiseptics,
washing/scrubbing skin, or by latex glove powder.
Allergic contact dermatitis: also known as chemical
sensitivity, contact dermatitis or delayed hypersensitivity.
This is seen as a blistering/rash resembling eczema where
latex came in contact with the skin. It appears 48-96 hours
after exposure to the latex product. Skin may become
thickened and crusted. This may progress to a generalized,
systemic allergy if exposure to latex continues.
Immediate allergic reaction (Immunoglobin E mediated):
immediate hypersensitivity reaction. This results in
allergic symptoms such as runny nose, sneezing, watery eyes,
hives, asthma/bronchospasm, anaphylaxis, or death.
IDENTIFICATION OF AT-RISK PATIENTS
1. Identify patients at high risk or with an actual latex
allergy upon admission by interviewing the patient,
parent, and/or family, by asking the following questions:
NOTE: If the patient, parent and/or family answers YES to
any of the following questions, initiate this protocol.
A. Has the patient had any of these reactions to any
latex/rubber product exposure? Possible reactions
-Unexplained anaphylactic-type allergic reactions
during surgical or dental procedures?
-History of Spina Bifida or other congenital disorder
(confirm with primary care physician)
-Chapping/cracking of hands
-Shortness of breath
-Difficulty in breathing/wheezing
-Facial and laryngeal edema
-Increased heart rate
-Abdominal cramping and/or diarrhea after exposure
to latex products
-History of cardiac/pulmonary arrest of unknown
2. Document latex allergy information on the patient's
chart. If available, place allergy armband on patient.
3. Notify Medical Director and/or surgeon; determine if
patient's procedure will be conducted at the outpatient
facility or moved to another site.
4. Avoid patient contact with any latex-containing product.
Main areas of concern are:
A. IV starts and blood draws (tourniquet, tape,
injection ports, etc.)
C. Any procedure where gloves are worn.
D. IV medications
KEY LATEX/RUBBER PRODUCTS IN HOME ENVIRONMENT INCLUDE:
Adhesive Tape Corsets Rubber Bands
Baby Bottle Nipples Erasers Rubber Cement
Balloons Face Masks Rubber Gloves
Bandages Foam Pillows Shoe Wear
Belts Garden Hoses Suspender
Brassieres Hot Water Bottles Teething Rings
Carpet Backing Ostomy Bags Weather Stripping
Approved By Governing Board