[core0]

Originally Posted by crackerjack

We do just as you did. Opening the latex kit exposes the room air to the allergen proteins. To open a latex kit in the room with a latex allergy patient would require an incident report at my facility. Besides, what was her goal in asking you to do that? From the cost standpoint there's little difference and from what I've seen on our cost inventory, more expensive to open a full latex kit then a silicone foley because the big expense of going latex free is the foley itself. The cost of assembling the needed supplies contained in a latex kit is not that costly.

Cost should be irrelevent but we are a $$ driven society and business is business, therefore, it's considered in what we're asked to do gotta save that buck!!!

The real question should be was this a real latex allergy. There are lots of people that have a "latex allergy" but it is really a latex sensitivity. I work in GI and if we have a real latex allergy case we have a standard protocol. Has to be done in the OR (not GI lab) has to be the first case of the day. Room has to be terminated the night before (complete scrub down). All latex material has to be removed before terminating the room and any cabinets with latex material have to be sealed.

As you can see this is a real pain and has led to a dramatic reduction in latex cases. Ask yourself a few questions. Is there airway involvement, can they wear regular underwear (elastic contains latex) etc. Most people have a latex sensitivity and you just need to avoid direct contact with latex. The ones that truely have a latex allergy give you a definite appreciation for the amount of latex in the hospital environment.

David Carpenter, PA-C

[TracyB,RN]

Our foley kits are also latex free. Most of our stuff is.
Ditto to core0's post. Most patients aren't truly allergic, but the ones that are, ooooh boy. The nasty, nasty consequences. YIKES

[crackerjack]

Originally Posted by core0

The real question should be was this a real latex allergy. There are lots of people that have a "latex allergy" but it is really a latex sensitivity. I work in GI and if we have a real latex allergy case we have a standard protocol. Has to be done in the OR (not GI lab) has to be the first case of the day. Room has to be terminated the night before (complete scrub down). All latex material has to be removed before terminating the room and any cabinets with latex material have to be sealed.

As you can see this is a real pain and has led to a dramatic reduction in latex cases. Ask yourself a few questions. Is there airway involvement, can they wear regular underwear (elastic contains latex) etc. Most people have a latex sensitivity and you just need to avoid direct contact with latex. The ones that truely have a latex allergy give you a definite appreciation for the amount of latex in the hospital environment.

David Carpenter, PA-C

We have the same policy in place for latex allergic patients in our OR however, unfortunately, if a patient says she/he is allergic to latex we have to treat it as such even if the sx symply indicate latex sensitivity. I appreciate the fact that it may be only a sensitivity but the fact that our patients are coming in for surgery places them at a distinct disadvantage healthwise. They are ill in some way and we are causing a major assault to the body which could result in the body reacting to latex proteins more extremely than in the past. Better to treat this like a 'pain is what the patient says it is' situation. It's kind of a sore spot at my hospital as we have several surgeons and anesthesiologists who wish to dismiss it altogether at times. It's extra work then there's the wait time to TC the room and set it up again when we failed to get the information at scheduling that the patient is latex allergic and find out the day of surgery. ugh what a nightmare!

[core0]

Originally Posted by crackerjack

We have the same policy in place for latex allergic patients in our OR however, unfortunately, if a patient says she/he is allergic to latex we have to treat it as such even if the sx symply indicate latex sensitivity. I appreciate the fact that it may be only a sensitivity but the fact that our patients are coming in for surgery places them at a distinct disadvantage healthwise. They are ill in some way and we are causing a major assault to the body which could result in the body reacting to latex proteins more extremely than in the past. Better to treat this like a 'pain is what the patient says it is' situation. It's kind of a sore spot at my hospital as we have several surgeons and anesthesiologists who wish to dismiss it altogether at times. It's extra work then there's the wait time to TC the room and set it up again when we failed to get the information at scheduling that the patient is latex allergic and find out the day of surgery. ugh what a nightmare!

The policies around here are different. They either need a documented airway problem - preferably by anesthesia or a positive latex IgA rast. Othewise No ticket no ride. The cost of doing all these "latex" cases was just prohibitive. I have done more than 200 rast tests in the last three years for latex allergy and only one of them has been a true allergy.

David Carpenter, PA-C

[crackerjack]

Originally Posted by core0

The policies around here are different. They either need a documented airway problem - preferably by anesthesia or a positive latex IgA rast. Othewise No ticket no ride. The cost of doing all these "latex" cases was just prohibitive. I have done more than 200 rast tests in the last three years for latex allergy and only one of them has been a true allergy.

David Carpenter, PA-C

We are to the point where almost everything we use is latex free anyway. The only changes we have to make are the bag on the anesthesia vent and to move it to first of the day, and latex free gloves for the surgical team. Our rooms are TC'd every night...or at least that's what our night orderly is supposed to be doing! Other changes would simply involve avoiding a few common items such as a penrose or using a latex free foley.

I'm surprised it is so cost prohibitive over non-latex allergy cases for your institution as most manufacturers and suppliers are moving to make their products latex-free.

As an aside, we had a patient recently who was a DO no less and was in for her second total knee. She and her PhD husband were very *needy* to say the least. They both insisted that she was allergic to the drain used on her previous total and were adamant that we NOT use that kind again. It was a standard silicone drain. I've never heard of anyone being allergic to silicone but hey, anything can happen. However, this woman also wore a CPAP nightly and brings it with her for PACU. The mask is silicone. Somehow the DO couldn't tell the difference in an allergic reaction and standard surgical site inflammation and irritation. Go figure.

Have a good day!

[GA,RNC]

I have a latex allergy and am scared to death of your supervisor's statement. Latex particles are deadly to some latex allergic people (they are to me!). My advice: keep yourself out of any litigation and keep your conscience clear and continue to use latex free supplies/equipment!

[scrubnurse]

Kleinbbc~
I just had this same thing happen! I have worked in the OR for 13 yrs, but new to L&D. In the OR, when we have a latex allergy, it is a major ordeal...
Change out this, can't use this, etc...
Well on L&D, I had my first latex allergy pt. I asked my preceptor what precautions to take besides the obvious. After going in the supply room, I discover they have silicone catheters, but no seperate urinebags/urinemeters. So I take the catheter out and ask where to find a urinebag to attach to the catheter. She says, "oh we just use the regular one. Just take the latex catheter off and put the new one on."
I was flabbergasted! I was just glad my pt never needed a foley. Now I am wondering how to handle this in the future. I don't feel comfortable doing that. Any thoughts???

[Marie_LPN]

Originally Posted by scrubnurse

Kleinbbc~
I just had this same thing happen! I have worked in the OR for 13 yrs, but new to L&D. In the OR, when we have a latex allergy, it is a major ordeal...
Change out this, can't use this, etc...
Well on L&D, I had my first latex allergy pt. I asked my preceptor what precautions to take besides the obvious. After going in the supply room, I discover they have silicone catheters, but no seperate urinebags/urinemeters. So I take the catheter out and ask where to find a urinebag to attach to the catheter. She says, "oh we just use the regular one. Just take the latex catheter off and put the new one on."
I was flabbergasted! I was just glad my pt never needed a foley. Now I am wondering how to handle this in the future. I don't feel comfortable doing that. Any thoughts???

In a pinch, call the OR and ask for a separate Foley bag.

And i'd push for separate bags until we got them stocked.

[scrubnurse]

Marie,
Forgot to mention I am also new to this hospital, and it is way bigger than where I used to work. I don't even know where the OR is at this hospital, so I can't call them and request a foley. They would think I was crazy.
Being new is the hard part. I hate to be that new person who comes in and makes waves, challenging current ways of doing things, but on the other hand, if I feel it is unsafe for my pt, I will not do it. I guess I will address this with the charge nurse.

[DDRN4me]

Originally Posted by core0

The real question should be was this a real latex allergy. There are lots of people that have a "latex allergy" but it is really a latex sensitivity. I work in GI and if we have a real latex allergy case we have a standard protocol. Has to be done in the OR (not GI lab) has to be the first case of the day. Room has to be terminated the night before (complete scrub down). All latex material has to be removed before terminating the room and any cabinets with latex material have to be sealed.

As you can see this is a real pain and has led to a dramatic reduction in latex cases. Ask yourself a few questions. Is there airway involvement, can they wear regular underwear (elastic contains latex) etc. Most people have a latex sensitivity and you just need to avoid direct contact with latex. The ones that truely have a latex allergy give you a definite appreciation for the amount of latex in the hospital environment.

David Carpenter, PA-C

I would never take that chance with someones life!!!! as we all know, a "latex sensitivity " could turn into full blown anaphalaxis in seconds...sorry i value my patients life and my license way too much to take that chance.