Double gloving?

From my experience, double gloving is a matter of policy for many facilities and not something that is optional. Having said that, when I am scrubbed and working neuro under scopes I tend not to double glove because of lack of sensitivity handling the small micro instruments. When I was younger, this wasn't so much of a problem for me to be double gloved, but with old arthritic hands, single gloving does have some benefit (at least for me) on these cases although I try to avoid them now because I can't double glove them and provide effective passing. However, for the majority of the cases there is no way I would only single glove. Being double gloved also allows you to maintain sterility if your top glove becomes compromised without having to wait for someone to remove your contaminated glove so that you can re-glove.

Thanks for your comments so quickly.

I am still double gloving not only to protect myself but as you say for maintenance of sterility if I have to change gloves.

I personally have found no problems as yet handling small instruments whilst double gloved (i practice in head and neck surgery) and I feel more secure whilst wearing 2 gloves. As far as policy goes in my UK trust the policy is that whilst double gloving is not compulsory for scrub persons it is recommended. Ultimately it is personal choice at my trust.

As TTA said, double gloving allows maintenance of sterility should the top glove become contaminated. I understand that you lose some sensitivity while wearing two gloves when you aren't used to them, but with time you will adjust to wearing two gloves. Benefits also include having two layers that something would have to pass through, which potentially removes more bioburden from the blade/needle; and it's also an additional layer that has to be crossed to begin with. With the prevalence of blood-bourne illnesses that have the potential not to be diagnosed immediately, double gloving just makes a lot of sense. It's also policy at my facility for employees (which doesn't include 99% of the docs).

P.S. You want loss of sensation? Try having to wear the latex-free gloves every stinking time you scrub. I have a latex sensitivity (rash, not full blown anaphylaxis) so not only do I wear two gloves, but my top gloves are extremely thick compared to the latex gloves.

Your facility still has latex gloves? They need to look into getting rid of them and getting the proper latex free ones, not the first ones that came out. My facility does not have any lates gloves and the undergloves feel like you are wearing latex gloves and the overgloves are even better.

We don't have latex gloves, but whatever they are made out of (polyisoprene?), I am allergic to, and the alternative is some very thick gloves as well.

I double glove for all the reasons listen above, plus a couple that weren't mentioned.

We have some green gloves and some white gloves, and when we double glove we do the green under the white, so if we get a tear or a tiny needle stick or something in the top glove, we can see it better with the green contrast underneath.

Also, the gloves I am not allergic to only come in 6.5 as the smallest size, and I wear a 6. Sometimes for the tiny micro instruments it is not ideal to single glove because they don't fit me properly. 6.5 unders and 6 overs give me a nice snug fit. I was also told sometimes with the double gloving you are able to get an in-between size as a result.

I agree on the sizing point. I use an 8 over glove and an 8.5 underglove which gives a nice snug fit without being tight and cramp inducing. We have a choice of latex or non-latex gloves in my complex with the split being around 50:50

I think on balance, and even after reading the evidence that shows an increased risk of injury when double gloved (from 1998!) I will continue to double up. I have altered my practice since my injury and have enough dexterity to function safely and effectively.

Thanks for your replies all. Good luck

Many valid points regarding double gloving. All are quite valid. However, evidenced based practices are advocating double gloving. Mostly, I circulate. I do scrub from time to time. I am trying (wish I knew how to italicize trying on my iPhone) to get into the habit of double gloving. It is difficult especially when used to a single glove. I find that wearing a half size larger than normal as your under-glove and your normal size as your top glove is the most comfortable. I, too, am latex sensitive. I wear a polypropylene underglove and latex top. My institution is looking into going 100% latex free. Apparently such a conversion is expensive. The only latex things we have left are gloves, foley catheters, and penrose drains. The floors have already converted to latex free Foleys. And no latex exam (non sterile) gloves are to be found anymore. The only latex gloves we have are the sterile ones in surgery. But this is probably a whole other thread. I digress. Good luck.

I don't know how many of you have experienced this, but I have noticed that non-latex gloves tend to rip much more readily than latex gloves. Recently there has been a progressive move to dispense with latex gloves altogether in my facility. I have always practiced double gloving, and feel that it is even more important now to do so with non-latex gloves.

I encourage residents and students to double glove and get used to the feeling. It takes some acclimating to the feel of double gloves. I was in an ortho case with a surgeon who used OrthoCord on a ligament, and just the act of pulling the suture taut broke his glove. He double gloves now. And curses the whole time!