Latex Allergy Follow-up

Updated: Jan 08, 2016
  • Author: Amy J Behrman, MD; Chief Editor: Erik D Schraga, MD  more...
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Follow-up

Further Outpatient Care

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  • Patients and their families should be educated to identify and avoid latex in home, work, and medical/dental settings.
  • Patients should be referred to an allergist or primary care provider for follow-up.
  • Patients should be aware of the life-threatening complications of anaphylaxis, bronchospasm, and laryngospasm.
  • Patients with type I hypersensitivity should carry subcutaneous epinephrine kits at all times.
  • Patients should obtain and wear a MedicAlert-type bracelet identifying their allergy.
  • Patients should be aware of the risk of cross-reacting fruit allergies.
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Further Inpatient Care

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  • Patients with major latex allergies who are admitted for allergic complications or unrelated conditions must be moved to latex-safe rooms with clear warnings on doors and charts.
  • All examinations and care must be done without use of latex-containing devices or equipment.
  • All providers should be educated to avoid inadvertent exposure.
  • Latex is the second most common cause of intraoperative anaphylaxis, which can be difficult to diagnose because of infrequent cutaneous signs and patients' inability to express symptoms. [15, 14] Known latex allergy or a history suggestive of major latex allergy should trigger the use of latex-free operating rooms and postoperative care.
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Inpatient & Outpatient Medications

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  • See articles on Anaphylaxis, Angioedema, and Asthma for inpatient and outpatient medications.
  • All patients with type I latex allergy should carry a subcutaneous epinephrine kit at all times.
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Deterrence/Prevention

Hospitals should make policy and purchasing decisions to minimize latex exposure in the institution, with the goal being to protect sensitized patients and employees as well as to reduce the risk of primary sensitization. Several cost analyses have found that becoming latex-safe is cost-effective for health care facilities. [34, 35]

Minimally, this requires reducing or eliminating powdered latex examination gloves and substituting less allergenic latex gloves or, ideally, high-quality nonlatex gloves. This strategy has been shown to reduce natural rubber latex aeroallergen, sensitization of exposed HCWs, and incidence of asthma in HCWs. [36, 37] Follow-up studies of latex allergic HCWs have shown a reduction in latex-specific IgE antibodies after latex use is substantially reduced in the healthcare workplace. [38, 39, 40, 24]

It also requires clear guidelines for the safe treatment of sensitized patients and for the accommodation of sensitized employees.

Multidisciplinary hospital committees can be effective in accomplishing these goals.

Non-healthcare workplaces should address the risk of workplace anaphylaxis. [41]

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Complications

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  • Respiratory compromise
  • Anaphylaxis
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Prognosis

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  • Most latex-allergic patients can function normally by avoiding significant latex exposure at home, at work, and in medical/dental situations.
  • Some patients will become more sensitized and have greater difficulty functioning.
  • A small percentage of patients with IgE-mediated allergy become so sensitized that inadvertent exposure to minute amounts of latex, either by contact or inhalation, causes frequent life-threatening episodes.
  • In the absence of effective immunomodulatory therapy, avoidance of latex and excellent ED care must be the patients' mainstays.
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Patient Education

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  • Patients can and should be referred to local or national support groups to stay abreast of new developments in latex-free devices that may make their lives safer and more convenient.
  • These groups frequently maintain lists of latex-safe medical and dental practices; many track regulatory and legislative developments.
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