| Gary Ludwig |
To Die For
| Gary Ludwig is the Chief Paramedic/EMS Bureau Chief for the St. Louis Fire Department. He is currently serving his third term as an elected board member to the EMS Section for the International Association of Fire Chiefs and lectures quite frequently at fire and EMS conferences. He has a Master's Degree in Management and is a licensed paramedic. |
This article can be found on
page 98 of the Nov/Dec 1997
issue of 9-1-1 Magazine.
Quick quiz:
EMS Professionals use it on a daily basis. Its
been around for a long time. They fit in the "palm" of your hand.
They come in "handy." And they can kill you! What is it?
Congratulations if you guessed latex gloves.
What? A latex glove can kill you?
Yes!
Latex allergies can be life threatening. Anaphylaxis is a real possibility for someone with NRLA (natural rubber latex allergy). Are you or your EMS organization capable of treating anaphylaxis? Most pre-hospital care givers are. However, how will you lessen your patient's exposure to latex if you are still wearing latex gloves? Are your gloves powder free?
There appears to be an extreme lack of education among health care professionals when it comes to dealing with latex sensitivity. Most hospitals and EMS agencies are not equipped to deal with a patient with latex allergy. What is latex? Latex is the milky white liquid from the Hevea Brasiliensis tree.
There are over 40,000 products that contain latex, including condoms. Have you identified all the products you can safely use on a latex allergic patient? Is it safe to use tape? Which brand? Unfortunately, there is no cure for latex allergy. The only treatment is to treat the patient's symptoms. Latex allergic individuals are advised to have total avoidance of latex. Considering there is over 40,000 products with latex, this can be difficult.
Latex allergy can begin as a hand rash when you are using latex gloves. You may also experience a runny nose, itchy eyes, urticaria, sneezing, hives, shortness of breath, chest tightness, wheezing, and/or coughing. If you have exhibited any of these signs and symptoms, you should be seen by an allergist to be tested.
Document all your signs and symptoms in a journal to be evaluated later or to develop a pattern. There are FDA approved blood tests available but there is no FDA approval on a skin prick test. There have been systemic reactions reported regarding the usage of skin prick tests on suspected latex allergic individuals. Individuals who have demonstrated allergies to bananas, kiwi, and avocado are highly cross reactive to latex.
Some states have introduced legislation to ban the use of powdered latex gloves in all health care facilities. Do you know if your state is considering this type of legislation? As an EMS agency, do you have a latex protocol? If your organization does have one, when was it instituted and have you read it and familiarized yourself with it. As an EMS professional, are you prepared to take care of a latex allergic patient?
Someone who has a latex allergy will always be allergic to latex. The more you are exposed to latex, the worse your symptoms. Minimizing your exposure may reduce your level of sensitivity but not your level of allergy. There are levels of severity, but not levels of allergy.
If you determine you are allergic to latex, what can you do? First and foremost....educate yourself. Evaluate your own exposures. Are you at risk? Have you ever worn a powdered latex glove? Have you had numerous surgeries? Research is currently being done about latex allergy. Numerous articles can be found on the Internet about latex allergies. A recent search using the AltaVista search engine listed over 100,000. Latex allergy related links includes many of the most informative sites.
The second thing you can do is eliminate the powder from your gloves, which can become airborne. This dust can fill your ambulance with deadly particles. Buildings can carry this dust in their air containment system, contaminating everything with latex-laden dust! Do you sometimes notice dust on your clothes? Latex dust! Have you hugged your children when you had dust on your clothes? Think about all the places you have touched with your powdered latex gloves. Have you increased someone's exposure to latex and not even known it? There is a good possibility of it. (There is a population of undiagnosed people with latex allergy. They don't know that they are allergic to latex and yet in an emergency, they will be treated by EMS professionals wearing latex gloves. You may be further sensitizing your patient without even realizing it.) As a result, some EMS organizations have eliminated the powder and switched to a non-latex alternative. By doing such, they are not only protecting your patient, but also protecting yourself.
The largest argument against switching gloves is the cost. But those in favor of non-latex alternatives would argue that it would be better to spend more money on better quality gloves than to pay for workman's compensation. They further contend that most workman's compensation claims can cost upwards of thousands of dollars while reminding you there is no cure! Some EMT and paramedics have suddenly found themselves without a career with a simple diagnosis of having a latex allergy.
There are some other things which can be done for latex allergies. The FDA has received numerous reports of reactions from latex containing medical products. The MedWatch program is a voluntary reporting agency of the FDA. The MedWatch report on latex allergy is over 900 pages long! There have been over 1600 reports attributed to latex glove usage alone! EMS agencies should report all adverse reactions to the FDA. Please report your reactions. You will not only be helping yourself, but helping others also. Certainly being aware of latex allergies, their causes and reactions, is something all EMS professionals need to be aware of.
