All patients with type I latex allergy should carry a subcutaneous epinephrine kit at all times.
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. A recent cost analysis found that becoming latex-safe is cost-effective for health care facilities.
Minimally, this requires reducing or eliminating powdered latex examination gloves and substituting less allergenic latex gloves or, ideally, high-quality nonlatex gloves.
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.
Federal guidelines to reduce latex exposure will have an impact on all hospitals in the near future.
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.
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.
All EDs eventually treat patients with severe latex allergies. Inadvertent latex exposure to such a patient in the ED may result in adverse outcomes and litigation.
Failure to maintain latex-safe equipment in the ED may result in adverse outcomes and litigation.
Failure to obtain a history suggestive of recognized or unrecognized latex allergy may result in adverse outcomes and litigation.
Discharge without appropriate patient education may result in adverse outcomes and litigation.
Failure to comply with evolving federal regulations to decrease latex exposure to HCWs and patients may incur liability for an institution.
Institutional failure to accommodate latex-sensitized HCWs may lead to litigation.