Alergia al latex

NATURAL RUBBER LATEX ALLERGY:
CONSIDERATIONS FOR ANESTHESIOLOGISTS
American Society of Anesthesiologists Committee on Occupational Health of Operating Room Personnel Jonathan D. Katz, M.D., Chair

Task Force on Latex Sensitivity Robert S. Holzman, M.D., Chair Robert H. Brown, M.D., M.P.H. Rukaiya Hamid, M.D. Carol A. Hirshman, M.D. Sandra B. Kinsella, M.D. Charise Petrovich, M.D. Gail I.Randel, M.D. Susan A. Vassallo, M.D. Jonathan D. Katz, M.D.

5M603LC

NATURAL RUBBER LATEX ALLERGY: CONSIDERATIONS FOR ANESTHESIOLOGISTS
This document has been developed by the Task Force on Latex Sensitivity of the ASA Committee on Occupational Health of Operating Room Personnel but has not been reviewed or approved as a practice parameter or policy statement by the ASA House of Delegates.Variances from recommendations contained in this document may be acceptable based on the judgment of the responsible anesthesiologist. The recommendations are designed to encourage quality care and safety for patients and health care workers in the workplace but cannot guarantee a specific outcome. They are subject to revision from time to time as warranted by the evolution of technology andpractice.

Copyright © 2005 by the American Society of Anesthesiologists. All rights reserved.

Natural Rubber Latex Allergy: Considerations for Anesthesiologists

TABLE OF CONTENTS
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Identification of High-Risk Groups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . 1 Routes of Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Signs and Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Operating Room Management of the Patient With Latex Allergy . . . . . . . . . . . . . 2 Treatment of Latex Allergy Reactions . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . 2 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Chemistry of Latex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Glove Technology and Manufacturing Standards . . . . . . . . . . . . . . . . . . . . . . . . . . 5 ClinicalManifestations of Latex Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Routes of Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Populations at Risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Prevention of Reactions in Previously Sensitized Individuals . . . . . . . . . . . . . . . . 12 Management of Latex-Sensitive Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Treatment of an Allergic Reaction to Latex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Management of the Health CareWorker With Latex Allergy . . . . . . . . . . . . . . . 18 Management of Health Care Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Future Directions and Implications for Anesthesiologists . . . . . . . . . . . . . . . . . . 19 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 TABLES Table 1:Types of Reactions to Latex Gloves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Table 2: Diagnosis of Latex Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Table 3: Screening Questionnaire for Latex Sensitivity . . . . . . . . . . . . . . . . . . . . 13 Table 4: Checklist for Management of Latex-Allergic Patients . . . . . . . . . . . . . . 15 Table...