What actions will you or the team need to undertake to ensure the safety of the first patient with an allergy to latex?
You are waiting for a RN Rosie has been working as an anaesthetic nurse for several months and she is in the anaesthetic room with Mrs A, who is to undergo a total knee replacement. Mrs A has had a premedication, which has made her drowsy, but she is clearly still very anxious and holding firmly onto Rosie's hand. Rosie notices that Mrs A's healthcare record It is the commencement of your morning shift and you have been assigned to work in the general surgery operating theatre. The operative list comprises of two adult patients for elective surgical procedures: the first patient has an allergy to latex; the second patient is morbidly obese (BMI 70, height 166 cm, weight 193 kg).
What will be an ideal response?
Answer:
Patients with latex sensitivity must be cared for in an environment free from contact with latex products. Some facilities may have established a ‘latex-free' operating theatre or environment, though all operating suites should have a procedure/work instruction informing the plan of care for patients with a latex sensitivity. However should latex products be present within the environment, non-latex equipment/consumables must be available for the provision of safe care for a latex-sensitive patient. Actions to be taken to promote patient safety include:
All perioperative staff should wear synthetic gloves and remove or replace any items containing latex. Staff should wash their hands before re-entering the theatre (Hohler, 2015).
Use only non-latex items within the operating room. Ensure the theatre was cleaned by staff wearing synthetic gloves where possible.
For Operating suites that use powdered latex gloves, ensure patients with a latex sensitivity are the FIRST patient on the general surgery list for the day (Australasia Society of Clinical Immunology and Allergy, 2010). Latex-safe terminal cleaning of the theatre should be done the night before the surgery. This practice and the air exchanges overnight should reduce the aerosolised latex particles. If scheduling the patient with a latex allergy as the first case of the day is not possible, as much time as possible for air exchange should be allowed (Hohler, 2015).
For Operating suites that do not use powered latex gloves, a patient with a latex sensitivity does not need to be the first patient of the day. Also the operating theatre does not need to ‘rest' for air exchanges to occur, as the risk of aerosolised latex particles are not present and the risk is reduced when powered latex gloves are not in use (Australasia Society of Clinical Immunology and Allergy, 2010).
Source equipment and consumables that are latex-free. Nurses should be familiar with the logo printed on packaging denoting the product contains latex. If in doubt about an item, always refer to the manufacturer for guidance. Consider keeping a record of the items remaining within your unit that contain latex (as the majority of items today are latex-free) and suggest an alternative for staff to use/source to ensure timely, safe care is given to the patient.
Post signs denoting a latex-free environment on external doors (Hohler 2015).
Protect the patient from anything that may contain latex (e.g. arm boards and operating room tables that may contain latex should be covered with linen) (ASCIA, 2010).
Ensure clear documentation and communication (including clinical handover) in a timely manner to all clinical areas associated with this patient's care. Therefore, ensure the postanaesthesia care unit is aware of and prepared for the patient's arrival. Communication regarding a patient's latex sensitivity should begin with their pre-admission and continue throughout the patient's hospital experience (Hohler, 2015).
Be alert and prepared for an adverse event. Prior preparation will ensure the patient's sensitivity is skilfully managed in a timely manner.
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