Latex allergy is an immunologic reaction to proteins present in natural rubber latex that come from the milky fluid of the Brazilian rubber tree. Many medical or dental supplies and devices such as catheters, gloves, and syringes are made from latex and can trigger an allergic reaction in sensitive individuals.
Groups at risk for latex allergy:
health care workers who frequently wear gloves
workers with occupational exposure to latex such as hairdressers, latex glove manufacturers, or housekeeping personnel
patients with a history of asthma, dermatitis, or eczema
patient exposed to repeated bladder catheterization such as those with spinal cord trauma and children with spina bifida
patients with food allergy, especially kiwi, bananas, avocados, or chestnuts
patients with a history of anaphylaxis of unknown etiology especially with past procedures or dental visits
patients with a history of multiple surgeries or medical procedures during childhood
Female patients are at greater risk because of gynecologic exams, contact with contraceptives, and obstetric procedures.
There are some foods that have a common allergen with latex that produces a cross-sensitivity reaction in latex-sensitive individuals. Foods with the highest allergen similarities to latex include, avocado, banana, chestnut, and kiwi. Moderate immunologic cross-reactive sensitivity is seen with apples, carrots, celery, melons, papaya, potatoes, and tomatoes. Please note that the foods listed may not produce a clinically significant reaction in latex-sensitive individuals. However, it is important for families to recognize these foods and minimize exposures.
Visit the American Latex Allergy Association (http://latexallergyresources.org/latex-cross-reactive-foods-fact-sheet) for a complete listing.
Latex allergy can cause various signs and symptoms, including generalized itching (on the hands and arms, for example); itchy, watery, and burning eyes; sneezing and coughing (hay fever–type signs); rash; hives; bronchial asthma, scratchy throat, and difficulty breathing; edema of the face, hands, and neck; and anaphylaxis.
To help identify people at risk for latex allergy, ask latex allergy–specific questions during the health history. (See Latex allergy screening.)
If the patient's history reveals a latex sensitivity, the doctor assigns him to one of three categories based on the extent of his sensitization. Group 1 patients have a history of anaphylaxis or a systemic reaction when exposed to a natural latex product. Group 2 patients have a clear history of a nonsystemic allergic reaction. Group 3 patients don't have a previous history of latex hypersensitivity but are designated as high risk because of an associated medical condition, occupation, or “crossover” allergy.
If your patient is sensitive to latex, make sure that he does not come in contact with latex because such contact could result in a life-threatening hypersensitivity reaction. Creating a latex-free environment is the only way to safeguard your patient. Many facilities now designate latex-free equipment, which is usually kept on a cart that can be moved into the patient's room. (See Choosing the right glove.) Updated lists of nonlatex products are available at the Spina Bifida Association of America (www.sbaa.org) and American Latex Allergy Association (http://latexallergyresources.org/medical-products).
Latex allergy patient identification wristband 
latex-free equipment, including room contents anaphylaxis kit.
After you've determined that the patient has a latex allergy or is sensitive to latex, arrange for him to be placed in a private room. If that isn't possible, make the room latex-free to prevent the spread of airborne particles from latex products used on the other patient.
Check for latex allergy in all patients being admitted to the delivery room or short procedure unit or having a surgical procedure.
If a patient has a latex allergy, bring a cart with latex-free supplies into his room.
Document the allergy on the patient's chart according to facility policy. If policy requires the patient to wear a latex allergy identification wristband, place it on him.
Write big
If the patient will be receiving anesthesia, make sure that “LATEX ALLERGY” is clearly visible on the front of his chart. (See Anesthesia induction and latex allergy.) Notify the circulating nurse in the surgical unit, the postanesthesia care unit nurses, and any other team members that the patient has a latex allergy.
If the patient must be transported to another area of the facility, make certain that the latex-free cart accompanies him and that all health care workers who come in contact with him are wearing nonlatex gloves. The patient should wear a mask with cloth ties when leaving his room to protect him from inhaling airborne latex particles.
If the patient is to have an I.V. line, make sure that it's inserted using latex-free products. Post a LATEX ALLERGY sign on the I.V. tubing to prevent access of the line with latex products.
Protect the patient
Flush I.V. tubing with 50 mL of I.V. solution because of latex ports in the I.V. tubing.
Place a warning label on I.V. bags that says “Don't use latex injection ports.”
Use a stopcock as alternative for giving medications through a running IV.
Use a nonlatex tourniquet. If none are available, use a latex tourniquet over clothing.
Remove the vial stopper to mix and draw medications.
Use latex-free oxygen administration equipment. Remove the elastic and tie equipment on with gauze.
Use nonlatex tape to secure lines and dressings.
Wrap your stethoscope with a nonlatex product to protect the patient from latex contact. Use a nonlatex stethoscope if available.
Wrap Tegaderm over the patient's finger before using pulse oximetry.
Use latex-free syringes when administering medication through a syringe. Also note that some prefilled medication syringes contain latex. Make sure to read the syringe before using it.
Keep an anaphylaxis kit nearby. If the patient has an allergic reaction to latex, treat him immediately.
Remember that signs and symptoms of latex allergy usually occur within 30 minutes of anesthesia induction. However, the time of onset can range from 10 minutes to 5 hours.
Don't forget that, as a health care worker, you can develop a latex hypersensitivity. If you suspect that you're sensitive to latex, contact the employee health services department concerning facility protocol for latex-sensitive employees. Use latex-free products whenever possible to help reduce your exposure to latex.
Looks can deceive
Don't assume that if something doesn't look like rubber, it isn't latex. Latex can be found, for example, in electrocardiograph leads, oral and nasal airway tubing, tourniquets, nerve stimulation pads, temperature strips, and blood pressure cuffs.
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