Latex allergy; the road ahead

2,197 views

Published on

This presentation is about latex allergy and streamlining care of latex sensitive patients

Published in: Health & Medicine
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,197
On SlideShare
0
From Embeds
0
Number of Embeds
65
Actions
Shares
0
Downloads
75
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Latex allergy; the road ahead

  1. 1. Latex Allergy <br />The Road Ahead<br />
  2. 2. What is Latex?<br />Natural rubber latex is the milky fluid extracted and processed from the rubber tree Heveabrasiliensis.<br />The fluid is made up of 60% water, 35% rubber and 5% organic substances.<br />(Bundesen, 2008)<br />
  3. 3. The Latex Molecule<br />The latex molecule is constructed of spherical poly-isoprene droplets coated with a layer of water-soluable proteins.<br />(Deval, Ramesh, Prasad, & Jain, 2008)<br />Of the 250 or so different proteins only 11 have been mapped.<br />(Bundesen, 2008)<br />
  4. 4. Production<br />During production chemicals are added, such as accelerators, antioxidants, emulsifiers, dyes, and stiffeners.<br />(Bundesen, 2008)<br />Most are destroyed in the manufacturing process, however the few that remain can cause dermatological problems.<br />
  5. 5. Cause of latex allergies<br />Type I allergic reaction is caused by the latex protein allergen.<br />Type IV allergic reaction is caused by the chemicals used in the manufacturing process.<br />
  6. 6. Known as a ‘true’ allergy.<br />The latex protein allergen provokes an immunologic response in the form of antibodies, specifically immunoglobin E. <br />Ig E binds with the allergen resulting in a cascading action of mast cells and basophil cells releasing chemical mediators such as histamines.<br />(Bundesen, 2008)<br />Type I reaction – The proteins’ fault<br />
  7. 7. Symptoms may include itching, reddening, hives (anywhere on the body), inflammation of the nasal mucosa, wheezing, coughing, shortness of breath, sneezing, conjuncgtivitis, asthmatic reactions, and hypotension. <br />In rare cases a severe type I reaction may be life-threatening when blood pressure drops and airways constrict.<br />Type I reactions have had contact with mucous membranes, the airways or bloodstream. <br />Rapid onset, effects skin, airways, central nervous system, gastrointestinal tract.<br />(Bundesen, 2008)<br />(Deval, Ramesh, Pradsad, & Jain, 2008)<br />Type I – signs and symptoms<br />
  8. 8. Type IV reaction caused by the chemicals added to the latex in production and not the latex protein itself.<br />Type IV reaction involves various cells, including T-cells but do not effect antibody formation significantly.<br />Onset is delayed from 12 to 48 hours.<br />Manifests itself most commonly as contact dermatitis. (Bundesen, 2008)<br />Type IV reaction – The chemical's fault<br />
  9. 9. Which is which?<br />Both types are preceded with exposure resulting in a non-allergic contact dermatitis.<br />Difficult to distinguish IV allergic contact dermatitis with non-allergic contact dermatitis – except that IV may spread from site of contact.<br />Though initially presenting with the signs and symptoms of a type IV reaction, with continued exposure over time, increasing severe symptoms manifest, to evolve into a type I reaction.<br />
  10. 10. Cross allergenicity-problems with proteins -<br />Type I allergy to latex involves sensitization to multiple constituent proteins.<br />Different proteins means people respond to latex in various ways. <br />As those latex proteins are found in the rubber tree, so they are also found in other trees.<br />
  11. 11. Fruity twist<br />Either the fruit allergy triggers a previously undiagnosed recognition of latex allergy or after years of exposure to latex or latex sensitivity the person develops a fruit allergy.<br />Most common groups of proteins that cause cross-allergy reactions have occurred with avocado, banana, celery, chestnut and pear. (Davel, Ramesh, Prasad, & Jain, 2008)<br />
  12. 12. Less common are reactions to apricot, buckwheat, cherry, fig, grape, kiwi, mango, melon, nectarine, orange, papaya, passion fruit, peach, peanut, pineapple, plum, potato, tomato and walnut.<br />
  13. 13. Population at risk<br />Those with a history of atopic reactions<br />Concurrent allergy to certain fruits<br />Children with neural tube defects like congenital spina bifida<br />Those who have had repeated exposure either through occupation or multiple procedures.<br />The most efficient source of sensitization in a medical environment is via aerosolized latex protein form powdered latex gloves. <br />
  14. 14. Latex Folder<br />Aim is to streamline care and management of patients with latex sensitivity.<br />
  15. 15. Building the Folder <br />List a products with latex content indicated for set-ups and products required during the procedure.<br />This list needed to be easy to use, complete and reliable.<br />Available Education and Guidelines<br />
  16. 16. Some Obstacles to Avoid<br />A – Z listings<br />Same product, different companies<br />Does ‘yes’ mean latex free? <br />Keeping the documents / statements<br />Updating<br />
  17. 17. Latex Folder- contents<br />Information Sheet<br />Theatre Management of Latex Sensitive Patients<br />‘Latex Free Zone’ signs<br />How to Use Latex Catalogue<br />Addition to Latex Catalogue<br />User Survey<br />Latex Catalogue<br />
  18. 18. Information Sheet<br />Quick reference guide.<br />Used for education and checking of cross-allergies.<br />
  19. 19. Latex Folder- contents<br />Information Sheet<br />Theatre Management of Latex Sensitive Patients<br />‘Latex Free Zone’ signs<br />How to Use Latex Catalogue<br />Addition to Latex Catalogue<br />User Survey<br />Latex Catalogue<br />
  20. 20. Theatre Management of Latex Sensitive Patients<br />Queensland Health guidelines ‘Latex Guide for Heath Care Facilities’.<br />Specific to theatre management<br />
  21. 21. Latex Folder- contents<br />Information Sheet<br />Theatre Management of Latex Sensitive Patients<br />‘Latex Free Zone’ signs<br />How to Use Latex Catalogue<br />Addition to Latex Catalogue<br />User Survey<br />Latex Catalogue<br />
  22. 22. Keeping the Catalogue current & relevant <br />Addition to latex catalogue form<br />How to use catalogue guide<br />Survey form<br />
  23. 23. Latex Folder- contents<br />Information Sheet<br />Theatre Management of Latex Sensitive Patients<br />‘Latex Free Zone’ signs<br />How to Use Latex Catalogue<br />Addition to Latex Catalogue<br />User Survey<br />Latex Catalogue<br />
  24. 24. Developing a Latex Catalogue<br />Contents page to find things quicker<br />
  25. 25. <ul><li>Legend on the top of each page
  26. 26. Tick or cross to indicate latex free or not
  27. 27. A – Z listing within category
  28. 28. Reference numbers to distinguish between different companies</li></li></ul><li>Statements<br />Statements from companies regarding whether a product is latex-free or not, are kept alphabetically in the latex statements folder.<br />
  29. 29. Are we there yet?<br />29 pages... over 700 products<br /> and still so many more to go<br />
  30. 30. Statements – The Road Ahead<br />Future directions involve computerising the whole catalogue and statements. Creating a link to from the catalogue to the individual statement that supports that product.<br />
  31. 31. Thanks<br />Bundesen, I. (2008). Natural rubber latex: a matter of concern for nurses. AORN, 2 (88), 197 – 210.<br />Deval, R., Ramesh, V., Prasad, G. B. K. S., & Jain, A. K. (2008). Natrual rubber latex allergy. Indian J DermatolVenereolLeprol, 74 (4), 304 – 310.<br />

×