CLEVELAND CLINIC FOUNDATION

The Latex Allergy Cart

Because so many items in the OR contain latex, at the Cleveland Clinic Foundation a special Latex Allergy Cart has been prepared for use in these cases. We recommend that other institutions assemble a similar collection of non-latex equipment.

Note that whereas the use of latex surgical gloves is strictly contraindicated in these patients, the need to avoid other items, such as latex bellows on the anesthesia ventilator, is more debatable. See Controversies in Latex Allergy.

The cart contains the following equipment:

Glass syringes

are supplied because the regular plastic ones have latex-tipped plungers.

Drugs

Many commonly used drugs come in vials with latex rubber stoppers.

Therefore drugs in glass ampules should be substituted.

The following are provided:

 
• Atropine 0.4 mg
• Benadryl 50 mg
• Ephedrine 50 mg
• Neostigmine 0.5 mg
• Normal saline 10 ml
• Phenylephrine 10 mg
• Procaine 1%
• Xylocaine 2%

Available (in the "uphill" refrigerator at CCF) in glass ampules are:

 
• Succinylcholine 200 mg
• Pancuronium 10 mg

IV Tubing

Regular IV tubing has latex injection ports

Tubing without ports is provided. Alternatively, tape over and do not use the ports. Use stopcocks for injection. The needleless injection systems are safe provided needles are not used (!)

Breathing systems

 
•  
• The regular circle circuits are plastic but the bags are latex. A Neoprene bag (1 litre or 2 litre) should be substituted.

  

   

•  
• The anesthesia ventilator bellows are latex. Neoprene ventilator bellows are available only for the Ohmeda ventilator. The bellows on the Siemens Servo Series ventilator are non-latex and can be used safely.
•  
• The soda lime canisters on the Drager machines do not have latex components. The fresh gas hose is also non-latex
•  
• Plastic face masks should replace the black latex rubber ones

  Non-latex Ambu bags (pediatric and adult) are provided

Airway Equipment

 
• Endotracheal tubes are made of PVC and are safe
• "Red rubber" nasopharyngeal tubes are made of latex

Substitute with a warmed uncuffed PVC endotracheal tube.

• Laryngeal mask airway cuff is silicon and therefore may be used

Webril

is provided, for placing under your latex IV tourniquet.

Non-latex gloves

Neoprene gloves of various sizes are provided.

REMEMBER: Latex-containing surgical items must also be avoided.