Anesthesia Set-up
    Monitors
    Intravenous line tubing
    Medications
    Latex-containing items
Latex Allergy Kit Contents
Treatment of an Allergic Reaction

Anesthesia Set-up for Latex Allergic Patient
- LATEX ALLERGY KIT
   .Kept at anesthesia tech station in main OR
   .Contains basic supplies and latex allergy protocol
- Set room up according to protocol guidelines
- Avoid hats, shoe covers and clothes with elastic bands, elastic stockings
- Make sure OR table and arm boards are fully covered with cloth
- Blood pressure cuff
   .Wrap patient extremity with webril or gauze under cuff
   .Wrap cuff connectors with tape or gauze
- Tourniquets
   .Wrap extremity with webril or gauze
   .Or use non-latex glove as tourniquet
- Stethoscope
   .Wrap tubing
   .Secure precordial with “safe” tape
- Anesthesia circuit
   .Apply filters to inspiratory and expiratory limbs
- EKG cables
   .Wrap cables if material is questionable
- IV set-up
   .60 drop IV set + 4 lengths of 6 inch extension tubing comprises a system without latex injection ports
   .Cover all injection ports with foil or brightly colored tape
   .Flush with 50 ml IV fluid before use
   .Use stopcocks for all injections
- Medications
   .Remove stoppers from medication bottles
   .Draw up immediately before use
   .Remove from cart all medications to which patient is allergic
- If time allows, remove these supplies from cart to prevent accidental use
   .Band-Aids
   .“Unsafe” tape – adhesive, paper, elastoplast
   .Double stick discs
   .Eye occluders
   .Headstraps
   .Skin temp probes
   .Neonate and infant oximeter probes
   .Latex gloves, tourniquets
   .IV sets with latex ports (including buretrol)

Contents Of Latex Allergy Kit
- Latex allergy protocol
- Tape – silk and Transpore
- Filters (2)
- Kling and Webril
- Non-sterile neoprene gloves
- Sterile vinyl gloves
- Sterile towels
- One Y-type IV set with all ports covered
- Tegaderm
- Albuterol inhaler

Treatment of an Allergic Reaction

1. Assess AIRWAY, BREATHING, CIRCULATION
2. Oxygen, pulse oximetry
3. Administer IV (calculate doses by weight in advance)
   .Epinephrine 1:10,000 (0.1 ml/kg) or (10 ug/kg)
   .Diphenhydramine (2 mg/kg)
   .Hydrocortisone (2 mg/kg) or SoluMedrol (1 mg/kg)
   .Ranitidine (1 mg/kg over 30 minutes)
4. IV fluids
   .Lactacted ringers or normal saline – 20 ml/kg or more
5. Continuous cardiorespiratory and blood pressure monitoring
   .Arterial line, CVP, PA cath as indicated
6. Treat bronchospasm
   .Nebulized albuterol 0.25 – 0.5 ml in 2.5 ml NS
   .Albuterol metered dose inhaler – 1 – 2 puffs by mouth piece, ET tube, or anesthesia mask
7. Vasoactive drugs as indicated
   .e.g., phenylephrine to raise SVR
8. Remove all possible sources of latex
   .IV sets, medications, monitor probes, cables
9. Consider ICU admission for further care and work-up

By Linda Georges, MD