Credited as the first hospital to introduce latex gloves, Johns Hopkins Hospital is now among the first to banish them.
A famed Hopkins surgeon ushered in the latex era more than a century ago to protect his surgical nurse's hands from harsh detergents used to disinfect them. Now, in an announcement yesterday, the hospital said it has gone latex-free to prevent rare but severe allergic reactions - called anaphylaxis - that can include wheezing, rapid heartbeat and a sudden drop in blood pressure.
"They occurred on the operating tables, but they can also occur in the clinics and on the floors," said Dr. Robert H. Brown, an anesthesiologist who headed the hospital's latex task force. "You don't need to see many kids with anaphylaxis to be concerned."
Some of the reactions occurred among children with spina bifida and bladder exstrophy, two birth defects that can require many surgical procedures early in life. As with most allergies, the worst latex reactions often occur with the second exposure to the offending substance.
While such reactions can be fatal, Brown said he knows of no such deaths at Hopkins. Still, he said, the problem warranted a solution, which has taken the form of gloves made from synthetic materials that do not trigger allergies.
Decision to ban
The allergies had been observed over the 1990s, when a change in the processing of latex caused an upsurge in latex reactions. The hospital leadership decided in 1997 to move toward an outright latex ban, and a year later it eliminated them from exams.
Then last May, the hospital took the final step: eliminating latex gloves from the operating room. Change came more slowly to that arena because surgeons, who rely so much on their sense of touch to perform intricate procedures, needed a replacement that wouldn't diminish their manual dexterity.
New materials
Surgeons now have their pick of gloves made from two different materials - polyisoprene and neoprene. Many found them awkward at first, but most adjusted to their feel within a few weeks.
"Some people don't like change," said Dr. Julie Freischlag, director of surgery. "When we first had the change, some people said they didn't think it was OK. Now they think it was fine."
Other hospitals are making the move as well. In October 2006, Harbor Hospital in Baltimore announced that it had eliminated latex exam gloves. Shriners Hospital for Children in Sacramento, Calif., is now 98 percent latex-free after implementing latex controls about two years ago.
