latex allergy - the real kind

[militarymd]

For those in the now...what do the major academic institution that deal with patients with true latex allergy do when it comes to medication vials that have rubber stoppers on them?

Do you remove the stopper before you draw the meds? or do you just draw it up like you would any other time?

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[jennyboo]

We have a posted list of meds for which the latex top is supposed to be pried off.

The drug I use most which involves prying the top off is fentanyl. There's a long list of others, most of which I don't use frequently.

 

[Consigliere]

At Children's Memorial in Chicago we just drew through the stopper.

 

[SleepIsGood]

For those in the now...what do the major academic institution that deal with patients with true latex allergy do when it comes to medication vials that have rubber stoppers on them?

Do you remove the stopper before you draw the meds? or do you just draw it up like you would any other time?

do you really have to remove the stopper? the medication came in the bottle where inevitably the rubber has touched the medicine several times (ie during transport, or when shelving the meds). So why remove the stopper? The 'rubber' particles have already touched the meds.

 

[militarymd]

At Children's Memorial in Chicago we just drew through the stopper.

this is the kind of information I'm looking for.....The medicine is already contaminated with the back side of the stopper.

 

[dfk]

most of our formulary stoppers are latex-free per pharmacy.
we pop off anyway.

 

[Brian Fantana]

On a side note, what does one with a "True latex allergy" do when he is ready to get "intimate" with the lady folk with his standard go-to condom? Does he use the side effect of local histamine release to his advantage, or does he use a different technique all together and hope for the best?

 

[Noyac]

Just draw from the stopper, the med has been in contact with the stopper for some time. I used to pry it off but now I go right through it. No difference.

Related note, do any of you pre-treat?

 

[lobelsteve]

On a side note, what does one with a "True latex allergy" do when he is ready to get "intimate" with the lady folk with his standard go-to condom? Does he use the side effect of local histamine release to his advantage, or does he use a different technique all together and hope for the best?

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[seamonkey]

brian,
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[militarymd]

Just draw from the stopper, the med has been in contact with the stopper for some time. I used to pry it off but now I go right through it. No difference.

Related note, do any of you pre-treat?

Although I agree with you, if you google "latex allergy rubber stopper"...a study from johns hopkins pops up that shows that puncturing the rubber stopper may increase the amount of "rubber" in the meds.

this is why I'm asking what institutional policies are.

 

[rsgillmd]

Although I agree with you, if you google "latex allergy rubber stopper"...a study from johns hopkins pops up that shows that puncturing the rubber stopper may increase the amount of "rubber" in the meds.

this is why I'm asking what institutional policies are.

One of my attendings once said something along those lines to me also when I asked the contamination question. I guess he wasn't making stuff up after all.

Either way, everyone I know at my institution pries off the caps.

 

[Brian Fantana]

Everyone at my institution draws through the rubber top and no one premeds with H1H2 blockers.

 

[Noyac]

Yea Mil, and I think policy is to remove the top. I just don't see the response/reaction from penetrating the cap. Do you have the article?

BTW, if it is a multi-use vial I pull the top off, one time use I go through it. I don't know why but thats what I do.

 

[militarymd]

Yea Mil, and I think policy is to remove the top. I just don't see the response/reaction from penetrating the cap. Do you have the article?

BTW, if it is a multi-use vial I pull the top off, one time use I go through it. I don't know why but thats what I do.

http://www.sciencedaily.com/releases/2001/06/010612070400.htm

 

[Kubed]

Old article, but an interesting case report:
http://www.anesthesia-analgesia.org/cgi/reprint/80/5/1057

 

[IctalSmile]

this is the kind of information I'm looking for.....The medicine is already contaminated with the back side of the stopper.

That's what I always figured.....poppin the top off isnt going to affect how it was bounced and sloshed around before it popped outta your pyxis....