A red rubber catheter. Would you believe that that's the only supply that we couldn't find a latex-free alternative for when we converted our hospital-based surgical center to a latex-free facility in October 2009? The ENT doctor who used the red rubber catheter in his tonsil cases now uses a flexible suction catheter instead, so technically, yes, we're 100% latex-free. We switched everything from medication vials — although many of the rubber stoppers on vials still contain latex today — to Penrose drains to breathing bags for our anesthesia machines to IV tourniquets to gloves.

And you know what? Now that we've converted, I can say with confidence that it's easier to be a latex-free surgical facility than not. When you treat all patients — and your staff — as if they have a latex allergy, you improve patient safety and you eliminate all of the kinks in your schedule that a patient with a latex allergy can cause.

The trouble with latex
The problem with latex allergies is that most patients don't know they have them. Or they think they might, but they're not sure because they've never been tested. Why play the guessing game? If you don't use latex at all, then patients can't have a reaction to it. It's as simple as that.

Even those patients who are aware of their allergy often forget to tell your pre-op phone nurse that they're allergic to latex only to remember the day of surgery. That would force us to reschedule the case to earlier in the day or break down 1 of our 4 rooms and make it latex-free for an afternoon, a move that was not without its drawbacks because it forced surgeons to use unfamiliar supplies.

Similarly, before we went latex-free we were unable to hold latex-free rooms for surgeons that didn't have a 7:30 a.m. start time. Think about it: If the third doctor to use OR1 tomorrow had a latex-free patient, we'd have to make the room latex-free for the entire day. Often times these latex-free, on-the-fly shifts meant we had to disrupt a high-volume surgeon who preferred to do all his right shoulder and knee cases together. Our orthopods like to do shoulders first. A carpal tunnel patient with a known latex allergy would force us to reconfigure our rooms. Bottom line: We could have done without the latex-allergy hiccups in our schedule.

And there were some of our employees with known latex allergies and some of our surgeons with sensitivity to powder in gloves to consider. Given all that, we decided to convert our entire facility rather than selectively make a room latex-free. Where to start? The supply room, of course.

Search for latex-free labels
When you and your staff take your next inventory, check every supply for a latex-free label. As you go shelf to shelf, set aside every product that contains latex; you'll have to find a latex-free alternative for these. You're already counting supplies and checking for expiration dates, so it won't take much more time or effort to look for latex-free labels.

You'll be pleasantly surprised to discover that many of today's products are labeled latex-free (or are imprinted with a no-latex sign). Even the IV antibiotic cefazolin is labeled latex-free. Those that aren't labeled latex-free may in fact be latex-free, but you're going to have to verify that by calling the companies. Examples of products that weren't labeled when we did our conversion: IV tourniquets, suction tubing, lite gloves, bulb syringes and Penrose drains.

We pulled 15 to 20 items from our shelves that weren't labeled as latex-free. Not bad. Better still, it turned out many of them were latex-free, we just had to verify with the manufacturer by calling them or researching their websites. The 3 items that we had the hardest time finding a latex-free alternative for were Penrose drains, red rubber catheters (we gave up our search) and IV tourniquets. Consult with your surgeons to discuss replacements for items that aren't available as latex-free. As in the case of our red rubber catheter, your docs might quickly suggest a simple alternative.

Pay special attention to your procedure packs. Many of the products in your packs may be latex-free, but if the pack contains latex gloves, then you can't consider the pack to be latex-free. Also, be aware of your pediatric breathing circuits. We found that the bag you attach to the anesthesia machine contains latex. Rubber stoppers on medication vials were another challenge. Most medication vials still contain latex in the stoppers. A workaround is to use Crile forceps to pop the top instead of poking it (if you do poke the top, do so only once).

What about gloves?
Most of our surgeons and staff were already using latex-free gloves at the time of our conversion. At the time, non-latex gloves cost us about a dollar more per pair, but we've found attractive incentives through our group buying programs. In 1 year, we purchased about 4,000 pairs of latex-free surgical gloves and 4,000 pairs of latex surgical gloves. The latex-free gloves were about $5,000 more than the latex gloves. In the grand scheme of things, $5,000 is not a lot of money to spend on patient safety and quality improvement. Our board was very supportive of this initiative. Plus, when you figure the amount of money you lose when an OR sits vacant, spending more for latex-free gloves is no big deal.

We trialed 3 different latex-free gloves and in short order settled on 1 type. We didn't get much resistance to switching gloves, especially after we presented the reasons behind our latex-free conversion at a quality improvement meeting.

It's easier to be latex-free than not. When you treat everybody like they have a latex allergy, you never have to worry about a patient's latex allergy again. What a relief that is. I now ask my colleagues, "How can you afford not to be a latex-free center?"