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Talking to EMTs About Your Allergy

“911, what is your emergency?” 

Cough, wheeze, “I’m having trouble” cough, wheeze, “breathing.” 

“I’ll have an ambulance there in no time.” 

“Wait”, cough, wheeze, “but I’m allergic to latex”, cough, wheeze. 

“OK, what special needs do you have?” 

This is not the time to have to explain how the EMS crew can decrease your exposure to latex. Careful planning can help prevent the above scenario. Your local EMS crews do not go out looking for latex allergic patients. It is your responsibility to bring this fact to their attention before a crisis occurs. 

First you need to find out which EMS unit (or units) may be dispatched in your area. If you visit relatives or friends, or work, shop, etc. outside this area; you will need to check which EMS units service those areas also. Use a non-emergency phone number to call the emergency dispatcher to get this information. Your local police dept. can help if you are unable to find this number. When you speak to the dispatcher, give him the addresses and ask which EMS unit would be called out first, second (in case the first out unit is unavailable), and third. Also ask if that unit is BLS (basic life support) or ALS (advanced life support). In some areas both BLS and ALS units are dispatched to a call. 

Once you find out just who you need to speak to, you need to prepare what to tell them. It will be most convenient to have everything written, give a copy to each EMS unit and keep a copy for yourself. Start with general information: name, address, birthdate and age, doctors and hospitals, medical conditions and medications. Include signs and symptoms of latex reactions, and recommended treatments. If you have your own latex free emergency equipment; make a list of all supplies and keep them together (maybe in a specially marked backpack) and describe what they are kept in and where they can be found in an emergency. Include other information such as specific treatment wishes (such as a living will), insurance information, emergency contacts, etc. 

A list of “medical products frequently containing latex and examples of latex-safe alternatives” and also a list of products found in the home should be presented to the EMS unit. Ask for an inventory of their equipment; go through it and indicate which products contain latex. Most EMS units have regular meetings. Request that they take some time during one of those meetings to review and discuss how to handle the latex allergic patient. If this meeting is held away from the ambulance station, volunteer to attend the meeting to assist with the presentation or to be available to answer questions. A word of caution: many people attend these meetings while on duty or directly after completing a shift and attend in the clothing they wore while working – clothing that may be contaminated with latex. Ask that the ambulance station post the information and articles you have given them. You may want to provide them with your phone number in case questions arise. Continue to send them lists and articles to keep them updated. 

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Questions to Ask While at the Dentist

A person with a latex allergy can be at risk in a dental office. Some materials used in a dental office containing latex are: gloves, prophy cups, tubing, nose pieces, rubber dams, some impression materials, bite blocks and stethoscopes. Therefore a few questions asked before an appointment may help avoid an allergic reaction. 

Do you have non latex gloves available for the procedure? Those individuals who come in direct contact with the latex allergic patient must wear non latex gloves. The whole staff should wear non latex gloves. Also make sure the office does not store latex gloves in close proximity to the patient during the procedure, because even if stored in a sealed carton, the proteins leach out into the air. 

How do you polish teeth after cleaning? Most offices use disposable prophy angles that have a rubber cap containing latex rubber. The exception is Denticator products that are made of ethylene, propylene and diamine to create a synthetic material. Alternatives to remove stains and polish teeth are a prophy brush or a prophy jet. A prophy jet polishes with air and baking soda. The piece that goes into the mouth and all the tubes from the prophy jet to the polishing piece are plastic 

Will this procedure require nitrous oxide? The nose piece for nitrous oxide is rubber latex and a barrier between skin and nose is not sufficient to ensure safety. There is a plastic nose piece surrounded by silicone but it is rigid, uncomfortable and non-conforming, increasing the chances of escape of gas toward the operator. Do without nitrous oxide and ask for local anesthesia. Be aware that the seal in prefilled lidocaine and anesthetic carpels are latex. A glass ampule is preferred, and the medication should be drawn up immediately before administration. 

What do you use in place of a rubber dam for a root canal? A rubber dam is a polyisoprene sheet stretched over a frame to isolate the tooth from saliva to keep it dry, increasing the success rate of the root canal. The dam is also a barrier to prevent anything from going down the throat during the procedure. In place of a rubber dam, use a vinyl or non-latex glove, or a double thickness plastic head rest cover over the frame. Lute an opening with an instrument that has been heated (do not attempt to use a punch as the material will tear) and then stretch the material over the frame. 

Polyisoprene rubber is also used in head gear and orthodontic bands. 

What materials are used to fill the root canal? The material of choice, gutta percha, is not safe for someone who is latex allergic because it is 30% rubber. It also contains zinc oxide, waxes and zinc silicate. This combination is used for endodontic points as a filling material for root canal. 

Alternatives to fill canals are glass ionomer cements, zinc phosphate cement and epoxy cement such as AH 26. A last resort is silver points but not an ideal material for root canal. Any of these materials should be used by an endodontist (dentist trained in root canal) as they have the proper instruments and experience in working with these materials. 

What materials are used for taking impressions? Impression materials are used to obtain a negative imprint of the tooth for the crowns, inlays or onlays, etc. Some older impression materials are rubber based. Alginate impressions do not contain rubber and are safe. 

Other devices used in the dental office containing latex are bite blocks and stethoscope tubing. Also, be aware of personnel wearing disposable gowns instead of reusable ones. Disposable gowns and mask may contain latex and the finish may have irritants to a latex sensitive person. 

When is an ideal time to schedule dental appointments? Preferably first thing in the morning, or the first appointment after vacation when the office has been closed. Another good time is after the cleaning crew has been in to vacuum the drapes, blinds, carpets etc. This will help with the removal of the latex tainted corn starch. This risk is reduced in an office that uses powdered latex gloves. 

To greatly reduce the risk to you and the staff in the office, suggest that they try a low protein non-powdered glove on a regular basis. Be careful, do not use low protein latex gloves with a patient that is latex sensitive. 

A small office with contained operators or separate room as opposed to a very open area is a consideration in choosing a dental practice. Also, a smaller staff can be a plus. The less personnel donning and removing gloves the better. 

There are offices that are aware of the latex allergic patient because a staff member is latex allergic. However, many offices are not aware of the serious consequences of latex allergy. Do not allow the dental office to treat this problem lightly. 

An initial visit to access an environment before you make an appointment is recommended to ensure your safety. If the office is not aware of the problems associated with latex allergies, use this article as a guide to questions that should be answered. 

As in all situations you are your first line of protection in any situation. Make anyone that needs to know about latex allergy an expert; offer to run a short in service for the staff of the dental office. 

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A Child’s Perspective on Latex Allergies

by Douglas, Pennsylvania 

I am six years old and have Spina Bifida, because of that I was told to not touch latex. It is boring to not be able to play with latex ’cause lots of things are made of latex. It makes me mad that I can’t chew gum especially. 

When I was sick with diarrhea and had to wear diapers, I got big red marks where the elastic touched. Last fall when my dad spread sealer on our driveway, I woke up sick in the night with croup. The doctor gave me a Proventil inhaler I can use now when I get “raspy”. When I get really “raspy” I have to take Albuterol syrup, it tastes yucky and it makes my hands shake. 

I try to be real careful and not to touch latex, but some things I don’t know. I had the principal at school call the manufacturer before I would go on the new gym floor because it was spongy feeling and I was afraid. They gym teacher had to get a different ball for me. My classroom has vinyl gloves in it and I wear them when we finger paint. The teacher finds something different that the eraser dinosaurs for me to use. I do O.K. on the playground because the part that is rubber touches my hinny over clothes and not my hands. 

When I have birthday parties and kids give me gun, I give it to my big sister. We can’t play balloon games or have them for decorations. My friends at church and kindergarten are learning about latex because of me. I remind my teacher, therapists, and sometimes my mommy to check if something is latex to keep me safe. 

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Living without Latex in Your Home

When faced with a Latex allergy, a lot can go through a person’s mind. There may be worry or concern for their wellbeing. Children will worry that it could happen to them. You might feel frustration and anger of helplessness that there is no known cure. You’ll likely experience anger about missing out on special events or attractions due to a loved one’s allergy, or perhaps concern about the future, both the latex allergic family member and the family. Sadness over limiting the types of toys, clothing or other items that can be kept and/or used around the family is a frequent feeling.  

When living with a Latex allergy, it is important to get everyone in the house on-board with the lifestyle. While this will mitigate some of the factors that lead to allergic reactions, it is also a useful way to feel less alone. Here are a few tips for changing up your home and lifestyle to better accommodate a Latex allergy.  

Home and Lifestyle Changes 

Latex avoidance is centric in the family’s lifestyle, and it is important to lead a more isolated and protected life. Carry basic latex alternative and treatment medical equipment at tall times. All family members have a responsibility to ensure the environment is latex free. Here are a few additional steps you can take. 

  • All shoes, boots and sneakers must be kept in sealed containers. 
  • Latex free undergarments and clothing must be used. 
  • Should not travel alone and must travel with another person to doctor appointments 
  • Most of the home ventures must be planned ahead to ensure latex avoidance. 
  • Decreased family activities – Cannot attend events that could result in latex exposure – Parties, function, etc. 
  • Removal of rubber items from house. 
  • Replacement of carpets, steam cleaning. 

Kitchen 

The kitchen is surprisingly full of Latex products. Here are a few to look out for.  

  • Replace rubber sink stoppers and sink mats with non-rubber types. 
  • Replace rubber or rubber-grip utensils and appliance (cooking and cleaning) with plastic or metal 
  • Avoid contact with rubber electrical or water cords and hoses. 

Bathroom 

Latex is water-resistant, which means bathrooms are full of products that use the ingredient. Here are some things to look out for while adjusting to a Latex-free lifestyle.  

  • Replace bathmats and floor rugs that have rubber backing. 
  • Replace toothbrushes that have rubber grips or handles. 
  • Rubber tub toys. 
  • Hairdryer cords and attachments. 
  • Sanitary napkins – some contain rubber. 
  • Adult/Child diapers – some contain rubber. 
  • Cosmetics – some contain rubber. 

Whole House 

Homes are filled with hidden latex products. If you’re adjusting to a Latex-free lifestyle, or if you want to provide more information to friends and family, use this list to illustrate the ubiquity of this ingredient and where Latex products most often appear.  

  • Remove or replace toys with rubber parts, such as rubber wheeled toys, koosh balls, balloons, balls, rubber stamp sets 
  • Kids adhesives such as glue, paste, art supplies, glue pens 
  • Older Barbie dolls and some other dolls are made of rubber 
  • Double – check each toy as many have rubber parts, buttons, etc. 
  • Avoid Rubber bands, mouse and keyboard cords, electrical cords, desktop and chair pads, rubber stamps 
  • Avoid mouse and wrist pads that contain rubber – use plastic types 
  • Avoid keyboards and calculators with rubber keys or switches 
  • AVOID pens with COMFORT GRIP or have ANY rubber coating! 
  • Check & replace any rubber backed rugs 
  • Phones can contain rubber mouthpieces, buttons, antennae and cords – avoid! 
  • Use vinyl for messy cleaning jobs 
  • Remote controllers for TVs, VCRs, etc. can contain rubber grips or keys – avoid! 
  • Electrical cords and weatherstripping – many are rubber 
  • Vacuums, hoses and attachments 
  • Broom handles and grips 
  • Camera, telescope, binocular eye pieces and other parts usually contain rubber 
  • Any adhesive including Envelopes, Stamps, glue. 
  • Newsprint – Newspapers mix ink with latex 
  • Pool toys – most pool liners are vinyl 
  • Bathing caps and elastic in bathing suits 
  • Outside yard tools (watch for comfort grip handles) 
  • Weatherproofing – Car seals, door seals, gaskets 
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Negotiating a Latex-Free Life

LATEX-SAFE Home 

Latex is used in thousands of household products, and for patients with severe latex allergy any contact may produce symptoms. To make a home LATEX-SAFE you must go through the home and remove as many latex products as possible. This requires that you take a home products list and remove and substitute with non-latex products where possible. 

LATEX-SAFE School 

In order for the school environment to be safe, you must work with the school and help them create a LATEX-SAFE environment for your child. You will also need to have them learn to give emergency medications. A home products list will help you show the school what is dangerous for your child and the available substitutes. 

LATEX-SAFE Products 

We have created a list of common household products that contain latex, with substitutes if they are available. The home products list, while accurate at the time of publication, cannot be relied on 100% because manufacturers change their products frequently. If in doubt, you must check by calling the manufacturer yourself to verify the absence of latex. 

Support Group 

You are not alone with your problems. There are lots of people with similar problems ready and eager to help you. Finding a local support group, or joining an online community, can significantly mitigate the burden of living with a Latex allergy.