A 24-year-old healthcare worker gives a history of urticaria and bronchospasm during a previous dental procedure where gloves were used, and skin testing confirms latex allergy. She is posted for elective day-care surgery. What is the most appropriate scheduling measure?

• A Premedicate with hydrocortisone and chlorpheniramine and proceed with routine equipment
• B Schedule her as the last case so airborne latex particles settle overnight beforehand
• C Schedule her as the first case of the day with a latex-free operating room setup ✓
• D Perform the procedure under regional block in the ward to avoid the operating theatre

Explanation

Airborne latex allergens carried on glove powder accumulate in the operating room during the day and take hours to settle, so a latex-allergic patient is scheduled first on the list when ambient levels are lowest. All equipment, gloves, catheters, and circuits must be latex-free, and the patient is first on the list even then. Prophylactic antihistamine or steroid does not reliably prevent anaphylaxis and never substitutes for allergen avoidance. Ward blocks still expose her to latex products.

Reference: Morgan and Mikhail's Clinical Anesthesiology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.