ABSTRACT
Background: Defibrillation guidelines recommend avoiding patient contact during shock delivery. However, hands-on defibrillation (compressions during shock) and manual pressure augmentation (MPA - pushing on the defibrillator pads during shock) may lead to improved clinical outcomes. There are limited data addressing the protection provided by personal protective equipment (PPE) during hands-on defibrillation and MPA. This study investigated the hand-to-hand and hand-to-knee leakage current experienced by a simulated kneeling provider wearing different PPE. Methods: A defibrillator was used in experiments on a pork shoulder, investigating three different hands-on positions: closed fist on defibrillator pads; open palm on pads with inadvertent finger contact (overhang); and open palm on the chest. Evaluated PPE included single and double gloves (nitrile and latex) and rescuer cargo trousers in wet and dry conditions (N = 126 experiments). Results: Mean hand-to-hand leakage currents in MPA without PPE was 0.41 mA (0.2-0.74 mA) and with PPE was 0.2 mA (0.08-0.58 mA). For experiments involving finger or palm contact on the chest, wearing any PPE resulted in a >99% reduction in mean leakage currents from an average 354.58 mA (258.96-446.22 mA) to an average 0.48 mA (0.16-1.56 mA). Rescuer trousers were insulative in dry conditions even without gloves (0.2-1.2 mA). Conclusion: This study demonstrated that the tested clinical examination gloves markedly reduced leakage current to the rescuer and that the lowest levels of leakage current occurred during MPA attributed to the electrical insulation of the pads.
ABSTRACT
BACKGROUND: In the growing need of microvascular surgery in modern-day plastic surgery, financial burden on surgeon or institution can discourage acquisition of skill particularly in the initial phase of laboratory simulation. This article describes the construction of a cheap, easy-to-make blood vessel model. MATERIALS AND METHOD: The model was made using infusion giving set, latex glove, scissors, tape measure and Swan glue CD 308. A cut sheet from the latex glove was rolled twice over two glue-painted segment of the infusion giving set stent. The stents were gently pulled out, turning the sheet into a conduit. The blood vessel model was then allowed to dry. DISCUSSION: The use of latex glove for initial training in microvascular anastomosis has been for long. Previously described productions into a conduit are cumbersome. This model is easy to construct and is useful in an office or dry laboratory setting. CONCLUSION: The latex glove blood vessel model described in this article is a useful material in the training of budding microsurgeons. Residents in our institution have reported a very good learning experience with its use.
ABSTRACT
BACKGROUND: Acinetobacter baumannii is a significant health care-associated pathogen because it is easily transmitted via fomites, extremely difficult to eradicate from the environment, and highly drug resistant. Understanding the environmentally mediated transmission dynamics of A baumannii is critical for more effective infection control. However, transfer efficiency of pathogen pick-up and deposit remains poorly understood. Our study estimates the transfer efficiency of A baumannii with and without latex glove use from the fingerpad to a fomite and from a fomite to the fingerpad. METHODS: Fomite-fingerpad transfer efficiencies were determined for 6 materials (glass, stainless steel, porcelain, polypropylene, polycarbonate, and rubber). RESULTS: For A baumannii, the fomite-to-fingerpad transfer efficiency was 24.1%, and the fingerpad-to-fomite transfer efficiency was 5.6%. When latex gloves were worn, the fomite-to-fingerpad transfer efficiency was reduced by 55.9% (to 10.6%) and the fingerpad-to-fomite transfer efficiency was reduced by 47.1% (to 3.0%). The average transfer efficiency between 2 skin surfaces was 32.5%. CONCLUSIONS: The fomite-to-fingerpad transfer efficiency of A baumannii was statistically significantly higher than the fingerpad-to-fomite transfer efficiency, regardless of glove use. There was no significant difference in transfer efficiency by material type, except for rubber, which resulted in marginally higher transfer efficiencies. Our results underscore the importance of frequently changing gloves during patient care and frequent handwashing-hand hygiene during bare-handed care for the reduction of pathogen transmission.
Subject(s)
Acinetobacter Infections/prevention & control , Acinetobacter baumannii/isolation & purification , Cross Infection/prevention & control , Fomites/microbiology , Hand Hygiene , Acinetobacter Infections/microbiology , Ceramics , Environment , Equipment and Supplies , Glass , Gloves, Protective/microbiology , Hospitals , Humans , Latex , Polymers , Polypropylenes , Rubber , Stainless SteelABSTRACT
This paper presents the case of a cadaver buried in a pine grove, in loamy soil at a depth of about 1.8 m. The case is quite interesting due to the fact that one hand of the victim was bare and the other one was clad in a latex glove. In the laboratory, the severed hands were gently washed with water. The left palm exhibited signs of advanced decomposition. The ridges were visible only on the thumb. The gloved hand was found to be in much better condition. There were signs of saponification on the palm. Ridges on both the palm and all fingers were visible. The fingers of the right hand, palm prints, and the thumb of the left hand were successfully matched against a ten-print card. The match provided the police with a positive identification of the missing person.
Subject(s)
Burial , Dermatoglyphics , Gloves, Surgical , Postmortem Changes , Adult , Humans , Latex , MaleABSTRACT
We compared perforation rates among operative staff who were randomly assigned either thick latex surgical gloves or conventional gloves for use in performing total knee arthroplasty. A total of 1120 gloves were assessed in 70 total knee arthroplasties. Additionally, the degree of tactile sensitivity provided by the gloves was compared using a two-point discrimination (TPD) test. Perforation occurred in 27 surgeries (38.5%) and in 48 gloves (4.29%). Binary logistic regression analysis revealed that the operator was a risk factor for perforation rate (Odds ratio 14.448, P < .0.01) and that the type of glove was not (P = .896). In the TPD test, tactile sensitivity was lower for a thick outer glove than the conventional double glove (P < .001 for each site). Not only did thick surgical gloves lower tactile sensitivity, they also offered no superior protective effect over conventional gloves.
Subject(s)
Arthroplasty, Replacement, Knee , Equipment Failure , Gloves, Surgical/adverse effects , Aged , Aged, 80 and over , Equipment Failure Analysis , Female , Humans , Logistic Models , Male , Middle AgedABSTRACT
Foreign body ingestion is a common clinical problem. Foreign bodies are generally swallowed accidentally and most pass out spontaneously. However, if a sharp object is not eliminated early, it can penetrate the bowel wall and cause severe complications. Endoscopic techniques for removing sharp foreign bodies safely include methods using a protector hood and overtube. An overtube is uncomfortable and has limitations in its diameter. We introduced a method using a latex glove, which is easily available, comfortable, and has no limitations in diameter. In addition, two endoscopes were used to reduce the risk of complications, and the large sharp object was easily wrapped with the latex glove. We report a case of a sharp and large foreign body being removed endoscopically using a latex glove and two endoscopes without any complications.
Subject(s)
Eating , Endoscopes , Foreign Bodies , LatexABSTRACT
Most of swallowed foreign bodies pass spontaneously. However, sharp objects are usually lodged in the proximal esophagus and cause aspiration, bleeding, obstruction, and perforation. Therefore, prompt retrieval of lodged foreign bodies are necessary. The safe extraction of sharp foreign bodies using endoscopic technique is difficult because sharp objects carry a significant risk of mucosal injury and perforation. Endoscopic techniques for retrieval of foreign body include methods using protector hood and overtube. The former is not available, the later is uncomfortable and its diameter is the limiting factor. Method using a latex glove is available, comfortable, and its diameter is not limited. The thickness of the glove is thinner than protector hood, but we think that a latex glove would seem to be a effective alternative. We report a case in which a sharp foreign body was endoscopically removed using a latex glove without complication.
Subject(s)
Esophagus , Foreign Bodies , Hemorrhage , LatexABSTRACT
This study was conducted to determine the prevalence rate of adverse reactions to latex gloves. The study compared allergic reactions to ordinary latex gloves with four types of hypoallergenic gloves among operating room nurses at a teaching hospital in Seoul, Korea. Data were collected from 63 operating room nurses by a questionnaire and direct observation of a skin prick test. Among respondents, 25 nurses with adverse reactions to latex gloves were selected for the skin prick and exposure tests with five latex gloves (1 ordinary glove, and 4 hypoallergenic gloves) using a repeated measures design of counterbalancing method. Study Results are as follows: (1) The response rate of the questionnaire was 96.8%, and the prick test was performed in 61 out of 63 nurses. (2) Common symptoms of allergic reactions to latex gloves were rash (49.2%), skin itching (44.3%), dizziness (31.1%), and eye itching (26.2%). (3) The prevalence rate of adverse reactions was 80.3%, and that of latex allergy was 9.8%. (4) Atopic subjects had more latex allergy than the non-atopics. (5) There was no difference in the incidence rate of latex allergy among the five gloves by the skin prick test. But with the skin exposure test, ordinary latex gloves had a higher incidence rate of latex allergy than the hypoallergenic gloves (p<0.0001).
Subject(s)
Surveys and Questionnaires , Dizziness , Exanthema , Hospitals, Teaching , Hypersensitivity , Incidence , Korea , Latex Hypersensitivity , Latex , Operating Rooms , Prevalence , Pruritus , Seoul , SkinABSTRACT
IgE-mediated sensitization to natural rubber latex can induce immediate hypersensitivity reactions ranging from contact urticaria to life threatening anaphylaxis. Recent reports suggest that asthma is also relatively frequent manifestation of latex allergy. In this case report, lat,ex induced asthma is described in an operat.ing room nurse regularly exposed t,o latex gloves. Her latex sensitivity was detected by skin prick testing. Specific bronchial provocation test with latex extract showed an early asthmatic reaction. Her symptoms had been much improved after avoidance. Occupational asthma induced by latex may be not uncommon among health care workers.