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Latex vs. Purple Nitrile Gloves
Original Post: When you get admitted to a hospital, one of the questions that they ask is if you have any allergies to latex. Some people do and as I look at boxes of latex exam gloves, I was wondering if anyone out there has addressed this concern for EMS and 1st responders. The Purple Nitrile gloves do not present the same allergic reaction possibilities and when you look at the chemical resistivity for the nitrile, they beat any of the others hands down. Where to do stand on this topic? Any advise?
UPDATE: Thank you for your responses and insight. The below information provides a basic summary and overview for the selection of EMS related gloves.
EMS Glove Style Information
Latex - Latex gloves are still the most popular because they offer strength, elasticity, slip resistance and comfort and of course cost less than Nitrile Gloves. They are supple and fit comfortably around your skin and have become the industry standard for years based on availability and cost alone. The downside is that they are made from natural latex rubber, a protein-based compound known to cause allergic reactions and irritations in some people. The major issue with latex is that some patients and providers have latex allergies; therefore the need for a latex-free environment needs to be provided.
According to the National Institute of Allergy and Infectious Diseases, up to 6 percent of Americans are estimated to have some type of latex allergy. Since Nitrile is a synthetic rubber, it doesn't create the same irritations and allergic reactions as natural latex rubber.
Synthetic - Synthetic gloves offer the same benefits of latex without any of the allergic risks because they are latex-free. These gloves are made from polyvinyl chloride. These gloves are looser around the cuff, which allow for more air circulation around the skin, dissuading EMS providers from using these because of the increased risk of exposure to the rescuer.
Vinyl - Vinyl gloves are the most economical choice. Also made from polyvinyl chloride, these gloves are soft and comfortable. The history of this glove type tearing easily, the difficulty of use, reduced tactile sense and not providing the same manual dexterity as Nitrile dissuades EMS providers from using this style of glove.
Nitrile - Nitrile gloves don't contain natural rubber latex proteins, so there are no latex allergy concerns. Because of the cross-linking of the Nitrile polymers, they don't puncture easily. Nitrile gloves are manufactured using synthetic latex, which provides three times more puncture resistant than natural rubber. They offer superior resistance to punctures and abrasions and are also used for protection against a variety of chemicals. Nitrile material also has a naturally low coefficient of friction, making them easy to don (put on). They are more resistant against chemicals like solvents, greases, oils and alkali solutions. The synthetic Nitrile polymers in the gloves respond to your body temperature and essentially mold the gloves to the shape of your hands.
Below are some of the reasons why Nitrile gloves would be chosen over latex or vinyl gloves.
No Protein Allergen
Anti Static Behavior
Good Chemical Resistance
High Puncture Resistance
High flexibility
Solvent Resistant
Powdered Nitrile Gloves - Cornstarch is often added to nitrile gloves to make putting on the glove as smooth as possible.
Glove Costs - All of these gloves come in powder and powder-free. The costs can vary dependent upon supplier, quantities ordered, etc. Here’s some general glove cost estimates to provide a means of comparing one to the other. This is not to be considered absolutely accurate and should be researched through your local vendors to get you the costs. Nitrile gloves last longer, are latex free and they fit better but they cost as much as 16% more. The benefits far outweigh the increased costs
Glove Cost Estimates / General Cost Comparison (*Estimates Only - Not Accurate)
Gloves (Powder Free / Box of 100)
Latex $ 9.00
Vinyl $ 9.10
Nitrile $10.70
Synthetic $ 4.00
Gloves (Powdered / Box of 100)
Latex $ 5.20
Vinyl $ 6.80
Nitrile $ 7.00
Synthetic $ 3.65
Glove Purchasing - Before purchasing any type of glove, whether it be latex, nitrile, or vinyl, you have to ask yourself a few things...
What amount of protection are you looking for?
Are you allergic to any materials that the glove is made from?
The quality of the glove and how it's made?
Powdered or Unpowdered?
The comfort of the glove?
The size of the glove?
Standardized Glove Measurement Scale - If protection is your major concern, there a few things you should know about the manufacturing of Latex, Nitrile, and Vinyl gloves. There are three standard measures that protective gloves are scaled upon.
Medical Grade - For medical use. Highest grade of protection. These gloves are thoroughly tested to pass FDA requirements and exceed a broad range of demanding specifications.
High Risk - For use in the emergency medical services fields. High levels of testing are required to assure proper requirements.
Utility Grade - Not intended for medical use and not tested for FDA specifications. These gloves are great if detail is a necessity. Normally used for painting and general hand protection. They are manufactured to ASTM (American Society for Testing and Materials) specifications.
Here is a table covering the strengths and weaknesses of certain gloves:
Latex Nitrile Vinyl
Protection 4 4 2
Allergy 2 4 3
Comfort 4 3 2
Elasticity 4 3 2
Price 4 3 4
Durability 3 4 1
How to Determine Your Glove Size - Most gloves are available in XS, small, medium, large, and XL sizes. Gloves can be manufactured with different cuff lengths, textures, thickness and other characteristics. Use the bullet list below to determine the size you'll need.
A. Use a tape measure to determine your correct hand circumference in inches. Measure at the widest part of the hand.
B. The chart below shows you how to find the glove size closest to the hand measurements in inches.
C. Sizes may vary among manufacturers and styles.
Hand Size Measurements = Glove Size
7" - 8" = Small
8" - 9" = Medium
9" - 10" = Large
10" - 11" = X-Large
Glove Safety Considerations
Expiration Dates - Gloves have expiration dates. You should discourage the use of expired gloves. Look for an expiration date on the individual packages of gloves.
Physical Inspections - Do not store gloves in direct sunlight; dispose any gloves that show any signs of discoloration, leakage or deterioration.
Latex Allergies - For providers using only latex gloves, you need to provide alternative gloves to workers and / or patients (6% of the total population) who are at more risk of developing latex allergic reactions.
Hazmat Glove Selection - Nitrile has been used for years now as an inner glove for hazmat incident entry teams donning Level A, B and C PPE. The chemical resistibility and permeation data alone support the use of Nitrile gloves for a variety of chemicals.
Nitrile Glove Storage - Make sure not to store nitrile gloves under conditions of excess heat or light, since this will cause more rapid rubber degradation.
TCSS, Mike : )
Replies to This Discussion
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Permalink Reply by Ben Waller on
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We exclusively use nitrile exam gloves for patient care. We also have a "latex free" protocol that ensures that we purchase latex-free medical items such as endotracheal tubes and etc. As far as I know, the only medeical items we have that contain latex are our BP cuff bladders, and they don't touch the patients' skin.
Anothe advantage of the nitrile exam gloves - they make much better hazmat inner gloves than latex.
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Permalink Reply by Spanner 122 on
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We no longer use latex gloves, blue or green nitril only (green are the same fit and feel as the purple, love them, but they cost more than the blue).
I didn't think anyone used latex gloves anymore, pretty hard to ask an unconscious pt if he's allergic.
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Permalink Reply by Oldman on
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Latex allergies are quite common, and people usually don't think it is a pertinent fact to relay to medical workers. Our department has been "latex free" for at least 10 years. Nitrile gloves have an added advantage of being strong, but even a pin hole will cause them to break open so you know you have a problem.
An additional footnote on latex allergies; If someone tells you they are allergic to bananas or avocados, they most likely are sensitive to latex as well.
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Permalink Reply by Michael Vito on
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An additional footnote on latex allergies; If someone tells you they are allergic to bananas or avocados, they most likely are sensitive to latex as well.
Ah ok, I'll keep that in mind.
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Permalink Reply by NATE on
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Our Dept. uses only latex free gloves and equipment. and to my knowledge the b/p cuff bulb is the only thing that we have that still uses latex. i agree with spanner hard to ask someone who is unconscious.
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Permalink Reply by T.J. on
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No latex gloves around here for use, we use the same brand of glove our local EMS unit uses, makes it easier I guess:)
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Permalink Reply by Tony P on
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Nitrile. That's what we're issued. We don't do any EMT stuff, but double glove for MVA's and also use the nitriles if assistang ambos.
I was told that we use the nitrile because they'll always split wide open with even a tine hole, whereas latex can stay in one piece leaving you unaware of the risk faced..
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Permalink Reply by Kimberly A Bownas on
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We have and now we carry latex free gloves. Even in my paid job all the gloves that we have are latex free. Why take that chance. We still ask cause there still are things that we use that the patient could be allergic to. I know in my vollie squad we use Nitrile and I think we use them in my paid job as well. There are so many brands out there it is hard to keep up...
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Permalink Reply by Jason Brooks on
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The only reason we carry latex free gloves is for the two guys that have eczema. The bigger concern is not that you patient has the sensitivity, its what you do when you find out. DO NOT remove your gloves in their presence. This will aerosolize the latex particles and make the situation ten times worse. Most likely unless you are holding the gloves under thier noses, they will be OK for the ride to the ER. You should notify the ER of the situation though. This is an ongoing debate. The guys do not like the feel of the nitrile gloves and they do no stetch as well as latex.
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if some one has a latex allergy, can't even be touched by the latex for some patients. We started carrying the the latex free case of one of our members and I like the nitrile's they aren't bad at all. The hospitals here now have either nitrile's or they have gloves that are really thin and clear. They are a lot harder to get on then the nitrile's....
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Permalink Reply by FETC on
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We are with Ben, we are a latex free ALS service the bladder on the BP cuff is made with latex but it is sewn inside another material that never touches the patient. All IV, ETT, etc are latex free. We use the purple nitrile gloves as well.
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Permalink Reply by Engineco913 on
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My department also uses the Nitrile gloves. They seem to be much more durable than the latex, and with the reactivity to patients being a lot lower we feel much safer operating with them.
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