Loss of glove integrity during emergency department procedures

Study objective: We sought to assess the loss of integrity of the latex-glove barrier during use in the ED setting. Methods: We conducted a prospective observational study in an urban ED and level I trauma center. Procedures performed by ED health care workers (HCWs) were directly observed, timed, and categorized. The gloves used by the HCWs were collected and subjected to the standard US Food and Drug Administration leak test. Results: Ninety-nine (7.9%) of 1,254 pairs of gloves used for observed procedures leaked, compared with 2 of 200 unworn control pairs (1.0%) and 12 of 300 pairs that were worn but not used (4.0%). Leak rates varied by manufacturer and were higher for gloves worn 20 minutes or longer (13.7%, P=.015), used for four or more procedures (50%, P<.01), or used for critical care procedures (23.5%, P<.01). Sixty-six of an additional 325 pairs of gloves collected from unobserved critical care procedures (20.3%) leaked. Conclusion: Loss of glove integrity occurs during the performance of ED procedures, subjecting the HCW to possible infectious-fluid exposure. Risk of glove perforation increases with duration of wear, number of procedures performed, and the performance of critical care procedures.