L oss of Glove Integrity During Emergency Department Procedures Karen N Hansen, M D *II Denise M Korniew icz, DNSc, RN ‡¶ David A Hexter, M D, M PH *§ Jan R Kornilow , M D * Gabor D Kelen, M D * 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 HCW s w ere collected and sub- jected 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 w ith 2 of 200 unw orn con- trol pairs (1.0%) and 12 of 300 pairs that w ere w orn but not used (4.0%). Leak rates varied by manufacturer and w ere 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 proce- dures (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 perfor- mance of ED procedures, subjecting the HCW to possible infec- tious-fluid exposure. Risk of glove perforation increases with duration of wear, number of procedures performed, and the per- formance of critical care procedures. [Hansen KN, Korniew icz DM , Hexter DA, Kornilow JR, Kelen GD: Loss of glove integrity during emergency department procedures. Ann Emerg M ed January 1998:31:65-72.] From the Department of Emergency Medicine, the Johns Hopkins School of Medicine, * and the Johns Hopkins School of Nursing, ‡ and the Division of Emergency Medicine, Department of Surgery, University of Maryland School of Medicine, § Baltimore, MD; Suburban Hospital, Bethesda, MD II ; and the Georgetown University School of Nursing, W ashington DC. ¶ Received for publication July 19, 1996. Revisions received January 27 and May 20, 1997. Accepted for publication May 29, 1997. Presented in part at the Annual Meeting of the Society for Academic Emergency Medicine in May 1992 and in poster format at the Eighth Inter- national Conference on AIDS/III STD W orld Congress in Amsterdam, The Netherlands, July 1992. Funded in part by Digitcare Corpora- tion of Beverly Hills, CA, and by Boston Medical Corporation, Annapolis Junction, MD. Copyright © 1998 by the American College of Emergency Physicians. INFECTIOUS DISEASE/ORIGINAL CONTRIBUTION JANUARY 1998 31:1 ANNALS OF EMERGENCY MEDICINE 65