Educate public safety partners about fentanyl protection

Glove-up; mask-up.

Simply utilizing these two pieces of personal protective equipment (PPE) or body substance isolation (BSI) can protect you from the majority of pathogens and exposure elements that we face on a medical call.

Add in some protective glasses and a splash-protective gown, and you’re covered from nearly head-to-toe for most other instances on an “average” medical call.

But what about when your call isn’t so “average?” What about the other responders on your scene – the law enforcement officers and firefighters? Should they be worried about the same exposure risks and taking the same universal precautions?

Protecting from fentanyl

Fentanyl has hit the news as one of the synthetic opioids that can be present in a number of physical or manufactured forms (e.g., powder, pill/tablet, liquid), which presents different on-scene challenges for emergency responders.

Fentanyl’s hype and publicity, have been over dramatized as though simply looking at it or coming into contact with a miniscule amount will invoke respiratory arrest (which has been shown to be false). Exposure to fentanyl, however, still does pose a risk to responders, especially if it’s exposure to highly-concentrated, commercial-grade forms.

While this type of exposure is highly unlikely in most residential settings, emergency responders can still come into contact with fentanyl in minimal-to-moderate exposure risk environments. NIOSH defines these risk environments as follows:

• Minimal exposure environments. Where fentanyl presence is suspected but not visible
  Example: An EMS response to a suspected fentanyl overdose or law enforcement operation where intelligence indicates fentanyl products are suspected but are not visible on scene.
• Moderate exposure environments. Where small amounts of fentanyl products are visible
  Example: An EMS response to a suspected fentanyl overdose or law enforcement operation where fentanyl products are suspected and small amounts are visible on scene
• High exposure environments. Where liquid fentanyl or large amounts of fentanyl products are visible
  Example: A fentanyl storage or distribution facility, fentanyl mining operation, or fentanyl production laboratory

In minimal-to-moderate exposure environments, the CDC recommends that emergency responders don appropriate nitrile gloves, safety glasses/goggles, wrist/arm protection and a disposable N100 mask for personal protection.

Share NIOSH guidance with public safety partners

NIOSH outlines two basic elements about our exposure risk to fentanyl:

1. We do have the appropriate PPE/BSI available to protect us from the significant majority of our exposure situations
2. The mere presence of or common exposure to fentanyl will not automatically induce respiratory compromise

Unless you walk into what looks like a chemistry lab, full of beakers, Bunsen burners, green boiling liquid and 55-gallon drums, you’re likely dealing with a minimal-to-moderate exposure risk environment. Any industrial-appearing site should be treated with a higher level of protection and care, regardless of the chemicals at hand. These facilities, nonetheless, should be pre-planned beforehand so that all responders are aware of the potential risks within the given facility.

For the significant majority of our responses, the CDC further explains that decontamination from fentanyl substances can be handled mostly with soap and water cleaning or showering.

Using appropriate PPE/BSI – nitrile gloves and a face mask – can protect you from the significant majority of the scenes that you may come across.

Making sure that you educate your responders – and embrace the culture and accountability of wearing proper PPE/BSI for any situation – is the key element of keeping everyone safe. Choosing your products wisely can help you to accomplish this.

This article was originally posted May 1, 2019. It has been updated.