Fentanyl use as a drug of abuse has increased in the United States. EMS providers are increasingly likely to encounter fentanyl in the line of duty.
Facts to know:
- Fentanyl is a synthetic opioid that is more potent than heroin or morphine
- Fentanyl can be present in many forms (e.g. tablet, capsule, powder, rocks, solutions)
- Inhalation of fentanyl as an airborne powder is the most likely exposure route that would lead to harmful effects, but it is less likely to occur than skin contact.
- Incidental skin contact is not expected to lead to harmful effects if the contaminated skin is promptly washed off with soap and water.
Signs and symptoms of fentanyl exposure include:
- Respiratory Depression
- Drowsiness or Unresponsiveness
- Constricted or Pinpoint Pupils
Prevention:
- PPE is effective in decreasing the risk of harmful effects from fentanyl exposure
- Wear gloves to prevent skin exposure
- NIOSH-approved respirators (“masks”) decrease the risk of inhalation exposure
- Eye protection can prevent mucous membrane exposure
If exposure occurs:
- Do not touch your eyes, mouth, nose or any skin after touching a potentially contaminated surface
- Wash skin thoroughly with soap and water; Do NOT use hand sanitizers as they may enhance absorption through the skin
- If you suspect clothing contamination, remove them via standard decontamination procedures
If an EMS responder exhibits signs or symptoms of fentanyl exposure:
- Move away from the source and call for assistance
- Administer naloxone per departmental protocols
- Perform rescue breathing/airway management as needed
- Administer CPR if indicated
US Customs and Border Protection: https://www.youtube.com/watch?v=6Yc9lSaSKls
Safety Recommendations for First Responders Handout: https://www.whitehouse.gov/sites/whitehouse.gov/files/images/Final%20STANDARD%20size%20of%20Fentanyl%20Safety%20Recommendations%20for%20First%20Respond….pdf
