With the recent incidents of potential drug exposures at incarceration facilities in Chillicothe, Ohio and Pennsylvania, we wanted to share the latest specific materials and recommendations. The majority of these cases do not involve true opiate intoxication. Many have had rapid breathing and tachycardia; definitely not indicators for naloxone.
“Myths and Facts” is an excellent document from the U.S. Department of Homeland Security’s Office of Health Affairs: http://www.peaf.us/sitebuildercontent/sitebuilderfiles/fentanyl-myths-facts-sep2017.pdf.
It has a short companion training video aimed at law enforcement and other public safety personnel. “Fentanyl: The Real Deal” is less than 7 minutes long, and can be found here:
https://www.youtube.com/watch?v=6Yc9lSaSKls&feature=youtu.be
The paper that provided much of the science behind these recommendations and that has been endorsed by numerous medical groups including our Regional Physicians Advisory Board (RPAB) is here: http://www.acmt.net/_Library/Fentanyl_Position/Fentanyl_PPE_Emergency_Responders_.pdf
These documents point out that skin contact is unlikely to cause symptoms or harm. Some media outlets have suggested that simply touching the drug can lead to death. The CDC says that skin contact with fentanyl can be a risk, but that fentanyl “is not likely to lead to overdose unless large volumes of highly concentrated powder are encountered over an extended period of time. Brief skin contact with fentanyl or its analogues is not expected to lead to toxic effects if any visible contamination is promptly removed.” The American College of Medical Toxicology and the American Academy of Clinical Toxicology wrote a joint position statement last year following the East Liverpool, Ohio incident, saying the risk for emergency first-responders is “extremely low.” “To date, we have not seen reports of emergency responders developing signs or symptoms consistent with opioid toxicity from incidental contact with opioids. Incidental dermal absorption is unlikely to cause opioid toxicity. For routine handling of the drug, nitrile gloves provide sufficient dermal protection,” the statement reads.
Finally, attached is the Ohio BCI bulletin on how to clean surfaces that may have been contaminated with fentanyl or analogs. Please share these materials with your personnel.
David N. Gerstner
MMRS/RMRS/EP Coordinator
Department of Fire I City of Dayton
300 N. Main St. I Dayton, Ohio 45402
Office 937.333.4551 I Fax 937.333.4561 I www.daytonohio.gov
24/7 Pager: 937-227-8705 or E-mail 9372278705@archwireless.net
david.gerstner@daytonohio.gov I http://DaytonMMRS.org