A Guide for First Responders in Handling Fentanyl Emergencies

Source: Tyler Olson - 123RF

NIOSH has released a video that shows emergency responders how to properly use personal protective equipment (PPE) to prevent occupational exposure to illicit drugs including fentanyl.

According to the CDC, first responders are most likely to encounter illicitly manufactured fentanyl and its analogues in powder, tablet, and liquid form. 

Potential exposure routes of greatest concern include inhalation, mucous membrane contact, ingestion, and percutaneous exposure (e.g., needlestick).

NIOSH has identified the following job categories as positions where responders might come into contact with fentanyl or its analogues:

  • Pre-Hospital Patient Care: Emergency medical services (EMS) providers, including first responders, fire department and private companies who attend to individuals with suspected fentanyl overdose. Responders may encounter drugs or drug paraphernalia on or near the patient.
  • Law Enforcement: Law enforcement officers who perform day-to-day law enforcement duties. Law enforcement officers may come into contact with fentanyl during the course of their daily activities such as traffic stops, apprehending and searching subjects, and responding to fentanyl overdose calls.
  • Investigation and Evidence Handling: Law enforcement personnel who conduct investigations related to fentanyl. Activities may include executing search warrants and collecting, transporting, and storing evidence. Evidence collection activities in the field have the potential to aerosolize powders. Also, law enforcement personnel who handle evidence in the chain of custody have the potential to come into contact with fentanyl unless controls are in place to prevent exposures.
  • Special Operations and Decontamination: Workers who conduct special operations where exposure to large amounts of fentanyl are expected. Examples include hazardous material incident response teams responding to a release or spill, and law enforcement officers executing search warrants on opioid processing or distribution sites, or participating in other tactical operations. These activities may aerosolize powders.

The CDC has further recommendations for first responders when dealing with opioid-overdose emergencies, including:

  • Standard safe operating procedures;
  • Training; and
  • Personal Protective Equipment (PPE);

The video was created as a joint effort with the Fredericksburg, Va. police and fire departments.