On July 12, 2017, The American College of Medical Toxicology (ACMT) and the American Academy of Clinical Toxicology (AACT) released a detailed statement on safety precautions for emergency responders in case of fentanyl exposure. Fentanyl is an ultra-potent opioid that police, firefighters and paramedics may encounter when responding to medical calls, crime scenes, or drug raids.
Despite concerning stories of emergency responders developing symptoms after exposure of skin to drug residue or powder, the reported symptoms have not been consistent with poisoning by opioids. In addition, these drugs are not absorbed well enough through the skin to cause sickness from incidental contact.
ACMT contends that emergency responders should exercise reasonable caution around unknown drugs. However, excessive personal protective equipment (which has been recommended by some safety organizations) may be harmful because bulky, unnecessary equipment could potentially interfere with vital tasks that emergency responders perform.
The ACMT fentanyl statement recommends that for “routine handling of these drugs, nitrile gloves provide simple protection” and that masks and face shields are only needed in very exceptional circumstances. According to the statement, “Toxicity cannot occur from simply being in proximity of the drug.” In the event drug powder gets on skin, ACMT recommends simply washing it off.
ACMT hopes that this guidance will reassure emergency responders. “Police and emergency medical technicians have challenging jobs,” said Andrew Stolbach, MD, a physician at Johns Hopkins, board member of ACMT and lead author of the statement. “We want these professionals to know that simple commonsense practices, such as wearing gloves, are more than sufficient to protect them. It’s just not plausible that getting a small amount of fentanyl on your skin is going to cause significant opioid toxicity.”
ACMT: Advancing the Care of Poisoned Patients
The American College of Medical Toxicology (ACMT) is a professional, nonprofit association of more than 700 physicians with recognized expertise in medical toxicology. Medical toxicology focuses on the diagnosis, management, and prevention of poisoning/toxicity and other adverse health effects resulting from medications, chemicals, occupational and environmental substances and biological hazards. Current projects at ACMT include research and treatment of synthetic cannabinoid abuse, opioid addiction, lead and mold exposure, Zika virus, venomous bites/stings and gas poisoning.