Scene Safety and Force Protection in the Era of Ultra-Potent Opioids

Prehosp Emerg Care. 2018 Mar-Apr;22(2):157-162. doi: 10.1080/10903127.2017.1367446. Epub 2017 Sep 28.

Abstract

Ultra-potent opioids (fentanyl, carfentanil) are now widely available and fueling an epidemic of overdose. First responders are increasingly exposed to these potent narcotics necessitating guidance for scene safety and force protection from medical directors. Reports in lay media have sensationalized accounts of exposure and harm that may lead providers to fear providing care to patients suspected of opioid overdose. The likelihood of prehospital providers suffering ill effects from opioid exposure during routine emergency medical services (EMS) operations is extremely low. We propose recommendation to assist medical directors in providing guidance and education to their providers minimizing the risk of provider exposure while allowing the delivery of prompt and appropriate care to patients with suspected overdose.

Keywords: PPE; carfentanil; overdose; scene safety.

MeSH terms

  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / pharmacology
  • Drug Overdose* / drug therapy
  • Emergency Medical Services*
  • Fentanyl / administration & dosage
  • Fentanyl / analogs & derivatives
  • Guidelines as Topic
  • Humans
  • Naloxone / administration & dosage
  • Narcotic Antagonists / administration & dosage
  • Occupational Exposure / prevention & control*
  • Protective Clothing
  • Safety Management*

Substances

  • Analgesics, Opioid
  • Narcotic Antagonists
  • Naloxone
  • carfentanil
  • Fentanyl