Illicit Drugs, Including Fentanyl: Preventing Occupational Exposure to Emergency Responders

[ Music ]>>Alright, I made entry>>Two seventeen.>>Ma’am, can you
get to the door?>>Step inside.>>Hi.>>Watch out sir.>>We got a call
for an overdose.>>I wasn’t overdosing.>>Back up.>>I was just nervous
because I had [inaudible]–>>Where’s he at [inaudible].>>Where’s your husband?>>Where is he?>>He left. He left.>>Who’s in [inaudible]?>>Open the door now. Out. That way. [Inaudible].>>You deal with that. I’ll deal with this. Here’s what I found on
the table>>At this point entry’s
already been made in the room. Sergeant Pitts and
Officer Tearnen had left to go get a search warrant and
we’re just holding the room for the search warrant to be
obtained so we can execute it. The female is on the bed. She’s complaining that
she has “allergies”. So she needed to blow her nose. I went to get her a towel
because I had knocked the box of tissues into the toilet. I gave her the towel and I’m
just standing there watching him just documenting it and waiting
for the search warrant. Piersol lets
her blow her nose; she does that several times and I’m watching the male suspect
just with his eyes rolling back in his head, making
sure he’s breathing okay and he’s not going
to fall out because at this point I only have two
doses of Narcan for four people. Prior to this I asked
for the rescue squad and the fire department to stage
outside in case I needed them because I knew they had more. By this time I believe
that we were told that Officer Tearnen had passed
out at the police department and was given Narcan there and
was transported to the hospital. Notice my partner I didn’t
pay attention to the time but as you see in the video he
just continues to look around. I thought he was doing
the same thing that I was. Over by the toilet, you can’t
see it, but there’s a book bag with needles poking out of
it, empty jeweler’s bags and white powder on the ground
between the sink and the toilet. It’s at this point my partner
said that his vision was going in and out and he felt like
the room was getting smaller and it was harder
for him to breathe so I moved him out of the way. I’m by myself now
with two people that are experiencing some sort
of possible medical emergency from whatever substances is
inside and another suspect. Those two are in handcuffs
and trying to keep him awake and call into dispatch, which
amazingly, the male suspect who has been nodding in and
out now seems to be alert and oriented and paying
attention to what’s going on for the first time
for at least an hour. I’m telling him to breathe. He’s having difficulty standing. So I’ve got my hands
underneath his vest. I’m trying to keep him
upright, make sure I’m safe. He couldn’t stand anymore
and I couldn’t hold him up. I’ve been trying to call
dispatch to get somebody up there from the
fire department because he was obviously
starting to go downhill rapidly. His breath started getting
more and more labored. It was hard for him to
stay awake or conscious. I’m still trying to talk
to him, still hollering in the radio that I need help. I remember flipping the door
latch open to keep the door from shutting behind me. I set him down. At this point I think
he’s overdosing. He had his own personal
Narcan so I took that from him and
gave it to him. Now I’m just– I’ve got my
partner with medical personnel and I’m just standing here,
securing the room and waiting for my supervisor to
tell me what to do. [ Music ]>>Take your time and slow down. If you rush you’ll
make small mistakes and those could cost you. For instance my respirator
was hung up on my camera mount and it didn’t create
the proper seal.>>We purchased P100 respirators
for every police officer and had them test it
and give them training on the use of those respirators. We implemented new
policy as it comes to donning the
respirators for any incident where there’s a suspected
heroine or fentanyl or illicit drugs. The officers are now required to
don their respirators in safety as well as protective
gloves and other PPE. And to have an officer
present while any of that evidence
is being collected.>>At the end of the day
if you can’t get there and help somebody it doesn’t
do you any bit of good and it doesn’t do that
person any bit of good. If you get exposed to it and
you’re laying on the ground next to them what does that help?>>One of the other things that we really haven’t practiced
a lot, but I think worked well on that scene, was
the integration with the fire department
and police department. I think because we are small
agencies and we see each other on a constant basis
that that helped play into that unified
command role that day. As we progress and move forward,
I think that unification of run-in incidents will only
make our responses stronger in the future.>>You should follow established
work practices as well as these recommendations
when illicit drugs are known or suspected to be present. [ Music ] When arriving at a scene analyze
the incident, assess the risk for hazards and determine
whether illicit drugs are suspected to be present. There are standard safe
work practices you can take to protect yourself. If you know or suspect
illicit drugs are present. Safe work practices. Do not eat, drink, smoke or use the bathroom while
working in the area. Even if you’re wearing
gloves, don’t touch your eyes, mouth or nose after touching any
surface potentially contaminated with illicit drugs. Avoid performing
tasks or operations that may aerosolize
the illicit drugs. Wash your hands with soap
and water immediately after a potential exposure
and after leaving the scene. Do not use hand sanitizer. Illicit drugs including
fentanyl pose a potential hazard to a variety of responders
such as law enforcement and emergency response
personnel. There is a chance that
responders may come into contact with illicit drugs such as
fentanyl during the course of their daily activities.>>You should receive training in conducting an on-scene
risk assessment related to illicit drugs and
demonstrate an understanding of the following: How
to recognize the form and determine the
quantity of illicit drugs. When to use PPE. What PPE is necessary. How to properly put on, use,
take off, properly dispose of and maintain PPE and
the limitations of PPE. What the potential exposure
routes are for illicit drugs. How to recognize the signs
and symptoms of an exposure. When and how to seek
medical help.>>NIOSH has identified three
levels of potential exposure. Minimal, moderate and high. Exposure levels are
defined as follows. Minimal exposure situation. Response to a situation
where it is suspected that illicit fentanyl or other
illicit drugs may be present but no drugs are visible. In this situation,
NIOSH recommends that you wear nitril gloves. Moderate exposure situation. Response to a situation
where small amounts of illicit fentanyl or other
illicit drugs are visible. In this situation
NIOSH recommends that you wear nitril gloves,
arm protection, a disposable NP or R100 filtering
face piece respirator or a reusable elastomeric
NP or R100 respirator and protective eye wear. High exposure situation. Response to a situation where
liquid fentanyl or large amounts of fentanyl products
are visible. Example. A fentanyl storage
or distribution facility, fentanyl milling operation or a
fentanyl production laboratory. In this situation NIOSH
recommends responders do not enter the area. Entry into these situations
requires additional PPE and training per your
department’s policy. Decontamination. If you or a coworker suspect
that you have come into contact with illicit drugs you
should do the following. Immediately exit the scene. Alert your supervisor
or dispatch according to your department’s policy. Remove contaminated clothing. Be careful not to disturb
areas of contamination and launder according to
your department’s policy. Shower immediately
with soap and water. If a shower is not
possible use soap and water to thoroughly wash and rinse
the contaminated skin while in a clean environment. Avoid breaking the skin
when washing and rinsing and cover all open wounds. Do not use hand sanitizers
or bleach solutions to clean contaminated skin. Store reusable PPE in a labeled,
durable 6-mil polyethylene bag until it can be safely
decontaminated according to the manufacturer’s
recommendations and place contaminated
single-use PPE in labeled, durable 6-mil polyethylene bag
and dispose of appropriately.>>This year has been
an uptick, if you will, for us in the amount of
opioid responses as well as I guess across the country. Don’t think it won’t happen to
you because it’s just a matter– it’s not when it’s if– it’s
when it’s going to happen to you because it will. [ Music ]

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