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PPE basics for first responders exposed to fentanyl: NIOSH releases video

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Photo: NIOSH

Washington — NIOSH has released a video intended to assist first responders with understanding personal protective equipment protocol when facing potential exposure to fentanyl – a synthetic opioid considered up to 50 times more potent than heroin – and other illicit drugs.

The 12-minute video, Illicit Drugs, Including Fentanyl: Preventing Occupational Exposure to Emergency Responders – Using Personal Protective Equipment, illustrates the fundamentals of PPE use when responding to situations under the three levels of potential exposure defined by NIOSH:
Minimal: It is suspected that fentanyl or other illicit drugs are present but not in view. NIOSH recommends wearing nitrile gloves.
Moderate: Small amounts of fentanyl or other illicit drugs are visible. NIOSH recommends donning nitrile gloves; arm protection; a disposable N100, P100 or R100 filtering facepiece respirator or reusable elastomeric N100, P100 or R100 respirator; and protective eyewear.
High: Liquid fentanyl or large amounts of fentanyl products are visible. NIOSH recommends first responders do not enter the area, as “entry into these situations requires additional PPE and training, per your department’s policy,” the video states.

Additionally, the video provides instruction for putting on, taking off and conducting a user seal check on respirators. The agency calls these the two most common respirators used to protect against illicit drugs.


NIOSH directs first responders to follow the manufacturer’s instructions for the specific respirator being used and notes that fit testing should be performed while wearing required safety equipment.

“A fit test verifies that the respirator fits you correctly,” the video states. “It must be performed before you wear a respirator for the first time and at least yearly after that.”

A related NIOSH video, released in March, states that first responders risk exposure to illicit drugs through inhalation; ingestion; mucous membrane contact via the nose, eyes and mouth; skin contact; and needlestick.

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