Fire Engineering - June 2017

case histories like those described earlier
are not uncommon. Illicit fentanyl is
often manufactured in China and smug-
gled illegally through western Canada,
where it is trafficked across the northern
United States border for distribution in
kilogram-size lots.
The lethal dose of fentanyl is as small
as two milligrams, which is equal to
three granules of salt or sand. Mixing
very small quantities of fentanyl with
heroin can result in lethal overdoses for
drug users. This is also a concern for first
responders that necessitates wearing
specialized PPE. Because of the micro-
gram size of the powder, fentanyl can
penetrate the filters of commonly used
APRs. First responders should consider
using self-contained breathing appara-
tus and Level A PPE when encountering
fentanyl operations.

Teamwork is the formula for success at incidents involving fentanyl. Specialized law enforcement units are trained to wear the necessary PPE and are familiar with the hazards. Fire/hazmat units are experts in this level of PPE but may lack familiarity with the hazards of fentanyl.

Don’t hesitate to call specialized law enforcement teams to help mitigate these dangerous drug situations.

New Response Considerations

Fentanyl enters the human body through inhalation and is also absorbed through the skin or mucous membranes (transdermal absorption). Operationally, many specialized law enforcement drug units are using Level A hazmat PPE as the standard for protection for their members. Although this sounds like an excessive level of PPE, fentanyl ranks right up there with PCP and LSD laboratories in terms of their numerous deadly hazards. Consider flash protection of the totally encapsulated suit since many drug-processing procedures use flammable liquids as solvents.

One currently employed method of producing fentanyl in the United States is the Siegried Synthesis Lab. It is not difficult to recognize an illegal drug lab.

Apparatus and tools common to this
method include laboratory glassware
such as round bottom flasks and petri
dishes, heating platforms, condensers,
containers of solvents, PPE, and possibly
pressurized tanks. In addition to toxicity
concerns, consider air monitoring for
the flammable vapors arising from the
solvents used in the synthesis process,
especially if containers are open or
spilled during a raid. Since flammable
vapors may be present, limit ignition
sources (pilot lights, electric sparks) as
a component of your response or entry
plan. Exothermic reactions involving oth-
er components may provide an ignition
source for flammable solvent gases.

Strategic Response Considerations

The following approaches can help to
reduce the hazard to your team mem-
bers when responding to a call that may
involve fentanyl:
• Be aware of the potency and exposure
routes. Ask questions to determine if
there is any chance that the powder
you are dealing with may be fentanyl.

The goal is to prevent exposures by proper planning before the operation begins. Appropriate on-scene questions include the following: Is anyone injured or showing any symptoms?

Has anyone been transported to the hospital? Is this an overdose call? Are there any persons with altered mental status or dead-on-arrivals (DOAs) on scene? Is there any chance this is a drug lab or a drug-associated call? Did law enforcement do any field tests on the powder in question? If so, what were the results? Why did you call the hazmat team or the fire department?

Are there any unusual odors? Are the occupants exhibiting suspicious behavior?

• Tactical and immediate withdrawal may be your best option if you are actually or potentially exposed to fentanyl. This could occur during a law enforcement operation, an emergency medical services (EMS) call ( possible overdose, DOA, for example), or on a fire response because of the lab catching fire. Tactical withdrawal may be especially important if on-scene members present with symptoms of overdose such as vomiting, dizziness, headaches, breathing distress, or