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Accidental Occupational Exposure to a Large Volume of Liquid Fentanyl on a Compromised Skin Barrier with No Resultant Effect

Published online by Cambridge University Press:  20 June 2022

Ryan Feldman*
Affiliation:
Froedtert and the Medical College of Wisconsin, Department of Pharmacy, Milwaukee, WisconsinUSA Medical College of Wisconsin, School of Pharmacy, Milwaukee, WisconsinUSA Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, WisconsinUSA
Benjamin W. Weston
Affiliation:
Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, WisconsinUSA
*
Correspondence: Ryan Feldman, PharmD, BCPS, DABAT Froedtert and the Medical College of Wisconsin Froedtert Hospital – Pharmacy Milwaukee, Wisconsin53226-3596USA E-mail: ryan.feldman@froedtert.com

Abstract

The high prevalence of fentanyl in the illicit drug supply has generated concern among first responders regarding occupational exposure. Social media sharing of unconfirmed first responder overdoses after brief exposure to fentanyl may be contributing to an inappropriate risk perception of brief dermal fentanyl exposure. This case details a dermal exposure to a large dose of analytically confirmed pharmaceutical fentanyl (fentanyl citrate, 10 microgram fentanyl base per ml), over a large skin surface area. Additionally, the exposure occurred at a site with some skin barrier compromise, a factor that can increase fentanyl absorption. The patient underwent appropriate decontamination and underwent a brief medical assessment with no clinical effects of opioid exposure observed. This information is of value to first responders and other health care workers who are at risk of occupational fentanyl exposure. Findings are consistent with in vitro and ex vivo data supporting low risk of rapid absorption after brief dermal fentanyl exposure.

Type
Case Report
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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