Corrections_Today_July_August_2019_Vol.84_No.4

Correctional Health Perspectives

such as the administration of Nalox- one or CPR. Being aware of scene safety when evaluating an impaired offender also includes assessing the geography of the scene. Multiple victims, close quarters (e.g., cell) or awkward access to the victim (e.g., bunkbed or shower) can restrict and inhibit a responder’s movements. Kneel- ing to treat a victim or having their hands occupied by medical sup- plies, restraints or radio can further compromise the responder’s tactical positioning — especially should the victim(s) or onlookers become hos- tile or violent. It is not uncommon for a victim to become unpredictable and/or aggressive when being re- vived. It is highly recommended that the responder request backup prior to the administration of Naloxone. First responders in a correctional environment quite often encounter a scene where bodily fluids are pres- ent. Blood, vomit, saliva, urine and feces are all capable of transmitting diseases, and staff should employ universal precautions prior to any contact where these fluids could be present — and in every case where fluids are readily apparent. Other, more routine tasks car- ried out by correctional staff, such as sorting and distributing mail — to include greeting cards, legal mail or books — and processing a crime scene where an inmate overdosed, can present occasions for exposure to synthetic drugs. Opening an envelope that contains a powdery substance,

U.S. Air Force/Mark Herlihy

A nasal applicator and Naloxone medication vial are designed to temporarily reverse the effects of an opioid overdose.

touching the postage stamp or envelope glue on a letter or closing a plastic evidence bag of powder that “puffs” into staff’s faces when inadvertently pushing the air out of the bag to seal, can expose staff to potential hazards. While physical contact with a substance that is absorbed through the skin (e.g., touching a powdery substance with bare fingers) is one way staff can become exposed to synthetic drugs, it is not the only way. Other routes of entry into the body include inhalation, ingestion, mucous membrane contact and per- cutaneous exposure. Lynch et al, 2018 and Suzuki and El-Haddad, 2017 have noted some less severe, but unpleasant symptoms experienced by responders upon

exposure to opioids that include lightheadedness and nausea. 2,3 Others have noted more severe symptoms of opioid toxicity experienced by re- sponders which include sluggishness, decreased respiration, constricted pupils, slow heart rate and low body temperature. 4 Protective equipment and prevention strategies It is clear that responders can experience a continuum of symp- toms which range from drowsiness to death from accidental exposure to synthetic drugs. Given these poten- tial outcomes, it is critical that staff be educated in the use of protective equipment and effective prevention strategies. →

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