Corrections_Today_July_August_2019_Vol.84_No.4

Correctional Health Perspectives

professionals respond, such as a cell that has K-2 smoke in the air, the use of a respirator may be neces- sary. However, a respirator can only provide appropriate protection on the face when staff are properly fit tested including being clean shaven in areas where the respiratory seal comes into contact with the skin. It’s also important to have the correct filtering respirator for the conditions encountered. As an example, an N-95 respirator — while sufficient protec- tion for dust or particles — would not be the right level of protection for an oil-based K2 smoke. In this case, a P-100 respirator is the better choice. Ventilation hoods for mail pro- cessing is another recommended safety-enhancing feature that may reduce exposure to aerosolized substances and should be used for routine mail handling procedures. While not every correctional emergency will involve synthetic drugs, it is prudent in this current climate and environment to assume that any unknown substance could be an illicit synthetic drug and treat it with universal precautions. This means assuming exposure and acting accordingly. It is equally prudent to assume that any down- or acting-out offender may be under the influence of a synthetic drug. These two as- sumptions — while clearly needing to be verified — will help to create the appropriate safety mindset for responding staff. Educating and training staff on synthetics and safe responding are

Becoming familiar with the methods of introduction, symptoms of use, potential inadvertent exposure and protection protocols are critical to the safe and secure functioning in today’s correctional facilities. Today’s synthetics are often of unknown chemical properties with unknown effects. Some synthetics can have dangerous short- and long- term effects. For inmates, synthetics can be a lucrative business which en- courages introduction. Staff’s quick and informed responses can help slow down and/or shut down these efforts and, in the process, save lives of victims and first responders. Endnotes: 1 Cornelius, G. (2001). The Art of the Con: Avoiding Offender Manipulation. American Correctional Association. 2 Lynch MJ, Suyama J, Guyette FX (2018). Scene safety and force protection in the era of ultra-potent opioids. Prehosp Emerg Care 22(2):157–162, https://doi.org/10.1080/10903127.2017.1367446. 3 Suzuki J, El-Haddad S (2017). A review: fentanyl and non-pharmaceutical fentanyls. Drug Alcohol Depend 171:107–116, https://dx.doi.org/10.1016/ j.drugalcdep.2016.11.033. 4 Ropper AH, Samuels MA, Klein JP, eds. (2014). Adams and Victor’s Principles of Neurology. 10th ed. New York: The McGraw-Hill Companies. Randy Shively, Ph.D. is the director of research and clinical development at Alvis. Deborah G. Schult, Ph.D. is the former assistant director of Health Services at the Federal Bureau of Prisons. John Caraway is the regional director of the South Central Region of the Federal Bureau of Prisons.

important to preventing exposure. Good communication between responders and the control room can provide valuable intelligence when every second matters and lives are at stake. Staff need to be reminded that if a significant exposure occurs, de- contamination by removing clothing and equipment, showering or being washed with water and donning fresh garments may be the appropriate re- sponse. As always, in instances where possible exposure is involved, imme- diate referral to medical attention may be the most appropriate response. Conclusion Given the current realities of il- licit synthetic drugs being introduced into the corrections environment, it behooves staff to become educated. Educating and training staff on synthetics and safe responding are important to preventing exposure. Good communication between responders and the control room can provide valuable intelligence when every second matters and lives are at stake.

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