Fentanyl patches – awareness for clinicians

Fentanyl is a pain relief, usually used to help prevent pain after surgery or other medical procedure.

It comes in patch form, and is a potent opioid analgesic – a 25 microgram per hour fentanyl patch equates to daily doses of oral morphine of up to 90mg. As a consequence, fentanyl patches are only used in patients who have previously tolerated opioids.

Although we don’t use fentanyl patches here in the Trust, we have received a patient safety notice for your awareness, should you attend a patient that uses them.

Overdoses

Regulatory authorities have received reports of life-threatening reactions and fatalities from fentanyl overdose occurring as a result of:

• inappropriate strength of fentanyl patches prescribed in opioid naive patients
• failure to remove an old patch before applying a new fentanyl patch
• exposure of the patch application site to a heat source (e.g. hot bath, hot water bottle, electric blanket, heating pad etc.) or increased body temperature (e.g. fever)
• inadvertent ingestion of fentanyl patches
• poorly affixed fentanyl patches transferring to another person
• children applying improperly disposed patches to their body believing the patches to be stickers or plasters.

Signs and symptoms of a fentanyl overdose include: trouble breathing, shallow breathing; tiredness or extreme sleepiness or sedation; inability to think, walk or talk normally; feeling faint, dizzy or confused.

Patients who experience serious adverse events should have the patches removed immediately and should be monitored for up to 24-hours after patch removal.

Published 8th January, 2016