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Infant and Toddler Ingestion of Illicit Fentanyl: A Case Series

Over the past few years, fentanyl has been associated with the significant increase in overdoses and fatalities in North America. Knowledge of pediatric fentanyl ingestion involves transdermal fentanyl overdose and its use in anesthesia and pain management. An overlooked aspect of fentanyl ingestion are young children who are accidentally exposed to illegal fentanyl in their homes. Clinicians must recognize the signs of an opioid ingestion and test for fentanyl to appropriately treat patients. Like other opiates, fentanyl responds to naloxone but may require higher or more frequent doses due to its potency. Diagnosing fentanyl ingestion may be challenging, as many urine toxicology screens do not test for fentanyl and clear histories are not always provided to suggest the need for specific fentanyl testing. To our knowledge, there is no research that specifically examines infants and toddlers who ingest illegal fentanyl. Thus, the objectives of this study are to (1) review the histories, which precedes the diagnosis of fentanyl ingestion; (2) identify symptoms of children who present with fentanyl ingestions; and (3) describe the child neglect implications and safety planning in cases of pediatric fentanyl ingestion.