Chemical Suicide Response
HMN- Unfortunately the holidays also means an uptick in suicides and we have been seeing a steady stream of Chemical Suicides across the Country. Although often these events are recoveries, there is always a chance of a viable victim rescue (it is what we do) and reviewing the hazards and having a plan BEFORE the call is a good idea. Phil Ambrose will be speaking on Rescue related to HazMat (and Chemical Suicide) response again at FDIC 2018 in Indianapolis. We also had the good fortune to discuss Chemical Suicide with Todd Burton, an instructor with IEC and HazMat Chemist with San Diego County with some good review of Chemical Suicide. Every scene is different, and as Phil points out… consider bullets, bombs or blunt force trauma FIRST – then consider a grab if there seems to be a viable rescue. Your FFTO and SCBA will protect you from any of the chemical mixtures (just not the three B’s mentioned), and have a plan for decon. That being said, if there is reason to believe something else is involved, or obvious signs of death, consider it a crime scene. Consider the worst case scenario when prepping your crew: A person in the vehicle, obvious signs of chemical suicide, and a carseat in the rear seat…. what would you do? What are your options? Here are some additional thoughts from Todd Burton:
We just had an H2S suicide about 2 weeks ago The H2S level was only about 10 ppm inside but it was overwhelming at 10 ppm and that’s the PEL. Same day Pasadena had one too (that was our call – HMN Ed). They may increase as we go into the holidays. FFTO/SCBA is good for most all methods as most gases never reach flammable limits. Each jurisdiction will approach a bit different based on SOG/SOP. First and foremost don’t disturb the scene too much as this is a crime scene. The one we just had was possible assisted or homicide. We just made the scene safe for medical examiner to investigate then you can finish the job.
HMN – There is an increased amount of O2 in the party store Helium (cost savings) so there is more potential for someone using the exit bag method to still have signs of life and be a VIABLE RESCUE.
Types of Chemical Suicide:
Simple break down by Todd Burton
1. Asphyxiant Gas Helium/Nitrogen
a. Easy peasey. Turnouts (FFTO) and vent monitor O2 with 4 -gas Don’t remove anything (if obvious signs of death, crime scene).
2. Hydrogen Sulfide
a. Normally DOA. 15 times lethal in 4 min (If the mixture is correct and no ventilation… so be ready to react to the viable victim – have a plan)
b. Recon in FFTO get a 150’ perimeter as the gas will thin out by then unless cold and at night (FFTO: Firefighter Turn outs AND SCBA)
c. Perimeter monitoring, get people out if you can. Shelter in place can be effective
d. Vent the area for 15 min
e. Re-monitor area to be below PEL
f. Have ME investigate
g. Depending on volume of reactants you may need level B for splash protection. Neutralize with fast set concrete. Once hard you can throw in trash, CA NON HAZARDOUS – HazMat Team ONLY
h. Superfund and remaining liquids if necessary
i. Body is not an issue for ME autopsy, no detected gases in autopsy
Detergent Suicide Voice Over Version
Industrial Emergency Council
San Diego Chemical Suicide Study
Quick Action Needed! – victim looks viable, child in the car, or…
- -FFTO/SCBA sufficient if none of the B’s are present (Bullets, Bombs, Blunt force)
- -Consider Ventilation by breaking a window (evacuate down wind)
Talk it up and have a plan!
3. Carbon Monoxide
a. Normally DOA by the time FD arrives on scene. Or the note prevents them from making entry when they can easily in FFTO
b. FFTO recon and vent
c. Perimeter monitoring, get people out if you can. Shelter in place can be effective
d. Eliminate CO source
e. Allow 15 min and re-monitor
f. Fairly easy
4. Cyanides
a. These are always DOA
b. There will not be any detectable HCN gas in the room only in the mouth of the deceased. About 3-7 ppm based on experience
c. Normally you can recon in FFTO to do monitoring for HCN gas and clear it for ME to do investigation, just remember when they move the body it may expel gas from the stomach
d. Offer assistance to the ME for monitoring during autopsy as the abdomen will vary from 10-20 ppm
e. DO NOT CUT OPEN STOMACH in the autopsy room, clip it off and put it in a ventilation hood to capture the liquid for analysis. The HCN meter will top out at 50 ppm normally above immediately dangerous to life and health.
FDIC 2018 Rescue in a HazMat
When do responders get hurt?
Often these calls do not come in as a HazMat/Chemical Call, they dispatch as EMS, Person Down, Unknown Medical.
These are dangerous because we do not have the proper PPE! Have a plan to back out, or assign a member to quickly don FFTO/SCBA for rescue, and train on the plan!
Have a plan as you would any structure or vehicle fire with Rescue.
5. Pesticides
a. These are messy
b. They usually throw up all over the place.
c. We use bleach to detoxify organophosphates
d. Transport is the issue here. Need plastic down in the box. Tyvek for attendants, APR… Transport in open vehicle if possible but it’s never done that way.
e. Also is the hospital ready to receive someone like this. Usually shuts down the ER. Treat outside. Or in negative pressure room
6. Phosphides
a. We have not seen these down here yet
b. Good case study in Virginia
c. Little bit goes a long way
d. FFTO are good for this
e. Phosphine can coat a PID lamp better to have an electrical chemical sensor
f. Vent to zero PEL is extremely low
g. Patient will continue to expel phosphine for 24 hrs or so read the study above
7. Azides
a. Have not seen this one but it happened about 2 yrs ago in the bay area
b. Decomposition products are hydrazoic acid and you can use an acetic acid dragger for cross sensitivity see chart.
