By Kevin Ryan
The Baltimore City Fire Department recently encountered a hydrogen sulfide suicide in a vehicle in the southwest portion of the city. BCFD has not seen many of these in the past 5 years. The first-in suppression officer quickly recognized the situation and requested hazmat. The notification immediately set up the incident for a successful completion with no injuries to responders.
The chemical suicide threat first emerged in the United States in 2008. The trend began in Japan the year before. Several methods have been seen since it first showed up here. Here are some of the more frequently used chemicals and methods.
· Hydrogen sulfide
· Carbon monoxide
· Sodium azide
· Hydrogen cyanide
· Suicide bag
The hydrogen sulfide method is one of the most common. These chemicals can be easily obtained, and the method is easy to execute. This method is typically done in a vehicle.
Mixing a hydrochloric acid (such as found in toilet bowl cleaners) with a sulfide source creates the hydrogen sulfide gas. Many readily available household chemicals can be used to create the deadly gas. One half cup of each chemical in a closed space is sufficient to cause death in a matter of minutes.
Indicators first responders can look for when they get on scene can include an unattended vehicle in a remote area, buckets, containers, odors, warning signs and possibly vapor clouds or residue. The San Diego Fire Department’s Hazardous Incident Response Team did an excellent 10-minute training video on hydrogen sulfide suicide in a vehicle.
In the San Diego experiment, it only took 6 minutes for the chemicals to reach a lethal level when only half gallon of acid and lime sulfur was used. And those levels remain lethal for another 20 minutes. When a gallon of each chemical was used, the time to lethal levels dropped to 4 minutes — well below most departments’ response time capabilities.
Carbon monoxide suicide is also called charcoal or hibachi suicide. This method does require a source of combustion in an enclosed area. The Harford County (Md.) Hazmat Response Team has had one of these. The victim ignited charcoal in a bucket, placed the bucket in his vehicle and allowed the carbon monoxide to take his life through hypoxia. Instant death from carbon monoxide can be achieved at 12,800 ppm. Heat is a byproduct of the process, so fire could be a possibility with this method.
A rarely seen form of suicide uses sodium azide as the chemical. Only two documented cases of this have been seen, one in Baltimore City and the other in Berkeley Calif. Each victim had a scientific background, as sodium azide is not commonly available to the public.
Ingesting sodium azide creates hydrazoic acid. The sodium azide solution tastes horrible, so it would have to be taken with food or drink. A glass of alcohol and box of dates were found next to the victim in the Baltimore City case.
Another form of chemical suicide uses cyanide. Here, potassium or sodium cyanide mixed with a strong acid releases hydrogen cyanide in the air. The bitter almond-like odor will accompany this reaction.
Hydrogen cyanide is a blood agent that interrupts oxygen intake at the cellular level. Antidote kits are available for this type of poisoning. The Cyanokit may be the most recognizable. The kit containing hydroxycobalamin may be used for exposure on the fireground depending on state medical protocols.
The necessary cyanides are usually found in pest products or in industrial uses such as electroplating. Access to these products can help provide clues as to what kind of suicide was committed if not immediately known.
Phosphine suicide can be done by using rodenticides mixed with acids. As little as 2.8 grams can be lethal when mixed. The fish or garlic odor typically seen in amines is present during the reaction process.
We know phosphine from Red P meth labs. Hazmat teams are probably already equipped to detect phosphine when this method is suspected. Rodenticides are restricted-use pesticides. These are not available off the shelf, so special access is needed to obtain them.
Finally, there is the exit bag or quiet suicide. In this scenario, the victim places a bag over their head with inert gasses pumped into the bag. This can cause unconsciousness and then death. Oven bags, party balloon helium or suicide tools can be bought online.
When planning for these incidents, there are several response questions to address.
· Is it a rescue or a recovery?
· What are the hazards?
· What PPE will be needed based on the hazards?
· What detection equipment will be needed?
· What is the best method for ventilating the space?
· What decon will be needed for responders and victim?
· What measures are necessary to transport a viable victim?
· What is the best method to transport a deceased victim?
Incident management should be the same as any other hazmat incident. Isolate, secure and deny entry. Set up hot, warm and cold zones. Establish unified command. Notify additional agencies, such as police. Secure the scene and leave the area safe, as these sometimes take place in a public area.
Like most other hazards, it is important to understand the nature of the hazard and have a plan to address it prior to the tone dropping. Chemical suicides fall into that area between rare and common, where we need to have a solid pan and train on that plan.
About the Author
Kevin Ryan is a member of the Baltimore City Fire Department Hazmat Operations Office. He is a 30-year veteran of the fire service with 25 of those years as a hazmat responder; he is currently a Level 3 instructor. He has previously written the Buzz Blog for Hazmat Nation. He can be reached at [email protected] for additional information.
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