EMS World

AUG 2011

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

Issue link: http://emsworld.epubxp.com/i/37132

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Page 23 of 71

CASE REVIEW the adults if their children are safe at school, being evaluated by emergency personnel, or have been removed to a certain hospital. On this day, they inform hundreds of parents that their children are OK; about 17 that their children are being evaluated; and one that their child is in stable condition and going to the children’s hospital for further evaluation. Incident Resolution Within a short time, the hazmat team identifi es that the exposure is not any high-level toxin. The culprit chemical is likely an irritant spray with capsicum resin, or pepper spray. The source is likely a spray bottle, the area of likely exposure just outside the cafeteria. The team identifi es a liquid line along the wall there, suggesting someone sprayed it intentionally (accidental discharges of pepper spray usually do not produce a straight line down a wall). When the team identifi es the chemical, the victims in the treatment area are released, the hospital is notifi ed, and the poison control center is briefed. In the fi nal step, a member of the hazmat team, the command staff, the Attack One offi cer and school offi cials walk the entire school to make sure there are no remaining odors, sources or dangers. Once that’s complete, students are allowed back in. The crew members complete patient documentation, the triage and treatment worksheets and the nonremoval releases. Copies of the worksheets and patient reports are passed to command, and a copy of the worksheets (without medical informa- tion) given to school authorities. Then the media gets a fi nal briefi ng. Pepper Spray Knowledge of pepper spray products will allow providers to manage victims appropriately without removing a lot of people to hospitals, and without the diffi culties of “wet” decontamination for a large group of exposed. The active ingredient in pepper spray is capsaicin, derived from cayenne and other peppers. The chemical is extracted from the pepper in an organic solvent such as ethanol. The solvent is then evaporated, and the remaining waxlike resin is oleoresin capsicum (OC). An emulsifi er like propylene glycol is used to suspend the OC in water, and it is pressurized to aerosolize it as a pepper spray. Capsaicin is not soluble in water, no matter what volume is used. Ask victims to not rub their eyes or skin, which may cause greater exposure or penetration. No difference has been found between water, milk, antacid solutions, baby shampoo and lidocaine gel in reducing the pain of an exposure. Time after exposure, generally 7 to 15 minutes, is the best predictor of pain control. State laws attempt to control the strength of these sprays and who may carry them; many states restrict products to no more E Be a part of the EMS Nation As an EMS practitioner, you are a valued member of your EMS service and your community’s public safety network. Now, take the next step and become a member of the EMS profession at the national level by joining NAEMT. Membership in NAEMT brings you: Great resources to grow your career and enhance your clinical skills  Opportunities to advocate for EMS at the federal level  Valuable networks to help you connect with fellow members of your profession across the country... and many more value-added bene⇒ ts Join with thousands of other EMS practitioners to advance and strengthen the EMS profession. www.naemt.org | 1-800-346-2368 For More Information Circle 23 on Reader Service Card 24 AUGUST 2011 | EMSWORLD.com Join NAEMT today. See Us at EMS Expo Booth #3404

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