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HWN Suggests

Managing the Effects of Riot Control Agents

There are no antidotes for any of these agents; thus, all treatment is aimed at symptomatic management. Clothing and other layers should be removed and sealed in airtight bags; care must be taken to avoid secondary exposure to police officers, nearby persons, and healthcare workers as particles may dry on skin and clothing.8 Mild soap and water can be used to wash any of these control agents off the skin. Transport of persons exposed to CS necessitates the police vehicle or ambulance to drive with the windows down to disperse remaining particles on skin. Ophthalmic treatment is based on copious irrigation with saline or normal water for 10-20 minutes, using topical anesthetics when needed.

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Featured

 Preparing for, Protecting Against, and Treating Tear Gas and Other Chemical Irritant Exposure: A Protestor’s Guide

Get out of the cloud of tear gas and away from the general area as soon as you can. Seek high ground, as most forms of tear gas are heavy; the closer you are to the ground, the higher the concentration of gas.

 So you’ve been sprayed and gassed…

Clinical effects can occur within seconds and are generally transient, resolving within 30 minutes. Prolonged exposure or exposure to a large dose, especially in a closed environment, has been associated with more severe effects, including burns, laryngospasm and chemical pneumonitis. Death is rare.

Previously Featured

Here’s What to Do With Clothing That's Been Sprayed With Tear Gas

If you come into contact with it, here's how to properly decontaminate or dispose of everything you're wearing.

Management of the effects of exposure to tear gas

Despite the frequent use of riot control agents by European law enforcement agencies, limited information exists on this subject in the medical literature. The effects of these agents are typically limited to minor and transient cutaneous inflammation, but serious complications and even deaths have been reported.

Ocular management for CS gas exposure: exploring treatment in the pre-hospital setting

The optimal duration for eye irrigation has not been agreed upon for chemical burns generally (Chau, Lee and Lo 2012) but it is interesting to note the time frames and quantities suggested for the treatment of CS Gas. Carron and Yersin (2009) recommend rinsing with saline for 10-15 minutes whereas others (Chau, Lee and Lo 2012, Sivathasan 2010) talk of ‘prolonged and copious’ irrigation to remove the solid particulates. For irrigation of Capsaicin Barceloux (2009) recommends at least 1-2 L of saline for eyes and skin.

Riot Control Agents

Chemical riot control agents are used all over the world. Tear gas and pepper spray are household names and the latter can be purchased for personal protection with the simple click of a button from many online retailers. Care of these patients begins with immediate and thorough decontamination of the patient’s skin and eyes as well as prompt evaluation of the patient’s airway.

Riot Control Agents AKA Tear Gas

1) Remove clothing by cutting off, don't pull clothing over victims head. 2) Wash with copious amounts of soap & water. 3) Blow dry then irrigate eyes with cold water/saline.

Tear gas at protests: How to protect yourself and what to do if you are exposed

Even though you may immediately want to hose off or shower, it's best to wait a few hours for the powder to dry, according to Guldin. Once it's dry, and you are safe and have access to a hose or shower, water can help remove the substance.

ToxCard: Riot Control Agents

Limited evidence for decontamination with milk, aluminum hydroxide-magnesium hydroxide (Maalox®), lidocaine gel, or baby shampoo. No significant pain difference among these decontamination techniques versus water.

Treatment for Exposure to Tear Gas and Pepper Spray

Overall, the treatment is similar to pepper spray. Those exposed should be removed from the environment and taken to fresh air. The vapor cloud is dense so higher ground can also be beneficial to avoid exposure. Quickly removing clothing, washing skin, and irrigate the eyes. It is important to dispose of contacts but glasses, once properly cleaned, may be used again.

What to Do If You’re Exposed to Tear Gas

While milk might provide some cooling relief to irritation, it doesn’t do much to help people exposed to tear gas. “With pepper spray, milk helps break down those oils,” says Bhuyan. “Diluted baby shampoo is another option. Milk for tear gas isn’t doing a lot except potentially providing some comfort.”

What to do if you’re pepper-sprayed

While pepper spray is physically painful, it can also make you feel helpless. Having a game plan ahead of time can help alleviate this feeling. It may also help to know that most symptoms will subside within 2 hours.

What to Do Immediately if You're Pepper Sprayed

While pepper spray contains the same ingredient used to soothe sore muscles, the concentration used in crowd control or personal safety situations is many, many times higher and will feel painful and not at all soothing to your body.

Resources

UMEM Educational Pearls

Initial management involves copious irritation of the affected area with water. There is limited evidence that decontamination with milk, milk of magnesia, or baby shampoo is better than water. Always consider projectile or blunt trauma that may be associated with the riot-control-related ED visits/complaint. Protect yourself by wearing PPE when evaluating/treating these patients.