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Wednesday

Don’t worry, its only pepper spray.

An intentional release of pepper spray caused twenty students from a Urbana, Illinois middle school to be transported to a hospital. According to the report published in The News-Gazette, a 14-year-old student discharged pepper spray into two occupied school hallways.

Students in the affected area were moved to the gymnasium where another burst of pepper spray was released. According to the report (link: http://www.news-gazette.com/news/2006/12/22/14-year-old_arrested_in_pepper_spray_incident) school officials quickly identified the material as pepper spray and called the fire department. Twenty students complained of irritation and respiratory symptoms common to riot control agents; fifteen of those were triaged as “green” or minimal. The triage status or condition of the remaining five students is not in the article. The kids, who are described as “frightened and panicked” were not exposed to the elements.

I have numerous questions about this incident. And while it’s clear we don’t have all the facts, I think it is important to look at the actions and attitudes portrayed in this event. My first concern is the statement about school officials recognizing the agent as pepper spray. How did they know it was just pepper spray? I doubt that any detection devices were utilized to identify or narrow a list of possible agents. In fact, devices designed to detect or confirm riot control agents are not often available to responders. It is realistic to assume that a container or dispersal device was found lending clues to the agent. However, we should never assume that the obvious agent is the only agent. Responders should be aware of signs and symptoms as well as dispersal patterns and physical properties when attempting to narrow a list of possible agents. Identification of the agent is important for patient care, decontamination, and provider safety.

Another, and perhaps more menacing issue, is that of intent. In this case, the perpetrator discharged another spray after students had been moved to the gym. I have two concerns; did the perpetrator have prior knowledge of evacuation plans and collection areas and plan a secondary strike, and was any measure taken to prevent the perpetrator from getting into the gym? Both of these issues are difficult to address, yet both were components in the Columbine massacre.


We must be reminded, also, that although riot control agents are considered “less-than-lethal” they possess the potential to create multiple patients, decontamination issues, and hazards to the responders. Although not deadly, riot control agents can exacerbate a variety of respiratory and cardiovascular medical conditions and cause hypoxia resulting in critical patients.

My recommendations:
Never assume the obvious threat is the only threat; other potentials should be ruled-out to a reasonable extent.

Take the time to pre-plan for a incidents at schools. Collaborative planning and training efforts between traditional and non-traditional responders (ie: EMS/Fire and school officials) will pay big dividends during crisis.

Be sure your response plans are tested, practiced and revised. Tabletop exercises are a great low-cost way of doing this. Plans should be general in scope with annexes for specific threats. Planning for school events must include accounting for weather, media, dispersal of victims prior to arrival and site security. Don’t forget to build in communication with local hospitals.

Recent concern over too much school security has made news lately asserting that school security measures are a result of paranoia and not actual potential (for more on school security, see School Security Should Go Over the Top, Mitigation Journal (December 2006 http://mitigationjournal.blogspot.com/2006/12/school-security-should-go-over-top.html). My stance is that schools are facilities of critical infrastructure by virtue of occupancy and potential impact of an attack/event. A natural disaster such as an earthquake or a Columbine-like attack will yield panic and disruption in any community. We cannot simply dismiss an event, any event, involving schools. They are soft targets and should be hardened and protected.

These providers saved lives…at risk of their own.

The Chicago Sun-Times reported that five paramedics and one paramedic student were overcome by chemical fumes after responding to what they thought was an asthma attack.

As reported in the Sun-Times; a man had been attempting to open a clogged household drain for several days using a variety of “consumer-level hazardous materials” (consumer-level hazardous materials or CLHM, is my phrase for the chemical products available at grocery stores, drug stores, Home Depot, Lowes…ect. that if used property are no big deal, but used improperly or mixed create a hazard..)

It seems that the homeowner died from the fumes emitted by mixing several consumer-level hazardous materials; Liquid-Plumr, chlorine bleach, and Rooto. The Liquid-Plumr was used first and after several days – he started adding the other products – resulting in the “consumer-level hazardous materials event. (A Consumer-Level Haz Mat would be an event created by improper use or mixing of this type of chemical and typically found in the single or multi-occupant residential setting or resident/institutional setting…a nursing home or school dorm.)

EMS was dispatched for an asthma attack and found the homeowner dead, his wife and adult son overcome and incapacitated. The paramedics rescued the victims from the house…becoming exposed to the fumes and requiring hospitalization. The article states that “The paramedics didn’t wear masks when they went in because they thought they were there for an asthma attack.”

Some important issues for discussion:
“Consumer-Level Hazardous Materials” or CLHMs contain a legitimate danger even if used properly. You should note that Liquid-Plumr contains Sodium Hypochlorite (NaClo = sodium hydroxide + Chlorine, A.K.A. bleach) and Lye as a stabilizer. Lye is also known as caustic soda and causes defatting/sapofacation…liquefaction of the tissues. This is considered worse than an acid burn and from what I can read, the other products (Commet and Rooto) contain sulphuric acid (H2SO4)

When you mix this stuff together, you’re going to get nasty results. In general, BLEACH + Acid yields CHLORINE GAS, BLEACH + AMMONIA yield Chloramines. This reaction can be violent, especially if the reaction takes place in a confined container or builds pressure as chlorine gas and oxygen are liberated.

These chemicals can (and are) used to create Homemade Chemical Bombs or HCB’s. For more on HCB’s see Homemade Chemical Bombs: A Legitimate Threat to Responders, Mitigation Journal (August 2006) Link: http://mitigationjournal.blogspot.com/2006/08/homemade-chemical-bombs-legitimate.html

It is reasonable to assume that this EMS service did not carry SCBA and therefore, any masks they could have used would be of the infection control type. HEPA masks, N95 masks and the like will provide no protection from chemical exposure. None whatsoever, remember that. The best you may be able to do is identify the situation and call for appropriate resources.

This scenario once again proves my point for the all-hazards approach to planning and training. This was not a terrorist event yet, the dangers are similar as are the ancillary concerns of responder safety, decontamination, receiving at the hospital, multi-agency integration (NIMS, anyone?) and mitigation.

Do yourself and your partners a favor; the next time you’re in the store, take a look at the chemicals in these consumer-level hazardous materials and do some simple research.

Read the Chicago Sun-Times article here:
http://www.suntimes.com/news/metro/179079,CST-NWS-orland20.article