Chemical Assisted Suicides

Transcription

1 Chemical Assisted Suicides Presented by Captain Rich Christensen Bellevue Fire Department Coordinator, Eastside Hazardous Materials Team

2 Course Goal To offer first responders and other public safety officials the basic tools and information necessary to develop guidelines for responding to CHEMICALLY ASSISTED SUICIDES.

3 Course Note The guidelines and procedures discussed in this presentation are based on practical experience and designed to educate responders called upon to handle a chemical suicide incident. It is impossible to plan for every situation. New best practices and training become available on an on-going basis. These planning and training efforts should be updated regularly.

4 Remember! Please remember that this information should be used as an educational guide and you should ALWAYS use your local training, guidelines, and procedures!

5 Introduction A rapid, safe and successful response to these unusual situations requires some planning and preparation. The occurrence of chemically assisted suicide incidents is increasing. Public safety officials must prepare for these situations. If handled incorrectly, responders will become victims. It is anticipated that the number of incidents will rise as more people become aware of the process. According to the FBI, the Bellevue incident in 2010 was the 15 th in the nation. Many more have occurred in the U.S. since, with an increasing variety of chemicals.

6 Emerging Threat The purpose of this section is to provide situational awareness to first responders who may come in contact with victims of this hazardous method of suicide. These incidents commonly occur in vehicles, but any confined or tightly enclosed area will allow relatively small amounts of chemicals to reach toxic and/or explosive concentrations.

7 Emerging Threat (2) There have been numerous documented cases in the United States involving the use of readily available household cleaners as a method of committing suicide that can expose responders to a significant health and safety risk. The method involves mixing those common household cleaners with various pesticides to produce a flammable, toxic gas. The resulting gas causes the victims to go unconscious and suffer heart failure.

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10 Emerging Threat (3) This method of suicide (commonly referred to as detergent suicide), originated in Japan and is occurring more frequently in the U.S. It claimed over 500 Japanese lives in early Instructions are available and abundant on the internet. Some sites will encourage anyone planning to use detergent suicide to provide appropriate warnings about the presence of the deadly gas to people who might encounter or respond to their situation.

11 Emerging Threat (4) Mixing the right combination of household chemicals can generate hydrogen sulfide, hydrogen cyanide, chlorine, chloramine, or other gases which can be immediately dangerous to life and health if inhaled in small, enclosed locations. DOT Response Guidebook 111 (Mixed Load/Unidentified Cargo)

12 Hydrogen Sulfide (H2S): Most Poison Gas Common - colorless - heavier than air; vapor density of similar to cyanide - 5 times more toxic than carbon monoxide - IDLH at 100 ppm - strong odor of rotten eggs Flammable Gas - flammable range of 4% to 44% - auto ignition point of 500 degrees Fahrenheit

13 Physiological Effects of H2S Once taken into the body, H2S rapidly interrupts aerobic metabolism at the cellular level. This results in rapid unconsciousness and respiratory arrest. Prognosis of a significant exposure to H2S is poor. At low doses, H2S results in profound CNS effects and altered levels of consciousness. As the dose increases, the patient will rapidly lapse into unconsciousness, respiratory arrest, seizures, coma and death.

14 Physiological Effects of H2S (2) The effects of H2S are the same as cyanide poisoning. In fact, treatment is the same if antidotes are RAPIDLY available: amyl nitrate and sodium nitrate.

15 Responder Safety First responders can be the first exposed to this hazard. Typically, persons committing this act have left hazardous warning signs displayed to anyone approaching the scene. This is not always the case.

16 Response Considerations SIZE-UP: If you suspect chemicals are involved, take all necessary safety precautions during the initial investigation: - bunker gear and SCBA - ventilation - safety line RESCUE or RECOVERY? - does victim appear to be breathing? - warning signs posted? - is victim wearing eye protection? - do you see open containers of liquid or other indications that chemicals are present?

17 Response Considerations (2) - do you see weapons? Don t become a victim! - witnesses at scene? - odors? - anything that just doesn t look right? In every case, use an all hazards approach. You could be dealing with any number of chemicals including those used in clandestine drug or explosives manufacturing. Always request Law Enforcement and Haz-Mat!

18 Response Considerations (3) DECONTAMINATION: Viable Patients and Responders - does the patient and/or responders have chemicals on them? - limited decon may be appropriate if no chemical contact took place. If in doubt, FULL DECON! - advise the ER staff ASAP that you will be transporting an attempted chemical suicide patient. This offers staff the lead time to initiate any required DOH protocols for potentially contaminated patients. (decon, isolation, etc.) DON T CONTAMINATE THE ER!

19 Incident Review: Bellevue, Wa. May, 2010 Residential driveway. No warning note for responders. Hate letter later found; meant for victim s spouse. Strong rotten egg odor up to one block away. Initial responders opened the vehicle, unaware of threat.

20 Incident Review: Bellevue (2) Chemicals and open container of liquid found on passenger side. The victim was found wearing an eye mask. Victim experimented with the same chemicals the week before in the garage.

21 Incident Review: Bellevue (3) Combustible Gas Indicator readings at or near Zero for LEL, H2S, & Carbon Monoxide. A Police Officer standing over 50 away was adversely affected by the vapors. Dept. of Ecology later responded and disposed of the chemicals and contaminated PPE.

22 Incident Review: Kirkland, Wa. December, 2010 Large commercial office complex. Strong odor of rotten eggs and a visible cloud encountered by building maintenance staff. Immediate physical reaction: nausea, headaches, burning eyes, & throat irritation. Fire Department responded. Crews immediately ventilated the structure and performed a search for victims. None were found. Hazmat called to the scene.

23 Incident Review: Kirkland (2) A room-by by-room assessment was performed by the hazmat team. A wet spot was found on the floor of a vacant office. As in the previous Bellevue Incident, CGI readings were at or near Zero. Samples taken and examined with the SensIR indicated the presence of hydrochloric acid. Nothing positive for H2S, but the odor was still strong two hours after our arrival. What happened here?

24 Incident Review: Kirkland (3) Investigation continues Several empty Lysol toilet bowl cleaner bottles were discovered in a nearby restroom garbage can. Building maintenance personnel stated they do not use that product. During the incident, a citizen reported to the KPD that he lost $50K in a questionable business venture; he scheduled a meeting for that morning to confront his business partner at what was later determined to be the contaminated office. The business partner did not show up for the meeting

25 Incident Review: Kirkland (4) The missing business partner was later found and taken into custody. During questioning by police detectives he admitted to mixing chemicals in an attempt to create the suicide gas he read about on the internet. As the reaction progressed, he panicked, changed his mind and fled the scene with the open pail of chemicals. The Lysol containers were left behind discarded in the restroom garbage can.

26 Incident Review: Kirkland (5) This incident evolved from an odor investigation initially into a: Chemical spill Haz-Mat Level B entry Criminal investigation involving local and Federal authorities Public Health case Becoming the common course of events!

27 Summary Chemical suicides are on the rise. Many chemical combinations are flammable in addition to being toxic. Responders must use an all hazards approach. Don t become a victim; respiratory protection is mandatory! Decontaminate patients and responders appropriately. Advise the ER staff ASAP prior to transport. These incidents are crime scenes which require Police and Haz-Mat!

28 Questions?

29 References Federal Bureau of Investigation (FBI), WMD Directorate, WMD Operations Unit, WMD THREAT CREDIBILITY ASSESSMENT: HYDROGEN SULFIDE GAS THREAT Firefighters Support Foundation Chemical Assisted Suicides: A New Threat to Public Safety Personnel Regional Organized Crime Information Center SPECIAL RESEARCH REPORT: Hydrogen Sulfide Suicide Washington State Fusion Center Bulletin: Hydrogen Sulfide Suicide Agency for Toxic Substances and Disease Registry: Hydrogen Sulfide

30 Thank You! For further information contact: Captain Rich Christensen Bellevue Fire Department