Chemical Suicides AKA “Detergent Suicides” Silver Cross EMSS EMD CE January 2015

According to the CDC, suicide is the 10th leading cause of death in the US and the numbers have been increasing since 2000. There is 1 suicide for every 25 attempts. Men are nearly 4 times more likely to die by suicide but women attempt 3 times as often. Chemical suicide originated in Japan in 2007 and started in the US in 2008. Suicide Stats

Method of suicide being promoted by some internet sites as “painless, clean and beautiful” How-to Instructions are readily available Chemicals are easily obtained Increased media coverage will lead to an increased awareness of additional suicide methods Chemical Suicide

80% of chemical suicides have resulted in injuries to bystanders or responders Safe responses to these high risk emergencies requires basic awareness and training Your questioning of callers and relaying of scene information, will be important for first responders Chemical Suicide

Hydrogen Sulfide, has the highest rate of occurrence and the most media and internet coverage. Recipes for other toxic gases, such as Hydrogen Cyanide or Methyl Bromide also exist. Other blogs and websites promote chemical asphyxiates, Helium or CO. Chemical Suicide

Colorless and smells much like rotten eggs Colorless and smells much like rotten eggs.  It can be detected by the human nose at concentrations between .13 and 100 parts per million (ppm).  At levels above 100 ppm and with exposures from three to 15 minutes, there is a paralysis of the olfactory nerves, which shuts down the sense of smell. Hydrogen Sulfide (H2S)

The concoction Mix Produces Acid and base ½ cup of each Hydrochloric acid Sulfur compound Acid and base Exothermic Somewhat violent reaction ½ cup of each Produces 1000 ppm Average sized vehicle or 3,500 cubic feet of a confine space The concoction

Typical Chemicals Used Acid Sources Muriatic acid Sulfuric acid Lysol disinfectant Lysol toilet bowl cleaner The Works, toilet bowl cleaner Kaboom Shower, Tub and Tile cleaner Tile and Stone cleaners Sulfur Sources Artist oil paints Dandruff shampoos Pesticides Spackling paste Latex paints Garden fungicides Lime Sulfur Bath Salts Typical Chemicals Used

Most cases to date have occurred in closed vehicles with warning signs left by victims. Other documented cases have been in closets, bathrooms, apartments, dorm rooms or hotel rooms and some have been without warning signs. Many of these resulted in exposure to others, including first responders. Chemical Suicide

Exposure and Treatment

Thinking about scene safety! EMS respond regularly for reports of a person unconscious in a vehicle.  In most cases, they will find the driver has a medical issue, is under the influence, or sleeping.  Unfortunately, chemical suicide is another scenario that can be very dangerous for responders. Careful evaluation of these types of calls will be key for responder safety. Thinking about scene safety!

Warning Signs / Vehicle Subject slumped over in the vehicle Suicide notes taped to the window Suicide note inside vehicle Yellow or green residue or haze Warning Signs / Vehicle

Warning Signs / Vehicle Windows taped Doors taped Vents taped up Occupant wearing goggles or gloves Gas cylinders present Warning Signs / Vehicle

Warning Signs / Vehicle Tools used to mix the chemicals Bottles of household chemicals Containers used to mix the chemicals Odor of rotten eggs or burnt almonds (cyanide) Seeping liquids from under doorways Warning Signs / Vehicle

If callers relay any of the information that indicates a chemical suicide, this is to be treated like a HazMat incident. Notify responders of any safety issues. Advise callers NOT to approach the vehicle or open doors. Advise them NOT to attempt to rescue or do CPR on unresponsive victims of chemical suicide. If a victim is still awake, ask them to exit the vehicle and move to fresh air. Keep bystanders away from scene and victim, so they will not be exposed. Questioning Callers

The following pages are taken from the NIOSH Pocket Guide and has Chemical Suicide Guidance information for Dispatchers and Responders. Zoom in or print out for a better view. Resource

Sources ATSDR.cdc.gov NIOSH USDOT ERG CDC MMWR Sept. 9, 2011 Fireengineering.com Firefighters Support Foundation Google Images Sources