Chemical Suicides

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Chemical Suicides A Safe Response
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EMS respond to thousands of cases a day of a
person unconscious in a vehicle.  In most cases,
the EMS will find the driver has a medical issue,
is under the influence of alcohol or drugs, or is
just plain sleep deprived.  Unfortunately, there
is another scenario lurking out there that can be
very dangerous.
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Chemical suicides have been on the rise. 
According to a New York State fire official, of
the 72 chemical suicides in the U.S. since 2008,
80 have resulted in injuries to first
responders.  These incidents are on the increase,
with more than 25 chemical suicides having been
reported thus far in 2011.
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A thorough EMS safety assessment at the approach
of a person down can prevent a secondary
exposure to toxic chemicals that may be present. 
There are potential warning signs to a chemical
suicide of which EMTs should be aware.  This
applies to structures as well as vehicles.
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A chemical suicide, or detergent suicide, is
self-murder by hydrogen sulfide asphyxia.  A
combination of common household cleaners can
result in a two-part cocktail that produces the
deadly gas.
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Internet searches and chat rooms provide the
potential suicide victim with a recipe for a
strong acid and sulfide solution that makes the
gaseous hydrogen sulfide.
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Hydrogen sulfide gas (H2S) is 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.
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When exposed to hydrogen sulfide gas from 0-50
ppm, a person suffers minor eye, nose, and throat
irritation.  From 10-50 ppm, the effects are
headache, dizziness, nausea and vomiting, and
coughing and difficulty breathing.
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Exposures to 50-200 ppm result in severe eye and
respiratory irritation, shock and convulsion,
coma, and possible death.  Levels above 700 ppm
will cause immediate death in as little as two to
three breaths.  Additionally, hydrogen sulfide
can be flammable if exposed to an ignition source
above 500 degrees (F).
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Chemical suicides normally occur in spaces like
vehicles and small rooms because hydrogen sulfide
gas, which is slightly heavier than air, must
build up in a confined area to reach lethal
concentrations.
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Vehicles are frequently used for chemical
suicides because they have airtight seals in the
doors and windows that easily allow the hydrogen
sulfide gas to accumulate.  Rooms in a structure
are typically more difficult to seal.
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Upon approaching a person down in a vehicle, in
addition to conventional EMS safety, being
mindful of the overt signs of a chemical suicide
can prevent EMS injuries or death. Detergent
suicide victims may leave either a sign or note
on their vehicle warning of the chemicals within.
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Because approximately half a gallon each of the
acid and the sulfide is needed to produce a
lethal amount of gas, look for visible containers
for liquid inside and outside the car.  These
containers may be bottles, buckets, or coolers.
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Although definitely not recommended as a
detection system, smelling the odor of rotten
eggs upon approaching a vehicle would constitute
a danger sign.
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• Chemical suicides can also be committed inside
  dwellings or structures. Warning indicators that
  may be present include
• Odor of rotten eggs
• Seeping liquids from under doorways
• Visible containers of liquids
• Duct tape used to seal windows or doors
• Signs or notes
• Residents or neighbors exhibiting breathing
  problems

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If the danger signs are present, you have
encountered a Haz-Mat situation.  Unless you have
training, and the proper respirator or SCBA, you
are not prepared to handle this call.  Notify
medical and rescue resources immediately.
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If the person is non-responsive, wait for trained
rescue personnel. If the person is conscious and
can be called out of the vehicle or room, do so,
but be very careful not to get into close
proximity of them because of the possibility of
off-gassing, or the release of poison gas from
the victims clothing or breathing.  Have the
victim move to fresh air and wait for rescue
personnel.
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Because of hydrogen sulfides flammability, and
the concentrated levels in a chemical suicide, do
not smoke or have spark generating tools or
Tasers introduced into this scenario. During
post-incident investigation, follow all safety
protocols for a Haz-Mat event.
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A severe exposure to hydrogen sulfide gas can
cause permanent eye damage, facial paralysis,
respiratory damage, nerve tissue damage, and
death.  Keep the danger signs in mind and always
use your best judgment.
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