I have to tell you about three people and their tragic demise.
The first is a 23 year-old graduate student who just learned that he failed in his final bid to secure funding for his research project. He takes the news hard.
The second person is a 17 year-old high school student who was just “outed on the internet” by one of his classmates for being gay. His parents still do not know that he is gay. He is beside himself.
And the third is a 35 year-old mother of three who was just diagnosed with terminal ovarian cancer. She can’t bear the fact that her family will have to endure the medical expenses and her suffering. She finds the circumstances unbearable.
What do they all have in common? They all committed suicide by chemical inhalation, they all were found in an enclosed area, they combined typical household products to kill themselves, and curiously they left a warning notice for first responders.
As first responders, we are trained and in some circumstances certified to respond to some interesting and sometimes surprising situations. Suicide is unfortunate and a final desperate response for the person leaving no alternative. In many instances, first responders (firefighters, EMS, law enforcement) are accountable for the after effects. Chemical suicides can be complex from other types of suicides.
The Scenario
As first responders, you are called by dispatch to a car parked conspicuously out of the way at a local “big box” parking lot. With you are law enforcement, EMS or fire, as you begin your size-up (from the time of the call and the information received) you begin to assess the situation. As you arrive, you develop an awareness for the situation.
This situational awareness, as you collect the clues, is not typical. As you approach, the car is parked between the lines, the motor does not appear to be running, and there does not appear to be anyone near or in the car. As you draw closer it becomes apparent that something is very different. A sign taped to the inside of driver’s side window is disturbing: DO NOT OPEN CALL HAZ-MAT TEAM AND POLICE DEPT. There is a Skull and Cross Bones drawn in the paper as well.
A quick “window survey” finds a person slumped over the passenger seat and a five-gallon pail with other small plastic bottles between their legs on the floor of the car. The air space seems to be foggy inside the vehicle.
1) Do you open the door to try and help the person or step back and call for further assistance?
2) What NFPA Codes and Standards could be used to design training for this type of situation?
3) What NFPA Codes and Standards could be included in the development and implementation of agency (fire, EMS, law enforcement) procedures and/or guidelines for responding to this type of incident?
Below is some information that might help in the decision-making process.
Chemical Reaction
Typical household and industrial cleaning products containing muriatic and hydrochloric acid mixed with garden and home center pesticides or insecticides containing sulfide will react creating hydrogen sulfide.
This reaction when inspired by humans at the threshold levels described by NIOSH will cause bodily reactions and harms from irritation of the olfactory (smelling nerve sensors) to death.
Inclusive of the characteristics, hydrogen sulfide is flammable. Hydrogen Sulfide has an auto-ignition temperature of 500°F. Gasoline’s auto-ignition temperature is 450°F. At just 4% LEL, the susceptibility of a reaction if the conditions are conducive for fire or explosion is troublesome for first responders at the time rescue and extrication.
Harms to the Body
In most cases, people who come in contact with hydrogen sulfide usually recognize it in low levels of concentration and smell the odor of rotten eggs or sour gas. The danger is that in higher concentration levels, the olfactory, or “smelling”, receptors are easily overwhelmed and the odor is no longer detected. As a person breathes the toxic chemical, signs and symptoms readily occur. Indicators include respiratory irritation, coughing, nausea, vomiting, headaches, disorientation, tremors, suffocation, coma and death. The higher the lethal concentration, the harder the body has to work to replace the displaced oxygen. Once the toxin reaches the brain, breathing functions dissipate rapidly and recuperation will be limited if not unattainable. While the inhalation exposure carries the greatest concern for harm to the body, hydrogen sulfide may cause harm to the skin and eyes and should not be ingested at any concentration level.
Tom McGowan
NFPA Staff Liaison
Comments