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December 27, 2006

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

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