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August 22, 2010

Six EMTs Exposed to Acid Fumes

As reported in the Rochester Democrat and Chronicle, six emergency medical technicians from the Ontario Ambulance were transported to an area hospital after exposure to acid fumes. As of this report, the exposure took place while providing patient care at the scene of a motor vehicle collision. The vehicle containing an injured driver also contained a quantity of muriatic acid. Muriatic acid is the same as hydrochloric acid (H3O+Cl-). The container of acid may have spilled in the cab of the pick-up truck as a result of the crash. The intended use of the acid remains unknown as well. The concentration and quality of the acid are not known, but were enough to cause symptoms and necessitate hospitalization.

Hydrochloric acid is one of the popular ingredients in the construction of homemade chemical bombs.

The good news (if there is any in this case) is this exposure took place outside with presumably good movment of ambient air. Exposure to most acids results in irritation of mucous membranes and respiratory difficulty at low concentrations. Exposure at higher concentrations (such as when a person cannot self-evacuate) can result in non-cardiogenic pulmonary edema and hypoxia.

Look for containers as clues to danger
This case is another reminder that the term "routine" has yet to be scrubbed from our vocabulary. Also, despite the warnings about bottle bombs, homemade chemical bombs, acid attacks, and of course, the ever popular WMD training, we're still not looking for these hazards when we respond to every-day events.  This exposure was not a result of a chemical attack or terrorist event...but lack of situational awareness and Optimism Bias could have cost responder lives.

Points to ponder:
What, if any, clues were there? Containers, odors, unidentified liquids in the vehicle?
Did the victim of the crash present with signs or symptoms that lead you to think something other than what the situation looked like? Could exposure to the acid fumes caused or contributed to the crash?
What PPE should EMS don for such an event? Let me answer...none. EMS typically is not equiped with the PPE needed for a chemical exposure.
Decon...decon...decon. Prior to leaving the scene...with early notification of area hospitals.

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