Podcast #203 - Treatment for Exposure to Tear Gas and Pepper Spray

Law enforcement has used tear gas and pepper spray to help with crowd control.  Many of those exposed will require some form of treatment.  This post is meant to help provide some guidance in regards to the treatment of such injuries.

Pepper Spray
How it works:
Pepper Spray is a lachrymatory agent (stimulates the eyes to produce tears).  Its active ingredient is oleoresin capsicum which is the same chemical that creates the heat you feel with chili peppers.  The dispersion is as an aerosol of liquid spray (images below from USA Today article).  It can cause irritation of the eyes and pain which can result in temporary blindness.  Additionally, it can cause burning and swelling of the nasal mucosa as well as a runny nose.  If inhaled, it can suddenly increase blood pressure and shortness of breath.  In patients with asthma or COPD, it can cause complications that can lead to death.

Treatment:
Any clothing that has pepper spray on it should be taken off as soon as possible.  It is also important to avoid pulling the clothing over the head.  Clothing should be stored in a plastic bag, sealed, and safely disposed.  Washing the skin with copious amount of water and using soap helps avoid further spread.  It is vital to avoid rubbing eyes as this can cause the compound to spread or go deeper.  Blinking and flushing the eyes can help remove the oils from the pepper spray.  Baby shampoo or diluted dish-washing soap may be helpful.  While milk has been used, it only reduces the burning sensation but does not remove the oil.  Based on a 2018 study, baby shampoo does not appear to work better than plain water.  When  in doubt, call the regional poison control center at 1-800-222-1222.

Tear Gas
How it Works:
​​Tear gas is actually a powder that is released as an aerosol.  The two types most commonly used by law enforcement are 2-chlorobenzalmalononitrile (CS) and chloroacetophenone (CN).  It activates pain receptors to the areas affected and can be considered a nerve agent.  It can cause exaggerated muscle cramping leading to involuntary closing of the eyelids, excessive tearing, blurry vision, itchiness, temporary blindness, chemical burns, nausea, vomiting, and diarrhea.  It can be difficult to swallow and lead to drooling.  Once again, people with asthma or COPD are at higher risk for complications.  Both pepper spray and tear gas can cause significant complications including long-term such as pulmonary edema, glaucoma, and laryngospasm. 

Treatment:
Overall, the treatment is similar to pepper spray.  Those exposed should be removed from the environment and taken to fresh air.  The vapor cloud is dense so higher ground can also be beneficial to avoid exposure.  Quickly removing clothing, washing skin, and irrigate the eyes.  It is important to dispose of contacts but glasses, once properly cleaned, may be used again.

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