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Hazmat suicide: What would you have done? News

April 3, 2012

EMS News in Focus
by Arthur Hsieh

Hazmat suicide: What would you have done?

A case like this often points out the limitation of response plans

By Arthur Hsieh

Editor's note: The emergency room at a Florida hospital was temporarily shut down Sunday morning after a man who had attempted suicide vomited up poison, sickening three paramedics. Art Hsieh takes a look at the unusual hazmat issue for responders.

What would you do in this situation? Based solely on the information provided in the article, I'm fairly sure I would've ended up in the same situation as the medics did.

I looked up my EMS system's protocols on how to handle such an event, and not surprisingly there were no specific protocols for emergency vehicles carrying a hazardous materials incident on board.

Armchair quarterbacking this incident, once it became evident that something was going wrong, I might have made the decision to divert the unit from wherever we were to a location that could be isolated, call for assistance and wait to be decontaminated.

There would be the dilemma of whether to treat the patient while waiting for hazmat assistance, or retreat from the patient for safety concerns.

Overall, a bit of a sticky wicket; a case like this often points out the limitation of response plans and the emphasis that such documents serve to simply provide guidance, and not specific instructions for every type of situation.
This case also points out how quickly an incident can deteriorate and become a major risk to both rescuers and patients.

Fortunately it appears that everyone escaped with minimal harm.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
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Doc Hawkins Doc Hawkins Wednesday, April 04, 2012 5:29:39 AM The Military has extensive protocols dealing with NBC consulting with their Med staff (especially a ship's protocols) would save much wheel reinventing.
Mike Dessert Mike Dessert Wednesday, April 04, 2012 7:37:12 AM Since 9-11 American emergency rooms have, with great expense, undergone extensive training for such contamination situations. I personally have been involved in some of this training. Procedures are clearly outlined and decontamination efforts are well described. This level of panic seems to stem from letting down your guard and not keeping up with current procedures and policies.
Steven Dessert Steven Dessert Wednesday, April 04, 2012 7:57:35 AM I’ve worked with nerve agents. Knowing that Malathion is an organophosphate like Sarin or VX would have been enough for me to don some kind of protective gear just in case what went down came back up. I would have definitely ran for fresh air if he blasted it around the room or in the ambulance.
Mike Dessert Mike Dessert Wednesday, April 04, 2012 1:40:30 PM Steven Dessert Yea, pretty much if someone starts the puking process in the back of the ambulance, it's time for fresh air. That's the worst.
Steven Dessert Steven Dessert Wednesday, April 04, 2012 2:00:12 PM Easy for me to say... I'm not an EMT. I'd be willing to bet personal safety is not always an EMTs first thought.
Mike Dessert Mike Dessert Wednesday, April 04, 2012 2:01:19 PM Steven Dessert You are correct, I was an EMT and Paramedic in Washington state eons ago. It was a different time then but the back of that rig cold get pretty nasty pretty fast. Usually you're doing everything you can to minimize the vomit and control the direction and landing spot for it. Obviously with a patient who swallows a substance that may come back up attention to detail is paramount. Caustic projectile vomit can be extremely dangerous. Oddly I don't miss those runs...LOL
Wayland Slater Wayland Slater Wednesday, April 04, 2012 3:20:49 PM I've been at some facilities that there was a seperate door into an airlocked room in the ER. Hopefully the ER was advised fully of what to expect. The ER staff would already fully dressed for HazMat. The pt. and the ambulance staff, male and/ or female would strip down and fully showered. There were detectors, including geiger (sp?) counters. The ambulance staff would exit to another airlocked room and treated themselves. That is the most advanced system that I've seen. Luckily I never had a HazMat situation that called for that.

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