Pepper spray: Difference between revisions
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===Pulmonary=== | ===Pulmonary=== | ||
*Patients with underlying respiratory disease such as [[COPD]] and [[asthma]] may experience shortness of breath or wheezing. To evaluation for [[Chemical pneumonitis]] a chest X-ray may be useful. | |||
==Management== | ==Management== |
Revision as of 16:28, 2 September 2016
Background
Pepper (oleoresin capsicum) spray is commonly used riot-control and violence suppressive agent. It was first used by Federal Bureau of Investigation personnel in the US in 1973.[1] The majority of the uses do not cause life threatening clinical effects. Commonly encountered effects include conjunctivitis, blepharospasm, and self induced corneal abrasions. Early decontamination minimizes the irritant effects.[2]
Active Ingredients
Oleoresin capsicum (OC) is the main active ingredient and is extracted from the genus of the plant Capsicum annuum. The five capsaicinoids include:
- Capsaicin
- Dihydrocapsaicin
- Nordihydrocapsaicin
- homocapsaicin
- Homodihydrocapsaicin
Capsaicin and dihydrocapsaicin constitute 80-90% of pepper spray[3]
Clinical Features
- Painful burning sensation on skin
- Involuntary eye closure
- Decreased hand eye coordination
- Lacrimation
- Blepharospasm
- Conjunctival injection
- Cough
- Shortness of Breath
- Throat pain
Differential Diagnosis
Chemical weapons
- Blister chemical agents (Vesicants)
- Lewisite (L)
- Sulfur mustard (H)
- Phosgene oxime (CX)
- Pulmonary chemical agents (Choking agents)
- Incendiary agents
- Cyanide chemical weapon agents (Blood agents)
- Prussic acid (AKA hydrogen cyanide, hydrocyanic acid, or formonitrile)
- Nerve Agents (organophosphates)
- Acetylcholinesterase inhibitors
- Household and commercial pesticides (diazinon and parathion)
- G-series (sarin, tabun, soman)
- V-series (VX)
- Lacrimating or riot-control agents
- Pepper spray
- Chloroacetophenone
- CS
Evaluation
Evaluation is focused on the irritated bodily area which is usually the eyes, throat, and skin, and lungs.[4]
Ophthalmologic
- Assess for corneal abrasions (approx 7% incidence) and blepharitis
- Patients may have decreased corneal sensation from 10 min after exposure to up to 1-2 hours and should be instructed to wear sunglasses or eyeware for protection.[5]
Pulmonary
- Patients with underlying respiratory disease such as COPD and asthma may experience shortness of breath or wheezing. To evaluation for Chemical pneumonitis a chest X-ray may be useful.
Management
Treatment should be consistent with any specific injuries that are identified. Treat any:
Dermatological
Death Associated with Pepper Spray
- Patient with excited delirium, placed in physical restraint (handcuffed in prone position) with a history of chronic bronchitis experienced asphyxia due to bronchospasm<Steffee CH, Lantz PE, Flannagan LM, Thompson RL, Jason DR. Oleoresin capsicum (pepper) spray and “in-custody deaths.” Am J Forensic Med Pathol 1995;16:185-92. </ref>
Disposition
See Also
External Links
References
- ↑ Object of Interest: Pepper Spray. The New Yorker http://www.newyorker.com/tech/elements/object-of-interest-pepper-spray
- ↑ Yeung MF, William YM. Clinicopathological effects of pepper (oleoresin capsicum) spray. Hong Kong Med Journal 21(6). 2015
- ↑ Reilly CA, Crouch DJ, Yost GS, Fatah AA. Determination of capsaicin, dihydrocapsaicin, and nonivamide in selfdefense weapons by liquid chromatography–mass spectrometry and liquid chromatography–tandem mass spectrometry. J Chromatogr A 2001;912:259-67.
- ↑ Zollman TM, Bragg RM, Harrison DA. Clinical effects of oleoresin capsicum (pepper spray) on the human cornea and conjunctiva. Ophthalmology 2000;107:2186-9.
- ↑ Epstein RJ, Majmudar PA. Pepper spray in the eye. Ophthalmology 2001;108:1712-3.