Riot Control Agent

Aka: Riot Control Agent, Tear Gas, Lacrimogenic gas, Oleoresin of Capsicum, Pepper Spray, Chlorobenzylidenemalononitrile, Chloroacetophenone, Chlorodihydrophenarsazine

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II. Definitions

  1. Riot Control Agent (Tear Gas)
    1. Aerosolized powders used by police and military to suppress crowds by causing eye, skin and nose irritation

III. Causes: Common Riot Control Agents

  1. Commonly used Riot Control Agents
    1. Oleoresin of Capsicum (OC, Pepper Spray)
    2. Chlorobenzylidenemalononitrile (CS) Powder
      1. Most common agent used in U.S. by police and border control agents
    3. Chloroacetophenone (CN)
      1. More skin irritation than with CS
  2. Older agents with greater toxicity
    1. Chlorodihydrophenarsazine (DM)
    2. Dibenzoxazepine (CR) Gas

IV. Mechanism

  1. Pain receptor (TRPA1) irritation and inflammation at skin, eye, nose
  2. Riot Control Agent exposure to CN or CS is rarely lethal unless in enclosed spaces

V. Findings: Signs and Symptoms

  1. Eye
    1. Eye tearing
    2. Conjunctivitis
    3. Chemosis
    4. Blepharospasm
  2. Nose
    1. Nasal congestion
    2. Rhinorrhea
  3. Lung
    1. Cough
    2. Bronchospasm
    3. Hemoptysis
  4. Gastrointestinal
    1. Nausea and Vomiting
  5. Skin
    1. Skin burning Sensation
    2. Contact Dermatitis (uncommon)
    3. Skin bullae (prolonged exposure)

VI. Management

  1. Decontamination
    1. Evacuate patient to open, fresh air
    2. Remove all contaminated clothing
    3. Wash all skin with soap and water (remove all traces of chemical)
    4. Eye Irrigation for 15 minutes
    5. Consider Diphoterine Wash (Decontamination and chelating solution)
  2. ABC Management
    1. Airway Management
    2. Supplemental Oxygen as needed
    3. Oral secretion and nasal secretion suctioning
    4. Acute bronchospasm management (e.g. AlbuterolInhaler or Nebulized Albuterol)
  3. Contact Dermatitis Management
    1. Burn Management as needed

VII. Complications: Rare

  1. Pulmonary Edema
  2. Reactive Airway Dysfunction Syndrome

VIII. Resources

  1. CDC Riot Control Agents
    1. https://emergency.cdc.gov/agent/riotcontrol/factsheet.asp

IX. References

  1. Tomaszeski (2020) Crit Dec Emerg Med 34(6): 32
  2. Olajos (2001) J Appl Toxicol 21(5):355-91 +pmid:11746179 [PubMed]
  3. Schep (2015) J R Army Med Corps 161(2):94-9 [PubMed]

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