CS Spray Exposure Clinical Effects and Management
Abstract
The number of people exposed to CS spray presenting to accident and emergency departments is on the increase. Its effects, though usually minor and short lived, involve several systems and can occasionally be life threatening. It is therefore important that staff are able to manage these patients and know when and how to protect themselves and others from further contamination.
The use of hand held defence sprays to incapacitate violent offenders has become widespread among many UK police forces. Accident and emergency personnel are therefore increasingly treating patients who have been exposed to CS spray. A basic understanding of its clinical effects is essential to permit the appropriate triage and emergency care of such patients.
O-chlorobenzylidene malonitrile was named CS after the two chemists Corson and Stoughton who synthesised the compound in 1928. In its natural state it is a fine white solid similar to talcum powder with a pepper-like odour. Its chemical formula is represented in fig 1. It can be disseminated as a fine dust via an aerosol or, when mixed with a pyrotechnic compound, as a smoke or fog of minute particles from a grenade or canister.
The “CS incapacitant spray” currently in use by the UK police forces contains a solution of CS in a solvent of methyl isobutyl ketone propelled by compressed nitrogen. In legal terms this is a firearm and requires a licence for its possession.’ In minute doses it acts as a severe irritant and lacrimator causing a severe local reaction within seconds of contact with mucous membranes and skin. There are other compounds with a similar range of irritant properties, namely chloroacetophone (CN), capsaicin, and chloropicrin.
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