Abstract

Hong Kong Journal of Emergency Medicine
Mass casualty incident involving pepper spray exposure: impact on the
emergency department and management of casualties
JJ Oh , R Yong , R Ponampalam, V Anantharman, SH Lim
Introduction: Exposure to pepper spray in an urban shopping complex resulted in 13 casualties being treated
at a tertiary public hospital emergency department (ED). This report describes the ED's organisation in
response to the disaster, and clinical management of those affected. Results: Thirteen casualties - 11 acute,
2 delayed - presented with symptoms ranging from ocular, respiratory and skin irritation to nausea, vomiting
and giddiness. The culprit agent was determined basing on the index patient's history and physical findings.
All cases were decontaminated at the ED's on-site Hospital Decontamination Station. Nine adults were
monitored overnight in the Emergency Observation Ward under the Toxic Inhalation Protocol and discharged
well. The index case was treated symptomatically with improvement, but discharged against medical advice
three hours later. No ED re-attendances were recorded. Conclusions: The effects of pepper spray exposure
are brief and self-limiting, but ED management can pose challenges in a mass casualty situation.

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