From the Guidelines
The immediate care for a patient exposed to oleoresin capsicum (OC) spray involves removing them from the exposure area and irrigating the affected areas with copious amounts of cool water or saline solution. This is based on the most recent guidelines from the American Heart Association and American Red Cross, which emphasize the importance of rapid removal of the caustic agent to minimize morbidity and mortality 1.
When caring for a patient exposed to OC spray, it is essential to:
- Remove contaminated clothing and jewelry to avoid trapping chemicals against the skin during decontamination
- Irrigate the affected areas with cool water or saline solution to help flush out the irritant
- Have the patient blink repeatedly if eyes are affected to help flush out the irritant
- Wash the skin with mild soap and water, avoiding harsh soaps or alcohol-based products which can worsen irritation
- Irrigate the eyes with sterile saline or water for at least 15 minutes if eye exposure occurs
Symptoms can be managed with cool compresses and over-the-counter pain relievers like acetaminophen or ibuprofen. A topical anesthetic eye drop like tetracaine may provide temporary relief for severe eye pain, but should only be used once under medical supervision. Most symptoms resolve within 30-45 minutes, though eye irritation may persist for 24 hours. It is crucial to seek immediate medical attention if symptoms worsen, breathing difficulties occur, or if the patient has underlying respiratory conditions like asthma.
The key to effective first aid is to prioritize the removal of the caustic agent and to avoid contaminating other individuals or areas with the substance, as emphasized in the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
From the Research
Immediate Care
- Decontamination is a priority in treating patients exposed to oleoresin capsicum (OC) spray, as it alleviates symptoms and prevents long-lasting effects 2, 3
- Thorough decontamination should be carefully carried out to avoid contamination of the surrounding skin and clothing 3
- Hypertonic saline, an amphoteric surfactant, and a chelating agent may be used to treat patients immediately, resulting in substantial improvement 2
Ocular Care
- Ocular exposure to OC spray can cause severe and permanent damage to the corneo-conjunctival tissue 4
- Patients with ocular symptoms may require further care from an ophthalmologist and topical medication 2
- Protective goggles may be an option when direct spraying into the face of individuals, such as in law enforcement training 5
Symptom Management
- Symptoms of OC spray exposure include itching, irritation, burning, and pain 2
- Treatment consists of symptom-directed supportive measures, and early detection and treatment of systemic toxicity 3
- For acute pain management, acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) may be used as first-line pharmacologic agents 6