Treatment of Pepper Spray Exposure to Eyes and Skin
The immediate treatment for pepper spray exposure to the eyes is irrigation with copious amounts of tap water for 15 minutes, while skin decontamination requires thorough washing with water to minimize tissue damage. 1, 2
Eye Exposure Management
Immediate Irrigation
- Begin eye decontamination immediately after pepper spray exposure to minimize eye damage 1
- Use copious amounts of tap water for irrigation, continuing for at least 15 minutes 1, 3
- When performing irrigation, take care to avoid contaminating the unaffected eye, other individuals, or surrounding areas 1, 3
- Some patients may need assistance keeping their eyelids open during irrigation 1
Alternative Irrigation Solutions
- If immediately available, eye irrigation with normal saline, Ringer's lactate solution, or commercial eye wash solutions is reasonable 1, 3
- Commercial eye irrigation solutions may provide more comfort and potentially result in less severe eye injury 1
Determining When to Stop Irrigation
- The definitive endpoint for irrigation is when a healthcare professional evaluates the injury and determines that the pH of the eye has returned to normal 3
- Persistent symptoms may require ophthalmologic evaluation 4
Skin Exposure Management
Decontamination Procedure
- Remove chemical powders from the skin with gloves or a piece of cloth 2
- Remove all contaminated clothing to prevent continued exposure 2
- Wash affected skin areas with large amounts of water 2
- Continue irrigation until burning sensation subsides 4
Special Considerations
Severity Assessment
- Most pepper spray exposures (93.2%) result in minor, self-limiting symptoms 5
- However, approximately 6.8% of cases develop more severe symptoms warranting medical evaluation 5
- The most commonly affected systems requiring medical attention are ocular (53.8%), respiratory (31.7%), and dermal (17.7%) 5
When to Seek Medical Attention
- Transport for medical evaluation should be considered for exposed persons with persistent ocular or respiratory symptoms 5
- Contact regional poison centers for expert advice on management of severe cases 1, 2
- People with chronic obstructive lung disease may be hypersensitive to pepper spray 6
Common Pitfalls to Avoid
Treatment Errors
- Delaying irrigation - immediate decontamination is critical to minimize tissue damage 1, 3
- Cross-contaminating the unaffected eye or other individuals during treatment 1, 3
- Using baby shampoo provides no better relief than irrigation with water alone 7
Potential Complications
- Severe corneal and conjunctival damage can occur despite immediate irrigation 8
- Potential complications include epithelial defects, limbal ischemia, reduced corneal sensitivity, and in rare cases, deep stromal scarring 8
- Although rare, fatalities have been reported following pepper spray exposure, particularly in individuals with asthma 6