CS is a particulate spray, not a gas

EDITOR—The most recent edition of the British National Formulary reviews the emergency treatment of patients exposed to 2-chlorobenzylidene malononitrile (CS) spray. 1 It is important to note that as used in the United Kingdom CS is not a gas but a particulate spray formulated for use against a violent individual. Law enforcement agencies have expressed concern about the use of CS spray. 2 3 The Department of Health has issued a comprehensive report on CS spray, concluding that there are no health concerns about the effects of CS when used appropriately.4

In the context of law enforcement, using chemical restraints is safer than hands-on contact or using other weapons that have a higher probability of causing death.5 CS has been used in the United States and has a long history of safe and effective use. No consistent adverse effects from acute exposure have been documented, nor has excessive or unfounded use been a problem. In Memphis, Tennessee, the introduction of chemical restraints in the police department dramatically decreased the number of injuries to police officers and to prisoners as well as decreasing the number of complaints of excessive force made against officers.5 In Tennessee all officers undergo training in which they are exposed to both CS and oleum capsicum, and no significant injuries from exposure have been reported.

The most important aspect of managing a patient who has been exposed to CS is to practise good hygiene by removing …