Care of the Chemically Dead: A Tale of Two Bodies

Introduction: A case of suicide by ingestion of aluminum phosphide in 1998 in Sydney, Australia and a case of suicide by potassium cyanide ingestion in 2003 in Avon, United Kingdom, resulted in cadavers that posed a residual chemical hazard. The difficulties experienced in managing the contaminated body, from the hospital through to buial in Sydney, provided the basis for planning through a response subsequently used to manage the contaminated cadaver in Avon.

Methods: This is a case review of the two incidents from emergency department and fire service records, and video footage of the burial of the cadaver in Sydney.

Discussion: The aluminum phosphide incident in Sydney highlighted the need for the effective handling of chemically contaminated cadavers. This included the safe handling and storage of the body, an effective multi-agency hazardous materials response at the hospital, and the need for dignified arrangements to be in place from death to burial. The lessons learned and subsequently, used successfully in Avon, United Kingdom in 2003, included the ready availability of gas-tight, chemical-resistant, body bags, and chemical-resistant personal protective equipment for health service staff.

Conclusions: Planning for the handling of chemically contaminated cadavers ensures a dignified approach to the cadaver and the family of the deceased. Planning for the management of one chemically contaminated body provides a template for managing a multiple fatality chemical incident. Effective, international cross-discipline communication allows lessons identified from incidents to be shared, and subsequently improve response procedures elsewhere.