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The Emergency Medical Response to the Cantara Hazardous Materials Incident*

Published online by Cambridge University Press:  28 June 2012

Gus A. Koehler
Affiliation:
California Emergency Medical Services Authority
Carol Van Ness*
Affiliation:
California Emergency Medical Services Authority
*
California EMS Authority, 1930 Ninth St., Suite 100, Sacramento, CA 95814USA

Abstract

On 14 July 1991, at 2150 h, a train derailment occurred near the Cantara rail curve about six miles above Dunsmuir in Northern California. The derailment spilled approximately 19,000 gallons of metam-sodium into the Sacramento River. When mixed with loater, metam-sodium degrades to methylisothiocyanate (MITC) and other gases. The contaminated river water passed the town of Dunsmuir and other occupied areas exposing residents to MITC gas.

From 15 July to 20 July (five days), a total of 360 people underwent triage. The majority of patients displayed minor exposure symptoms that did not require hospital care. Mercy Mt. Shasta Hospital, a small rural hospital close to Dunsmuir, received the majority of patients. As of 29 July, 15 days after the incident, Mercy Mt. Shasta Hospital had seen 244 exposed patients in its emergency department, and had admitted five. Three had symptoms that could have been spill-related. Three Regional Poison Control Centers provided medical toxicology advice.

Medical management of the emergency medical services (EMS) response to the event was piecemeal and weak. There did not appear to be a medical operations component at local Emergency Operations Centers (EOC). Most health care personnel interviewed complained about inadequate information about the substance and the situation. Local fire service mutual- aid agreements to obtain additional fire service and ambulance personnel worked well. It is important to emphasize that everyone who believed they had been exposed to the chemical underwent triage and received appropriate acute medical care.

Type
Case Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

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Footnotes

*

The findings, conclusions, and recommendations expressed in this paper are the authors and should not be attributed to the California Emergency Medical Services Authority.

References

1. California Department of Health Services: Briefing Document, 5 July 1991.Google Scholar
2. California Office of Emergency Services: Situation Summary: Siskiyou Train Derailment, July 17, 1991, as of 1200 hours.Google Scholar
3. California Department of Forestry and Fire Protection: A Report on the Application of the Incident Command System for the Cantara Incident, 25 August 1991.Google Scholar
4. California Office of Environmental Health Hazard Assessment: Health Risk Evaluation of the Metam Spill, 1992.Google Scholar
5. University of California at Davis Regional Poison Control Center: Letter to Gus Koehler, EMS Authority, 5 August 1991.Google Scholar
6. San Francisco Bay Area Regional Poison Control Center: Letter to Gus Koehler, EMS Authority, 20 August 1991.Google Scholar
7. Oregon Poison Center: Leller to Gus Koehler, EMS Authority, 15 August 1991.Google Scholar
8. California Department of Health Services: Medical Surveillance for Metam Spill Related Illnesses, 5 August 1991.Google Scholar
9. Kent, Olson (Editor): Poisoning and Drug Overdose. Norwalk, Connecticut: Appleton and Lange, 1990, p 107.Google Scholar
10. California Emergency Medical Services Authority: Hazardous Materials Medical Management Protocols, Second Edition. EMSA 231, February 1991.Google Scholar
11. California Department of Health Services: Questions and Answers about Metam Sodium. Public information sheet released on 7 October 1991.Google Scholar