Chlorobenzylidenemalonitrile gas exposure from a novelty personal-protection gun

We present an unusual case of chlorobenzylidenemalonitrile (CS) tear-gas exposure from the unwitting discharge of a personal-protection handgun loaded with CS gas. The gun was in a bag of toys purchased from a local thrift store and was discharged by a child. The responding paramedic presumptively identified the substance as CS based solely on personal experience. This recognition led to suboptimal field management of the incident with the paramedic failing to follow the standard operating procedures for an unknown chemical exposure. As this was a benign agent, there were no serious consequences. This case highlights the pre-hospital and emergency department challenges associated with the management of an unknown chemical exposure and the potential consequences if the chemical is a toxic substance. A methodical approach following established protocols can reduce the potential for negative outcomes. Review of the literature found no other report of CS gas exposure from such a personal-protection weapon.