Down and Dirty Medical Guide

Dear Comrades:

I am going to make this quick and dirty. All of these remedies are "first do no harm protocol," which means you can't hurt an injured person more by doing them. Hopefully, this is of some help.

Stay safe, comrades. If you have specific questions about injuries you have seen, feel free to tweet at me - @brazenqueer.

COMMON PROTEST INJURIES AND HOW TO TREAT THEM

1. CHEMICAL AGENTS

Chemical agents are things like tear gas and pepper spray. Both have different treatments, but you can protect yourself from both in similar ways. To protect your eyes, wear a pair of shatter-proof swim goggles with a tight seal. This will stop chemical agents from reaching one of your most vulnerable areas - your eyes.

If you do get tear gas in your eyes or any chemical agents on your skin, rinse them with water. Lots and lots of water. There is a lot of misinformation out there about things you can use that are not water, including milk, LAW (liquid antacid and water), and baking soda and water. These should not be used for various reasons (milk can grow bacteria and has allergy concerns, baking soda is a powder and can scratch eye surfaces if not properly dissolved in water, some chemical weapons react to the alkalinity of LAW and it  can actually make the injury worse, among other reasons.)

To do a proper eye wash, use a bottle that can spray in a continuous motion. A bottle of water with a "sport cap" is perfect and available at most convenienvce stores. First, have your patient kneel in front of you. Have them tilt their head towards whichever eye you are flushing. (Ex: If you are flushing their left eye, have them tilt their head to the left so the contaminated water flows towards the ground and not onto their clothing.) You may have to help them open their eye. To do this, place your thumb firmly on their upper eyelid and press upward. If they are wearing contacts, have them remove them as quickly as possible. Then, with your bottle, spray the eye using a hard, swift, continuous sweeping motion from the inside of the eye (the nose side) to the outside. You may have to do several flushes. The goal is to force the chemicals out of the eyes. For a quick demonstration on how to do a proper eye flush, please watch this video: bit.ly/eyeflushvid

Advise your patient to decontaminate as soon as possible. Pepper spray is oil-based and will continue to burn as long as it is left on the skin. Lotions, creams, makeup, and other skincare products exacerbate this, and should  not be worn to protests. Advise your patient to remove all contaminated clothing in a neutral area (a garage, a backyard, etc.) and triple bag it until it is ready to be washed. Contaminated clothing should be washed separate from all other household items. They should then shower, using cool water and very mild soap to cleanse the skin.

Breathing in chemical agents can be mitiagted with a mask - even a bandana tied around the face can be helpful. The best treatment for getting chemical agents in your mouth is to first get away from the source of the agent (i.e. move away from the tear gas). If you need to, you can wash your mouth out with water. Do not swallow the water. Rinse your mouth, and then spit it out.

2. PROJECTILE OBJECTS

The first and most important rule of projectiles is this: if your patient has a foreign object lodged in their body (i.e. a "less than lethal" round) do not attempt to take that thing out. Leave it where it is, even if you can get to it. Immediately call for a higher level of care and stabilize further as necessary. If the projectile is not completely below the skin (i.e. if part of it is "sticking out" of your patient), stabilize the area around the injury to reduce movement of the imbedded object. See the section 3 for tips on how to treat bleeding, and section 4 for tips on how to treat broken or damaged bones and joints.

3. BLEEDING

If your patient is bleeding badly, immediately put pressure on the wound with whatever you have available. If the blood soaks through, just put something else on top. Do not release pressure - not even to look to see how the wound is doing. Just. keep. holding. Do not try and tie a tourniquet. Do not pack the wound with anything. If bleeding is severe, or the patient is bleeding from the head or ears, immediately call for a higher level of care and monitor for signs of shock (see section 6).

4. MUSCULOSKELETAL INJURIES

If you suspect a musculorskeletal injury (that is, an injury to a bone or joint) do not attempt to set it or move it into a more "natural" position. The best thing you can do is stabilize the limb. You can do this one of two ways: For a damaged bone, stabilize the joint both above and below the suspected break site. (Example: if you suspect a bone in the forearm is broken, you would stabilize the wrist and the elbow.) For a damaged joint, stabilize the bone above and below the suspected damage site. (Example: if you suspect someone has sprained their wrist, stabilize the hand and the forearm.)  For hands and fingers, stabilize in the position of function (easiest way to do this is roll something up - guaze, tissues, etc. - and place it in their palm, allowing the fingers to gently and naturally curl around the object). Your goal in stabilization should be to reduce movement of the affected area as much as possible. For example, for a broken arm, you can use a t-shirt to gently but firmly bind it to your patient's body. A leg can be bound to your other leg. Reduce movement as much as possible, and check for motor, sensory, and function of the affected area (i.e. "Can you feel me touching your fingers? Can you wiggle your fingers?"). Move the person only if they are in immediate peril, and immediately call for a higher level of care.

5. HEAD/NECK WOUNDS

If someone is hit in the head and loses consciousness, or you suspect they may have an injury to either their head or neck, ONLY MOVE THEM IF THEIR LIFE IS IN IMMEDIATE PERIL. Head wounds are tricky things and moving an injured person with a head/neck wound can exacerbate an injury. Keep the person as still as possible in the same position you found them and immediately call for a higher level of care.

6. KNOW THE SIGNS OF SHOCK

If a person has been injured and they begin to exhibit any of the following symptoms, they may be in shock: anxiety or agitation/restlessness; bluish lips and fingernails; chest pain, confusion; dizziness, lightheadedness, or faintness; pale, cool, clammy skin; profuse sweating, moist skin; rapid but weak pulse; shallow breathing; unconsciousness. If you think a person may be in shock, immediately seek a higher level of care. If there are no other injuries preventing you from moving your patient, immediately move them to a place where it is safe for them to lay down. Place them flat on their back and cover them with something to keep them warm. Monitor their breathing and airway and, really, get them to a hospital. Please.

7. GENERAL TIPS FOR MEDICS

DO NOT EVER, EVER TOUCH OR TREAT SOMEONE WITHOUT THEIR CONSENT. When approaching an injured person, identify yourself clearly and ask for permission to treat them. Example: "My name is Jane, and I am a street medic. Do I have your consent to treat you?" If they say yes, first ask where they are hurt. Example: "Okay, can you tell me where it hurts or where you are injured?" Clearly and concisely explain EVERYTHING you do before you do it. Example: "It looks like you have a cut and are bleeding. I am going to take this gauze, and press it down on the cut to stop the bleeding. If you would like me to stop treating you, please tell me." If a person does not consent to treatment, or withdraws their consent during treatment, do not touch them, or immediately stop touching them.

If you feel the person is too injured to properly understand what is happening, or seems confused and disoriented, you can assess their level of what is called alertness and orientation (A&O) by asking the following questions:

- What is your name? (Since this is a protest, and I know we're all concerned about security culture, you can tell them a nickname is fine.)
- Where are you?
- What day of the week is it?
- What just happened to you?

PLEASE NOTE: IT IS IMPORTANT YOU ASK THE QUESTIONS AS THEY ARE WRITTEN. If you ask a person, "Do you know where you are?" and their response is, "Yes," that does not give you an accurate read on their alertness and orientation. They could think they are in California when they are really in New York. It is important that you know your patient actually knows accurate answers to your questions. If a person is A&Ox4 (that is, can accurate answer all 4 questions) or A&Ox3, they can consent to or decline medical treatment. If they are A&Ox2 or A&Ox1, look for a buddy or friend that could possibly help them make the decision for treatment. The latter two also indicate something greater possibly going on, and a higher level of care may be needed.

Always try to protect the privacy of your patient. Don't be shy about telling people with cameras to leave. If you need to, ask people around you to form a circle around you, backs facing you, so that you can not only treat your patient in privacy, but they can watch the area around you and warn you if the situation becomes too unsafe to continue treating your patient.

Always wear gloves when treating a patient. Never use latex gloves - latex allergies can be life threatening. Instead, use nitrile gloves. When treating people who have been exposed to chemical agents, change gloves before touching any other part of a patient's body. Please watch this video for a tutorial on how to properly remove soiled gloves: bit.ly/removeyourgloves

8. GENERAL TIPS FOR PROTESTERS

IF YOU ARE PLANNING TO PROTEST, PLEASE TAKE OUT CONTACT LENSES, AS CHEMICALS CAN GET TRAPPED BEHIND THEM AND CAUSE SERIOUS DAMAGE TO THE EYE. Also beware of glasses, as they can shatter if hit with projectiles.

Wear clothing made of cotton that will wick away moisture. Synthetic fabrics can trap chemicals against the skin, causing irritation.

For the love of everything holy, don't go out drunk, high, or otherwise altered. You need every ounce of your wits about you in situations like these.

Drink lots of water, and avoid drinking beverages with caffeine in them.

Most importantly, whether medic, or protester, or both: Have people you can talk about your experiences with. These situations are traumatizing. There is no shame in admitting that. Sit down, talk, debrief, admit that this is some heavy fucking shit you are going through. Laugh, cry, scream, hug each other. Check in with friends to make sure they are okay. If you notice people withdrawing, reach out to them.

THIS IS INTENDED AS A QUICK AND DIRTY OVERVIEW ONLY.

If you would like a more in-depth and comprehensive guide, please download and read this amazing guide by a dear comrade and fellow street medic: www.riotmedicine.net

But please remember that nothing replaces an in-depth training done by a qualified street medic collective. Find one near you, or join an online one!

Love you all.

<333
Brazen Queer