A Protester’s Guide to Basic First Aid
With peaceful protests no longer guaranteed safe and police forces becoming more aggressive in their tactics of riot crowd control, medical care is becoming a necessity. However, the number of caregivers to injured persons is severely disproportionate. Any effort to decrease this ratio, either by becoming a caregiver or preventing injury to yourself, is valuable.
I am a trained Emergency Medical Responder (EMR) and would like to share my knowledge of first aid care to help you keep yourself safe or provide care for others in need.
In this article, we will cover the treatment of various injuries that are specific to these protests, such as those sustained by rubber bullets, pepper spray, and tear gas, as well as other scenarios you may find yourself in.
For your convenience, I have provided a table of contents below. Please seek the information most useful to you.
Table of Contents:
- Protecting Yourself — What to Wear & What to Bring
- Laws — Good Samaritan Laws, Scope of Practice, &Consent
- Medical Supplies — Homemade First Aid Kit & Other Supplies
- General Injuries — Bleeding Control for Minor & Major Wounds; Concussion; Severe Head Injury; Shock
- Specific Injuries — Rubber Bullets; Pepper Spray; Tear Gas; Stun Grenades; Shrapnel; Sonic Cannons
- Medical Conditions — Insulin Shock (Diabetes); Anaphylactic Shock; Heart Attack; Heatstroke and Heat Exhaustion; Seizure/Epilepsy
Protecting Yourself.
The best thing is to avoid injury altogether. This section will discuss ways to help protect against and prevent injury.
“Protest Fashion”
What you wear to a protest can mean the difference between minor and serious injury. Here are important considerations when determining what to wear.
Clothing
- Wear layers and thick clothing. Long sleeves further help to protect.
- Wearing a white base layer, such as a T-shirt or tank top, can help make it easier to find bleeding wounds.
- Bring extra clothes in a sealed plastic bag, in case of contamination from tear gas and pepper spray.
- *Do not wear any dangling necklaces or earrings. Additionally, rings on your fingers could be a problem in the event of a hand injury that causes the fingers to swell.
Footwear
- Wear comfortable shoes that you can easily run in. will protect against ankle sprains and other injuries due to improper footwear.
Gloves
- Heavy duty or tactical gloves can help protect against abrasions and cuts
- Heat-insulated or flame-resistant gloves are imperative if you plan on coming in close contact with tear gas canisters (see section: tear gas)
Hair
- Long hair should be pulled back and out of the way.
Head Protection
- Wear a helmet to protect against head injury.
Skin Protection
- Do not wear vaseline, mineral oil, or oil-based products like lotion or makeup. These can trap chemicals like tear gas.
Eye Protection
- Do not wear contacts, as they can melt in your eye.
- Also avoid wearing glasses without proper protection, as they can shatter upon impact, leaving glass in your eye.
- If possible, wear ballistic grade eye protection, which are designed not to shatter in the event of an impact. Ski/swim goggles or athletic eyeglasses may suffice.
Face and Respiratory Protection
- Remember, we are still in the middle of a Covid-19 pandemic. Wear a face covering like a bandana, balaclava, or surgical mask. This will also help protect your identity.
- To protect against tear gas and pepper spray, a gas mask is most ideal.
Other Forms of Preparedness
- Bring a backpack to carry all your things. It can also serve as protection for your back.
- Cover any identifying features, such as birthmarks or tattoos that can be used to identify you in the protest. *But remember, do not cover them with makeup.
- With a Sharpie on your skin, write down important phone numbers of people to contact, medications or medical allergies if you find yourself arrested or unable to communicate to caregivers, as well as blood type (for serious traumatic injury that calls for blood transfusion.)
- Do not attend protests alone. Go with people who you trust and can look out for you. Be sure to establish a plan in the event of separation.
- Bring food or money for food if you expect to be protesting for long hours.
- Drink plenty of water. Dehydration can be just as detrimental as sustaining physical injury.
If Under Arrest
If you are risking arrest, be sure that you bring any medication for pre-existing health conditions that might pose a serious problem while in custody (Ex: heart conditions, HIV, diabetes, hypertension, etc.)
Under the Eighth Amendment of the Constitution, people in police custody are required to be provided with adequate medical care, (under the implication that the denial of medical care is a form of cruel and unusual punishment.)
Unfortunately, while guaranteed by the Constitution, corrupt or otherwise negligent systems may not respect this right.
If you are denied medical treatment while in custody, know that your civil rights have been violated.
Good Samaritan Laws
The thought of providing care for others may feel daunting, especially if you do not have any prior medical training. However, in all 50 states, Good Samaritan Laws, actually encourage bystanders to provide assistance in an emergency.
The laws vary slightly by state, so for specific descriptions of these laws in your state, please consult the resource below.
These laws state that you may give emergency care or assistance with protection from prosecution as long as your actions follow the following criteria:
- The care was given in the event of an emergency that was not caused by the volunteer themself.
- The provided care was within reason, not grossly negligent or reckless
- The care was given without the expectation or acceptance of a reward of any kind
Scope of Practice & Negligence
The term ‘scope of practice,’ technically applies to professional medical caregivers working under a license, as it refers to the levels and types of procedures they are allowed to perform.
However, as an untrained first aid provider, you also have a scope of practice, which is quite limited due to lack of formal training.
That said, you should not, under any circumstance, attempt any medical procedure you are not trained to do. Doing so can cause further injury and would be considered negligent, landing you in legal trouble.
Consent
Before providing first aid care of any kind, you must ask for consent to do so.
Approach the victim, identify yourself and your level of training, and ask if you can provide care.
For example:
“My name is [name]. I am not a doctor but I do know basic first aid. May I help you?”
There are two types of consent to be aware of.
The first, expressed consent, in which the person understands your question and permits you to give care either verbally or with a clear, indicative gesture.
*Touching someone without their consent can be considered assault.
If someone refuses care or withdraws consent at any time during the procedure, call for more advanced medical personnel.
If the person is a minor (under the age of 18) you must obtain consent from the parent or guardian if they are present.
If the parent/guardian is not present, consent is implied, leading us to the next section.
Implied Consent
Implied consent is that which is not expressly granted. This occurs when you are unable to communicate with the victim, most commonly because they are unconscious.
Intoxicated, developmentally disabled, or confused persons are also considered to have implied their consent, under the assumption that they would grant medical care if they were able to communicate. But these people should be cared for by a professional.
When in Doubt:
When in doubt, it is safe — and advised — to assume that you have consent.
Safety is the most important thing. So if you are unsure of a victim’s wishes, it is important to help. For first aid providers, consent is not as important as it is for an emergency medical service professional (who will face serious legal charges for negligence.)
It is best to help those in need.
I advise that protesters without medical training provide care only for conscious and alert persons with relatively minor injuries.
Homemade First Aid Kit
Real medical supplies, such as gauze and instant cold packs, are best to have on hand; however, you can improvise a basic first aid kit with the following items:
- Clean strips of cloth — alternative to bandages; best if they are white
- Unscented menstrual pads and tampons — can be used for bleeding control
- Gaff tape — used for securing bandages around wounded limbs. (do not stick directly to skin.)
- Sharpies — for making notes, like time of injury occurrence, person’s name and information, allergies, etc. on their skin.
Also consider bringing the following supplies for trained medical caregivers on the scene:
- Alcohol/Disinfectant,
- Sterile gauze pads and wrap bandages
- Medical tape
- Eye pads
- Butterfly bandages
- Instant cold packs
- Neosporin
- Bandage scissors and tweezers — (be aware that police may consider these to be “weapons,” which is a load of crap, but still a possibility.)
General Injuries
*Even before you ask for consent to administer first aid, always ensure that your surroundings are safe — a first aid provider that is hurt cannot help others.
Bleeding Control
The main idea for bleeding control is to prevent significant blood loss and encourage the natural clotting behavior of blood.
Procedures are generally the same for major and minor types of bleeding.
Minor Wounds — Cuts and Abrasions
Non-serious wounds, like cuts and abrasions that affect the capillaries (very small blood vessels) near the surface of the skin can be treated with simple gauze and pressure, and should generally stop bleeding after a few minutes.
To treat, cover the wound with a clean cloth or gauze and apply pressure to the wound by pushing directly on it with a single or both hands.
It is important that you do not lift the cloth or gauze (as in to check the wound) because this interrupts the body’s natural clotting process. As tempting as it is DO NOT LIFT THE GAUZE.
For very minor wounds, the person may apply pressure to the wound themselves — just be sure that they are applying adequate pressure.
Note:
Cuts or abrasions to the face and scalp will bleed a lot, even if minor (due to the sheer amount of blood vessels that are close to the surface)
Nothing to be alarmed of unless the bleeding does not stop and the person exhibits symptoms of traumatic head injury, such as nausea, vomiting, disorientation, etc. (see section: head injury)
[blood illustration warning in the next section]
Major Traumatic Bleeding
If you come across major traumatic bleeding such as large gashes and punctures affect the more major blood vessels in the body, you must act immediately and seek advanced medical care.
There are two types of bleeding you may encounter: arterial versus venous bleeding.
Human Physiology in a Nutshell:
The human body has two sets of blood vessels, arteries (carry blood from the heart to the rest of the body) and veins (carry blood from body tissue back to the heart).
Arterial bleeds occur when arteries are damaged. These wounds spurt blood due to the strength of the person’s heart beat pushing the blood. Bleeding from these types of wounds appear bright red.
Venous bleeding occurs when veins are damaged. Similar to arterial bleeding, it is also more severe than capillary bleeding; however, these wounds exhibit a steady stream of darker red blood.
Treating Major Traumatic Bleeding
Both types of bleeding require strong compression. Following the same guidelines as above, cover the wound with gauze or cloth and apply manual pressure directly over the wound. This will cause the person pain, but understand that it is necessary.
If blood soaks through the initial gauze or cloth, again, DO NOT LIFT THE DRESSING.
Stack more dressings on top of the wound. Repeat these steps if blood still soaks through.
Wipe away any excess blood and continue to apply pressure until more advanced medical care.
Concussion
A concussion is a (relatively) mild traumatic brain injury caused by a blow to the head or violent shaking (whiplash) of the head and body, which can vary from mild to severe, either with or without loss of consciousness.
You may encounter people with concussions due to the use of police batons or protesters being pushed to the ground.
In determining if concussion has occurred, ask the person directly, or inquire from witnesses if they saw a head injury occur.
Symptoms to watch out for: nausea, headache, fatigue, poor balance, mental confusion, or loss of consciousness.
To treat, immobilize the person’s head and do not move unless absolutely necessary for their safety. Apply ice to reduce swelling if possible.
Severe Head Injury
In the most severe cases of head injury, brain damage is very likely, as well as spinal injury.
Look for clear or yellow, milky fluid leaking from the ears and nose.
This person should not be moved, as they have most definitely suffered severe head trauma.
An ambulance must be called, as this person must be treated by a professional. While you wait for help, ensure that the person is not moved or their head disturbed in any way.
Treating for Shock
Shock occurs when the organs do not receive blood, and thus oxygen, a physiological response to trauma. If left untreated, the condition can be fatal. The person needs professional medical care fast.
Symptoms include:
- rapid, weak, or absent pulse
- rapid, shallow breathing
- lightheadedness
- cool, clammy skin
- nausea
- confusion
- anxiety
- thirst and dry mouth
Until a trained medic arrives:
- Lay the person down, if possible.
- Elevate their feet 12 inches unless they have a suspected injury to neck, head, spine, or hips. This allows blood to flow closer to their vital organs in their torso. Do not raise the person’s head.
- Turn the people on their side if they are vomiting or bleeding from the mouth.
- Keep the person comfortable and warm by loosening restrictive clothing, covering them with a coat or blanket, and keeping them still.
- DO NOT provide the person with anything to eat or drink. Someone in shock may vomit, which can result in chocking. Wait for advanced medical personnel to administer any fluids via IV.
Specific Injuries
In this section, we will discuss the specific injuries that are common due to police tactics used during protests.
Rubber Bullets
In the past few weeks, there have been growing reports of people being shot with rubber bullets. There is also news on rubber bullets with metal cores, which make them more damaging.
Despite their “non-lethal” description, rubber bullets still can cause serious injury if used improperly. The extent of damage depends on distance and location.
When used properly, at a far enough distance and shot at non-lethal parts of the body, rubber bullets may only result in minor contusions and abrasions.
However, if used improperly, at close range, and aimed at the torso, neck, head or face, and fingers, may cause injury to internal organs, crushed windpipe, and bone fractures,
Protecting Against Rubber Bullets
- The best prevention of serious injury is maintaining distance and wearing thick clothing (denim, leather).
- Protective pads designed for athletes may also be useful. Additionally, people with penises and testicles may benefit from wearing an athletic cup. *But be wary, police may interpret such preparedness as an invitation to be more aggressive.
Eye protection is a must, as multiple reports of police shooting people n the face have surfaced over the past few weeks.
- Wear protective goggles
- Do not wear eye- or sun-glasses without protection, as the glass will shatter and enter the eye, causing further damage.
Treating Injury from Rubber Bullets
In the event that you are struck by a rubber bullet, two cases could be true.
The first, no skin is not severely broken, resulting in bruising, which can be treated immediately with a cold pack.
Second, the skin is broken. For abrasions, any bleeding should be stopped first, then should be cleaned with disinfectant, such as rubbing alcohol or Betadine.
If the wound is deep and bleeding, follow the procedures for bleeding control. If you suspect a fracture or embedded particles, seek professional medical attention.
For detailed information on rubber bullets:
Pepper Spray
Most of us are familiar with pepper spray, as it is the most commonly used form of crowd control by police forces, dispersed as a spray or from a grenade canister.
Pepper spray is a lachrymatory (tear-inducing) agent that causes burning pain and temporary blindness, if in contact with eyes, due to its main active ingredient called capsaicin.
Prevention for Pepper Spray
- Wear a face covering or mask
- Wear goggles
- Cover up most of your skin
Treatment for Pepper Spray
- Move the person to an isolated area, away from where pepper spray may be lingering.
- Flush the eyes and mouth with milk. The reason for this being that certain proteins in milk bind to the molecules of capsaicin, lifting them off the surface of your mouth/eyes and allowing them to be flushed away.
- Follow up by flushing with clean water to remove milk residue.
- Flush affected skin as well.
- Remove any contaminated clothing. It is best to avoid pulling clothes over the head, where they can recontaminate the eyes and nose; however, do whatever is possible at the moment.
For more information on pepper spray:
Tear Gas
The most popular form of riot control to dominate the current discussion surrounding the protests — next to rubber bullets — is tear gas.
Tear gas actually not a gas, it’s a crystalline powder that is dispersed as a fine spray or cloud via the explosion of its grenade housing.
That said, powder is a solid, which settles to the ground eventually. Thus it is important that you do not drop to the ground near where a tear gas concentration is highest.
How Tear Gas Works
Tear gas binds to any moisture it comes in contact with, this includes the moisture in your eyes, nose/sinuses, mouth, sweat on your skin, and even the grease in your hair.
When this occurs, the active ingredient in the tear gas targets the pain receptors in the nervous system.
The immediate symptoms that occur include stinging eyes, blurred vision, general disorientation, emotional and psychological distress, restricted breathing, and secretion of mucus and saliva in the respiratory tract.
It is important to note that this precise secretion makes symptoms worse, as the increase in mucus will cause more of the tear gas powder to stick to it.
[It is important to note that exposure to tear gas is more dangerous for those with pre-existing respiratory conditions, like asthma.
It is also important to be mindful that exposure can make you more susceptible to Covid-19.]
Prevention for Tear Gas
- Wear a face covering or gas mask to protect your nose, mouth, and airway
- Cover your head with a scarf or beanie
- Wear goggles to protect your eyes. Do not wear contact lenses
- Do not wear skin products that tear gas will cling to
- Cover most of your skin, as contaminated clothes can be discarded quickly
Treatment for Tear Gas
- Move to a ventilated area, away from tear gas immediately. Fresh air is vital to steadying respiratory distress.
- Flush the eyes, mouth, and nose, out with clean water. It is not required that you use milk, as there is no capsaicin chemical in tear gas to break down.
- Flush the skin with water. It is important to flush away any and all traces of the powder, which can cause burns left on the skin for extended amounts of time.
- Remove contaminated clothes. As similar to pepper spray, avoid pulling over the head.
You may have seen in Hon Kong, that protesters are fighting back against these tear gas canisters, extinguishing them with water or throwing them back at police.
It is important that you do not attempt to pick up a deployed tear gas grenade without proper protection.
Tear gas grenades burn at around 370°Fahrenheit (F.) For reference, water boils at 212° Fahrenheit.
With this knowledge, it is imperative that you do not touch these canisters when they are burning.
For more detail on tear gas:
Stun Grenades
A newer tactic that police are introducing to their tactics of crowd control is the use of stun grenades — at least confirmed in Seattle, Washington, where a news broadcaster was hit by one during an on-air interview.
A stun grenade, also called a flash grenade, flashbang, thunderflash, or sound bomb is an explosive device that temporarily disorients a target by producing a blinding flash of light that impairs vision and an intense “bang” greater than 170 decibels than can cause temporary deafness and loss of balance.
Like the rubber bullets, the nonlethal intentions of the device means nothing, as they can result in serious injury.
Treating Injury from Stun Grenades
The primary symptom that you will need to care for is disorientation.
An affected person will be stumbling around, sometimes unable to communicate with those around them.
- Approach them carefully and identify yourself. They may not hear you, in this case, consent is implied.
- Guide the person to a calm area away from the source of the blast and wait with them until they regain their senses.
- Treat any wounds sustained from the blast or falling to the ground. These will most likely be minor abrasions and cuts; in which case, follow the procedures for bleeding control.
For more information on stun grenades:
Shrapnel
Shrapnel is considered any object(s) that becomes embedded into a wound due to an explosion. More simply, they are (relatively) small impaled objects.
Wounds that incorporate shrapnel will become more common if the police continue to use explosive devices as a part of their crowd control tactics.
Treating Shrapnel Injuries
It is important that you DO NOT TOUCH THE SHRAPNEL and seek advanced medical care.
Your first instinct may be to remove the embedded object(s); however, in most cases, the shrapnel is providing pressure against the blood vessels, preventing any bleeding. (This concept also holds true for any type of impalement.)
For injuries with small pieces of shrapnel, stop the bleeding by following the procedures discussed in the section: Bleeding Control, and seek a medic.
Do not apply direct pressure to wounds with large impaling objects. Place two rolled up pieces of gauze/cloth at the base of the object — one on each side — to immobilize the object, and seek advanced medical care.
Sonic Cannons
I recently heard news that the NYPD was introducing sonic canons. Whether or not these canons are introduced in your area or not, it is important to know what to do when you encounter them.
Sonic canons work to disperse a crowd by emitting very intense frequencies at extremely loud volumes, up to 120–150 decibels (dB).
The human threshold for hearing until hearing damage occurs is 90 dB. At nearly the sonic equivalent of a gunshot or even a jet taking off, damage to the cells in your inner ear is permanent and irreversible.
Earplugs can help reduce the effects of these sonic canons. But it is safest not to subject yourself to long exposure around these loud sounds.
Medical Conditions
Under the stress, adrenaline, and exhaustion of being on the streets for long hours at a time, pre-existing medical conditions may pose issues up while at a protest.
Note: You must find a trained medic who can provide proper care; however, there are things you can do until a medic arrives.
Diabetes
People with diabetes are often very diligent with self-care. However, the dangers of insulin shock can occur if they do not eat at regular intervals.
Insulin shock occurs when a diabetic person is hypoglycemic, meaning their blood sugar has dropped below safe levels. These people can become unconscious and slip into a seizure or coma if left untreated.
Because people with diabetes are often self-aware, they most likely know the treatment they need. It is best to listen to them and offer any help they tell you they need.
Treating Insulin Shock
If the person is coherent and conscious, provide them with high-sugar food to raise their blood sugar level back up.
If the person is unconscious, seek immediate medical help. Do not attempt to administer anything orally, as they may choke.
Anaphylactic Shock
You may come across someone suffering from anaphylactic shock as part of a severe allergic reaction.
A person with known allergies should carry an epinephrine pen (EpiPen). So in this case,
- summon a medic
- ask if the person is carrying an EpiPen with them and if they need help administering it. (In most cases, they can do it themselves.)
While it is best to find someone trained to administer an EpiPen, anyone can do it.
If the person needs help administering, follow these steps. (Clear instructions are marked on the EpiPen itself.)
- Carefully remove the EpiPen from its clear carrier tube.
- Remove the blue safety release on the back end of the EpiPen by pulling straight up.
- Grip the barrel of the EpiPen in your hand with the orange tip pointing to the person. Make sure not to touch either end of the EpiPen with your fingers, doing so could result in accidentally stabbing yourself.
- Firmly inject the orange tip into the middle part of your upper thigh, pushing until it “clicks.” It sounds violent, but you really need to stab firmly. If the orange tip does not depress, the drug is not being administered.
- Hold the EpiPen in place for at least 10 full seconds.
- Remove the EpiPen and gently massage the area of the injection for about 10 seconds.
- Seek medical help
Heart Attack
Important: Symptoms can manifest differently in (at-birth-assigned) males versus (at-birth-assigned) females.
Symptoms in Males:
- discomfort/tingling in arms, back, neck, shoulder, or jaw
- chest pain
- shortness of breath
Symptoms in Females:
- sudden dizziness
- heartburn sensation or chest pressure
- nausea
- sudden tiredness
- cold sweat
- sudden paleness
What to Do:
- Act quickly to summon a medic.
- Be ready to perform CPR if you know how, or find someone who can until help arrives.
Heatstroke and Heat Exhaustion
Heatstroke and heat exhaustion are similar, yet two different things.
Symptoms of Heat Exhaustion:
- moist and clammy skin
- pupils dilated
- normal or subnormal temperature
Treating Heat Exhaustion:
- Rest in a cool place, preferably air-conditioned but at least in the shade
- Lie the person on their back and raise their legs above their heart level
- Drink cool fluids. Sports drinks with electrolytes aid in treating dehydration, which may be a factor in the cause.
- Remove any unnecessary clothing to help cool temperature
Symptoms of Heatstroke:
- dry hot skin
- appears to have a fever
- very high body temperature
- no sweating — this is a characteristic symptom
Heatstroke is an emergency. A person can go into a coma and die if left untreated.
Treating Heatstroke:
- Call 911 immediately. Heatstroke requires hospital treatment.
- Move the person to a cool place
- Remove any unnecessary clothing (clear unnecessary bystanders, for privacy, and strip them to their underwear.)
- Take any action to reduce their body temperature, such as spraying them with cold water or fanning them.
- If possible, apply ice packs to the groin, armpit, and neck regions, but cover their body as much as possible in any case.
- If the person is conscious, you can offer them cool fluids (water, sports drink) to drink while sitting up. However, most people suffering heatstroke are not in a mental headspace to safely accept fluids orally.
- Again, call 911. This person needs to be taken to the hospital.
Seizure/Epilepsy
For this section, I am referring to a grand mal seizure; the one where the person falls to the ground, shaking, limbs rigid, eyes rolling back, clenched jaw.
If the person knows themselves to have epilepsy or seizure spells, they may feel it before it happens, but sometimes, there may be no signs at all.
Treating for Seizures:
- get a medic
- clear the area of objects and people that the person could hit during the seizure
- do not intervene, let the seizure run its course. Do not try to restrain the person or put something between their teeth.
- After the seizure stops, turn the person on their side in case they vomit, which can be dangerous if inhaled
- When the person regains consciousness, the may be disoriented and/or exhausted. They may also be embarrassed for having urinated or defecated themselves. Offer covering and a change of clothes if possible.
- If they tell you they have never experienced a seizure before, they need medical attention immediately.
So why am I telling you this?
A few days ago, I came across a video on Instagram of a protester with a piece of shrapnel embedded in her face. She was disoriented, unable to hold up her head as blood rushed down the front of her face. The people around her were screaming helplessly, not knowing what to do.
I don’t want you to be those bystanders. I want you to be able to step into a situation like that, knowing to call for a medic, knowing to stabilize the object, knowing to wipe away the excess blood, knowing to keep her calm until help arrives.
Protesters on the frontlines are begging for anyone with medical training or first aid knowledge of any kind to step forward and offer it. Even celebrities Halsey and Yungblud were seen in LA last week providing medical care for protesters despite their limited training.
After having read this article, hopefully, you now find yourself in a position to provide care to others. Even if it’s minor, it’s better than doing nothing.
However, understand that in giving you this information, it is not so you can start exercising your protest fantasy of being a hero. That is not what this is for. I am giving you this knowledge so that you will be able to take care of yourself and offer help to others who are in pain or injured in the action of these protests. Use it with good faith.
Please help by spreading this knowledge with others you know who are attending these protests.
The information provided in this article was pulled from various resources, including the ones below:
