Protest First Aid
Adaptation and responding to the needs in resource-limited environment are cornerstones of practicing wilderness medicine.
We’ve seen these needs change drastically in the last few months as the world copes with COVID-19, and again as worldwide protests take place.
These events have made new questions arise for those with medical training: What to do if someone has been pepper sprayed? How to assess and treat eye damage for that instance? Or manage projectile wounds from rubber bullets and canisters?
Here are a few ways wilderness medicine training can be adapted to provide first aid that might be needed at a protest.
Pepper Spray
Pepper spray products are used for personal protection against assailants. In the USA law enforcement agencies use pepper spray during policing and riot control.
Pepper Spray contains capsaicin, the same compound that gives the ‘hotness’ to chili peppers, but in a much higher concentration. Contact with your eyes causes burning, pain, and tears; on your skin, burning, pain and irritation.
Signs and Symptoms
- Eyes may close immediately
- Inability to see
- Eye pain
- Burning in the throat
- Wheezing
- Dry cough
- Shortness of breath
- Gagging
- Gasping
- The inability to breathe or speak
The effects generally are temporary, resolving in 30-45 minutes.
Treatment
First, try to get to a well-ventilated area away from the spray. The spray is oil based, making it hard to remove.
Eye exposure:
- Remove contact lenses.
- Try not to rub your eyes.
- Try to blink a lot to encourage tearing.
- Irrigate with lots of water.
- “No tears” baby soap in the eye rinse may be helpful, followed by irrigation with lots of water.
Skin exposure:
- Try not to touch your skin, which can contaminate your hands and spread the oil
- Try to remove the oil with soap (dish soap may help); people have used cooking oils and milk as well.
If the pain persists, or there are problems with vision or trouble breathing, seek medical attention.
Tear Gas
There are several different chemicals used in tear gas that are intended to cause irritation to the eyes or the skin. The effects of most of these agents usually abate in 15-30 minutes, but high exposure, prolonged exposure or exposure in confined space can cause serious lung and skin irritation.
Signs and Symptoms
- Eyes: excessive tearing, burning, blurred vision, redness
- Nose: runny nose, burning, swelling
- Mouth: burning, irritation, difficulty swallowing, drooling
- Lungs: chest tightness, coughing, choking sensation, noisy breathing (wheezing), shortness of breath
- Skin: burns, rash
- Nausea and vomiting
Treatment
- Move to a well-ventilated area; avoid dense, low-lying clouds of riot control agent vapor.
- These agents tend to sink, so consider moving to higher ground.
- Treat eye exposures by rinsing the eyes with copious amounts of water. Remove contacts. Wash eyewear thoroughly before using again.
- Treat skin burns with standard burn management techniques.
- If you think you may have been exposed to riot control agent, you should remove your clothing and rapidly wash your entire body with soap and water. Try to avoid pulling clothing over your head, and try to take clothing off inside out.
Eye Injuries
There is not much that can be done for eye injuries. If you think there is an irritant in the eye, irrigate with water.
If there is an object in the eye:
- Attempt to flush the object with water or gently dab it out with a moist clean cloth.
- Lift the upper eyelid over the lashes of your lower lid.
- If there is continued irritation after removal, treat as an abrasion.
- If unable to remove the object or discomfort persists, evacuate the patient and seek advanced medical care.
- If the embedded object is large, stabilize in place and shield the injured eye.
If the eyeball is injured:
- Shield, do not place pressure on, a globe injury.
- Elevate the head (don’t lay flat) to attempt to lower intraocular pressure.
- Seek medical care.
Projectile Wounds
Life-threatening bleeding is spurting, soaks clothing or pools on the ground, or is associated with missing body parts and altered mental status.
Controlling Bleeding
- Manual direct pressure and elevation: is the most commonly useful technique. Pressure with fingertips or gauze must be focused on the source of the bleeding. Elevation might help with bleeding control.
- Wound packing: Pack (stuff) the wound with hemostatic gauze, plain gauze, or a clean cloth and then apply direct pressure.
- Pressure Dressings: Used to secure a dressing to free the hands for other tasks after bleeding is controlled.
- Tourniquet: Should be wide (minimal width 1.5 in or 4 cm), padded, ideally 1-2 in or 5 cm above the wound.
NOLS recommends only practicing care within your scope of training. We also recommend using your judgment—if someone is in need of help, do your best to responsibly care for them.
