Street Medic Information
IntronIAs a medic, one should always be aware of the dangers, both medical and otherwise, present at any demonstration. This page deals mostly with preparing for and treating medical emergencies at a protest. The links page, however has many links to help protesters deal with non-medical dangers.
SummarynIThe following table contains quick links to all of the conditions a medic should be aware of before going to a protest. Each condition contains general information, preventative measures, signs and symptoms, and appropriate treatments. As well, contained below are tow sections dealing strictly with what to bring and how to dress for the protest.
(Adapted from "Princeton University Outdoor Action Guide to Hypothermia and Cold Weather Injuries" by Rick Curtis)
We expect that hypothermia will be a major concern if the weather is cold and the protesters are not adequately prepared to be exposed to cold for a long time. Quebec City is a chilly and windy area. Remember, most people are outside in the winter for less than 30 minutes at a time. Few are out for more than two hours. Quebec City climate: April: Minimum: -2 Celsius/ 28 Fahrenheit. Maximum: 8 Celsius/ 46 Fahrenheit , snow + rain May: Minimum: 5 Celsius / 41 Fahrenheit. Maximum: 17 Celsius / 63 Fahrenheit.
Hypothermia occurs when the body cools down too much because of cold weather or being wet and cool.
Risk Factors: Cool , cold, wet, or windy environment. Improper clothing and equipment. Fatigue. Dehydration. Age. Immobility. Poor food intake. No Knowledge of Hypothermia. Alcohol intake, cigarettes. Poor circulation. Not taking hypothermia seriously.
· Dress appropriately for long term exposure
to the weather. This cannot
be stressed enough. This is not a time to be fashionable with jeans and sweatshirts
as outer garments. Appreciate the Bundled-Up look. Insulate with layers of dry
clothes that can breath (let body moisture escape). Think about : snowmobile
gear, long underwear, snowsuits, snowboard pants & overalls, warm boots & gloves,
· Carry extra dry clothes. Especially socks and shirts.
· Make sure clothes, boots and gloves are not constricting with the layers. Tight clothes, boots and gloves may constrict circulation of warm blood, and can decrease the insulation ability of the materials.
· Avoid local pressure, cramped position.
· If you are going to be immobile, or on the ground: You need extra insulation - both clothes and ground protection. Think about padded hockey pants, foam padding, etc.
· Gear: consider hand and feet warmers, aluminum space blankets, thermos.
· Prevent getting wet - water resistant outer gear is not only good against rain & water, but also works fine against wind, tear gas and pepper spray.
· Wear shell on the outside against wind - if no risk of getting wet or exposed to chemicals.
· Clothes next to skin must be of materials such as synthetics or wool, that can wick away sweat. Cotton (our most common clothing material) next to skin is bad - it soaks up sweat and you remain wet.
· If you know that overheating is not a risk factor, consider antiperspirant to reduce sweating. (Especially on feet)
· A good hat is a must - we loose a significant amount of heat through our head.
· Keep well hydrated, and eat energy foods such as carbohydrates.
· Avoid cigarettes and diuretics such as coffee or alcohol as they shunt warm blood away from skin.
· "Buddy system" keep a regular watch on each other's faces, ask about hands & feet sensation.
· Regular "self check" for cold areas, wet feet, numbness.
· If at any time you discover a cold injury, stop & rewarm the area (unless doing so places you at greater risk).
· Practice being outside for 5+ hours on a cold day to test your clothes and your system. Do the amount of physical activities you would be doing at the protest, and eat/drink the foods you plan to bring with you. If you are comfortable after 5 hours, your gear and system should work.
Shivering. Can't do complex motor functions with hands
but can still walk and talk. Skin is cool due to vasoconstriction. Hands numb.
If shivering can be stopped voluntarily, it is mild hypothermia. If a person
cannot count backwards from 100, they could be hypothermic.
Moderate Hypothermia: Shivering not under voluntary control . Loss of fine motor control - particularly in hands - can't zip up coat - due to restricted peripheral blood flow. Incoordination.
May have: Dazed consciousness. Slurred speech. Violent shivering. Irrational behaviour - may even undress unaware that s/he is cold. "I don't care attitude" - flat emotions/affect.
Severe Hypothermia: (Don't let it get this far!): Shivering occurs in waves until shivering finally ceases. Irrational. May be able to maintain posture and appearance of awareness. Progresses to: Person can't walk, curls up into fetal position to conserve heat. Muscle rigidity. Skin is pale. Pupils dilate (become big). Pulse rate decreases. As it progresses, breathing and heart rate decreases. Then the person looks dead, but is still alive.
Treatment of Hypothermia:
Hypothermia can develop into a medical emergency. The person must
Mild to Moderate Hypothermia
The best way is by the person's own body heat. Replace wet clothes with dry clothes. Additional layers of dry clothes & blankets to insulate the person against escaping body heat. Increase physical activity. Consider: Get out of cold. Add Fuel & Fluids: Carbohydrates are quick (best in mild hypothermia) & Proteins which gives a slower heat over a longer time. Fats give off heat slower and longer, but takes more energy & water to break down fat.
Inefficient ways: Hot drinks. Feels better than is effective. Careful not to burn mouth/tongue.
Add Heat: External heat source (warm room).
If outside: body to body contact - get into a sleeping bag in dry clothing with a warm person in lightweight dry clothing. Heat pads.
1. Reduce Heat Loss:
Hypothermia wrap: Provide a shell of total insulation. No matter how cold, the patient can still internally rewarm themselves more efficiently than any external rewarming. Make sure patient is dry, with synthetic layer to minimize sweating on skin. Use multiple layers, foam, etc. to create insulation. Include aluminum "space" blanket to prevent radiant heat loss.
2. Add Fuel & Fluids:
Warm Sugar Water - With severe hypothermia, stomach shuts down and wont absorb solid foods. Dilute mixture of warm water w sugar every 15 minutes. Dilute Jello works best since it is part sugar part protein.
Urination: A full bladder is a place for extra heat loss. You will need to help the person urinate.
3. Add Heat:
Hot water bottles, hot pads, etc. to transfer heat to major core arteries - neck, armpits, groin, palms of hands. Best to rewarm the core body this way only - not the arms & legs. (When person becomes hypothermic, blood is shunted away from arms/legs. If peripheral vessels open up, cold acidic blood from periphery goes to core - may cause heart arrhythmias and death.
· Happens only in temperature below freezing.
If tissue freezes, ice crystals form in cells. Distal
areas of body most susceptible: ears, nose, fingers & toes.
· Treatment: Do not rub tissue: can damage cells from ice crystals. Rewarm gently. If deep frostbite, consider immersion in warm (not hot) water 25 - 40 minutes. If hot - can burn damaged skin. Thawing is complete when part is pliable and colour and sensation return. Once area has rewarmed, there can be considerable pain.
· Wrap affected area in sterile gauze and protect from movement and further cold. Treat as a tissue injury - consider hospital if significant tissue damage.
· Once a body part has been rewarmed, it cannot be used for anything until tissue begins to repair. It is essential that in not be refrozen - causes more damage. If you cannot guarantee that the tissue will stay warm, do not rewarm it.
· If person is hypothermic and frostbitten: priority is treating hypothermia. Do not rewarm frostbitten areas until core is warm.
Wet feet loose heat 25x faster than dry. The body uses vasoconstriction to shut down peripheral circulation in foot to prevent heat loss. Skin tissue than can begin to die. Can also cause permanent damage to the circulatory system making person more prone to cold related injuries.
Prevention & Treatment of Trench
· Keep feet dry. Water-proof boots. Check feet regularly (if wet from sweating or immersion), stop and dry feet, put on dry socks, consider plastic bag over dry socks / between wet boots - but beware of vapor barrier increasing sweat wetting foot.
· Some mountaineers will put antiperspirant with aluminum hydroxide on feet for week before trip (keep feet from sweating up to a month).
· Experiment to see if your feet sweat much. If not, consider vapor barrier. If so, use socks that wick away sweat, and water-proof boots. · If trench foot sets in, foot is more susceptible to damage by walking on it.
How To Dress
As a street medic, your primary priority is your own protection. Therefore, compiled below is a list of not only medic-specific items of clothing, but also a general overview of clothing to ensure the medic is protected.
Cover up as much as possible to protect skin from tear gas or pepper spray exposure.
Wear clinched wrist and ankle clothing.
Avoid cotton and wool as outside layers, which are fuzzy and absorb chemicals.
Wash clothes in a non-detergent soap several times. This is because detergents enhance the effects of the chemicals on one's skin. Castille (or vegetable) soap works best and can be found at any pharmacy.
Wash yourself with castille soap before the protest.
Wear rain gear as an outer layer. This ensures maximum protection against chemicals contacting your skin. There is a trade-off here between comfort and protection.
Do Not Wear:Piercings, jewellery, ties, or anything else that can be grabbed by the police. Some piercings may be taped over.
The following is a list of clothing a medic should bring to a demo
What to Bring
As a medic, there are numerous things one should bring to an action to ensure the safety and preparation of all people involved. The following tables are divided into two tables: One for general items, which everyone should have, and one specific to trained medics whose sole role in the action is to help people who are victims of action misfortune. It is extremely important that any container brought to an action to carry water, alcohol, or any solution, be non-leaking, pop-topped and easily squirtable.
General Supplies common to all members of an action
General Supplies common to all members of an action
Medics Standard First Aid Kit
The portable first aid kit could mean the difference between a minor injury and a desperate situation spiraling out of control.Those items with a star are not necessary for a good first aid kit. Only bring Items you can safely and effectively use.Items marked with a star are optional.
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