About this episode
Providing Medical Care During Civil Unrest
1. Opening
Brief introduction of the episode
Define civil unrest contexts:
Protests
Riots
Mass demonstrations
Politically charged gatherings
Why medical care becomes complicated in these environments:
EMS access delays
Crowd density
Law enforcement operations
Environmental hazards
Emphasize guiding principles:
Personal safety first
Situational awareness
Know your limits
2. Understanding the Operational Environment
What makes civil unrest medically unique
Unpredictable crowd movement
Law enforcement presence and tactics
Noise, confusion, and sensory overload
Limited ambulance access
Common operational constraints
Blocked streets
Limited lighting
Communication disruption
Delayed EMS response
Situational awareness basics
Know entry and exit routes
Stay on the edge of crowds
Avoid getting boxed in
3. The Most Common Injuries Seen in Civil Unrest
Blunt Trauma
Common causes:
Falls
Being pushed or trampled
Baton strikes
Thrown objects
These injuries can range from minor bruising to serious head injury or internal bleeding.
What to look for
Pain or swelling
Deformity suggesting fracture
Difficulty moving a limb
Head injury symptoms:
Confusion
Vomiting
Severe headache
Loss of consciousness
Basic treatment
Move the person out of the crowd if possible
Apply ice or cold pack if available
Immobilize injured limbs with a sling or improvised splint
For suspected head injury, keep the person still and monitor mental status
If symptoms worsen (confusion, vomiting, severe pain), they need EMS evaluation
Key reminder for listeners
Blunt trauma in chaotic environments often gets ignored — but head injuries and internal bleeding can worsen over time.
Lacerations
Common causes:
Broken glass
Debris
Improvised projectiles
What to look for
External bleeding
Deep cuts with visible tissue
Embedded debris
Bleeding that soaks through clothing
Basic treatment
Put on gloves if available
Apply direct pressure with gauze or cloth
If bleeding continues, use a compression bandage
For severe extremity bleeding, apply a tourniquet
Cover the wound with a clean dressing
Additional considerations
Do not remove deeply embedded objects
If the wound is large or continues bleeding, the patient needs hospital care
Key reminder
The vast majority of life-threatening bleeding can be controlled withpressure and time.
Respiratory Irritants
Common exposures:
Tear gas (CS)
Pepper spray (OC)
Smoke from fires
These agents cause severe irritation but are usually temporary.
Common symptoms
Burning eyes
Tearing
Skin irritation
Coughing
Shortness of breath
Disorientation
Basic treatment