"It Didn't Go So"

"It didn't go so," she said under her breath. —Erna Brodber, Myal, p.84.

Roles for providers in action medical support - 18 Dec 2016 06:31

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Medical providers who have not cross-trained as street medics are welcomed as an integral part of street medic mobilizations. It feels good to get out of the hospital or the clinic and work in the field, free for a moment from the encumbrances of paperwork, "cover your ass" medicine, and frustrating administrators. However, many other things are also different on the street. You don't have staff, advanced diagnostics, easy referrals, charts to give you baseline on patients, or a controlled working environment.

By working outside of medical institutions, each action medical worker becomes personally responsible for establishing and maintaining appropriate clinical boundaries in the street. How you carry your social authority may cause some people to cling to you and others to be afraid of you and refuse care. Working as part of an action medical mobilization requires an open mind, real humility, and a willingness to learn from anybody, admit what you don't know, be creative, and constantly improvise. And it can change your life.

A few roles have a particularly good "fit" with providers who have not cross-trained as street medics.


You can plunge right into the fire and work in the field at actions, housing, or jail support as the buddy of a street medic. Don’t cheat yourself by buddying up with another medical provider; find a street medic who is not a medical provider. Your exchange with her in the street will be worth it. When choosing your buddy, get to know her and ask her questions before making a commitment. Ask when and where she was trained as a street medic, and if it was a 20 hour training. If she can't tell you, or didn't attend a 20+ hour training, she isn't a street medic. Find another buddy.

It is appropriate to ask a street medic for names and contact info of people she has worked with at past actions who can "vouch" for her as a medic. Feel free to ask, and to check in with those people and find out what they have to say about her. Ask her what actions she has worked at and what she thought of them. Ask what kind of risks she prefers to take at actions. Ask about her political philosophy. Ask if she holds any certifications or licenses in the medical field.1 Ask if she is an herbalist. You're looking for someone you can trust in the field, and someone you would like to work with. Some medics may not want to work with you if you do not have action medical-specific training. Among the many legitimate reasons for their preference might be their concern about your practical politics of informed consent or your skill in more highly fluid tactical situations. Don't be offended; be grateful your lack of affinity was discovered *before* you entered the field!

If you find someone you'd like to buddy with, encourage her to take point and to provide the majority of the care. Start practicing empowerment with your buddy! If she seems really inexperienced it's probably because she is. From your position as the "scene assessment" buddy, you can learn what your buddy knows and maintain the detachment to kindly help her grow in her confidence with assessment and care skills. Her bad health promotion judgment calls are learning opportunities for her and sometimes chances for you to kindly and respectfully help her learn. You will probably make bad tactical judgment calls, from which she can help you learn. You and your buddy can decide to switch roles in the course of care if she wants you to get hands-on with the patient or you need her to make judgment calls about your team's response to a rapidly developing environment. Debrief after every patient, and take the time to listen as well as to teach.


Action first aid spaces and wellness centers are very different animals from most community clinics. They exist as an additional tier of care provided by action medical at an action, and do not replace existing community health services when those are needed. Patients who do not immediately need emergent care services offered by technical medicine use action wellness/first aid space to rest, get a higher level of patient care than can be provided in the street, get injuries documented, receive wellness services or nursing care, or consult with an herbalist or other clinician.

A common sight in action wellness/first aid spaces is "the drunk guy who face-planted." His friends flagged down a street medic and reported he stood up on a park bench and fell on his face. He's drunk so you can't really evaluate the cause of his altered mental status. No vomiting, no observed transient loss of consciousness, pupils equal, round and sluggish in response to light. The medics try to get the guy's friends to take him home and follow the guidelines on the head injury aftercare sheet, but they came all the way from Montreal and really want to be out in the streets. So the friends take him to the action wellness/first aid space. During his evaluation, he's meek and apologetic. Medics make him comfortable and let him sleep, herbalists brew up some tea, and a medic wakes him up every hour to check his pupils and look for late developing signs like raccoon eyes or Battle's sign. He feels better by the time his friends come back, and the medics send his friends home with clear instructions for using the head injury aftercare sheet.

Action wellness/first aid spaces don't see themselves as definitive care. In a pinch, they stretch their resources and pull off amazing feats with patients who absolutely refuse transfer to definitive care. But for everybody else, the clinic triages them into those who leave quick with or without a simple intervention, those who stick around for a while for assessment over time or rest, and those who leave quick in an ambulance or a car for the hospital. The action wellness/first aid space needs a good list of local low-cost and free health and social services to give patients who require definitive follow-up or services the action wellness/first aid space cannot provide.

There isn't a staff at the action wellness/first aid space to keep things running smoothly, just the volunteers scheduled during your shift, with whatever skills they have. They serve the patient, not the doctor. A street medic with experience in action wellness centers or action first aid spaces (and their buddy) should always be onsite to do clinic coordination or everything could fall apart. Jobs that need to be done include scheduling, constantly organizing and labeling supplies (and throwing out or hiding supplies that should not have been donated), cleaning up, and staffing the front desk. Some spaces include intake workers; in others, you do your own intake. People come in waves that depend on the action and mood in the street. Sometimes it's dead for three hours, then the space is suddenly swamped, right after the provider left from boredom.

Nurses and herbalists prove some of the best at intuitively understanding what is needed in action wellness/first aid spaces. The basics are two pillows and a blanket somewhere that is quiet, clean, accessible and feels friendly and safe enough for patients to relax; a box of correctly-sized exam gloves; and a caring, competent, sympathetic clinician. Everything else is extra.

Generating records for lawsuits and criminal defense

Patients sometimes want police-inflicted injuries documented for legal purposes. Common injuries include almost visibly imperceptible wrist abrasions or bruising combined with compression neuropathy of the superficial radial nerve caused by long custody in overtight handcuffs, or 30 cm wide contusions in lateral lumbar regions caused by blunt force trauma (usually from projectiles fired at fleeing protesters). Sites where requests for injury documentation are most common include at jail support (when support teams including medics, legal, and comfort maintain vigil outside holding facilities to receive released arrestees), in the action wellness/first aid space, and at housing sites. Street medics take photographic and written evidence of injuries and give these records to the patient. Reports written by anybody other than a medical provider are considered hearsay by judges, but usually a legal team can use them to build a case.

Medical providers have the authority to create official medical records which can be used as legal documents in court. The authority to create legal documentation of injuries can be a great asset to patients. In the United States, medical doctors and doctors of osteopathy are granted this right in all states. The ability of nurse practitioners to produce official medical records with the authority of legal documents in court is governed differently by each state's advanced practice nursing or advanced nursing practice laws. When producing medical records for patients, be sure to provide your business card or other contact information along with the record, so the patient can easily contact you and call you as a witness in court. Be aware that if they do initiate a lawsuit, it may be several years before you are called.

Medical records for hungerstrikers

Official medical records are also highly useful in support of hungerstrikes. Hungerstrikers use their own declining health as a bargaining chip, often when more moderate tactics have failed, and all they have left to bargain with is their own lives. Accurate, regular medical records collected every week (or more frequently during precipitous declines in health) can be given to the patient who may then share them with their support team in order to publicize their cause and their determination. Records may be used in court and you may be called as an expert witness if the court intervenes on the behalf of the hungerstrikers.

The role of a support medic during hungerstrikes is never to support the strikers' health — health support begins when strikers voluntarily break their fast and need info about a safe food reintroduction schedule, aftercare, and recovery support. Hungerstrikers' intent is to get as dangerously unhealthy as possible as quickly as possible and be as well-publicized in their campaign as possible so they can win as soon as possible. Lab reports on significant bloodwork interpreted by a sympathetic doctor on an evening news program can spark widespread concern and sway public opinion very quickly.

When hungerstrikers are incarcerated people (as they often are), you may use your social privilege to gain access to them and release the records to the support person(s) of their designation. In these situations, your special access allows you to be a valued advocate if they are being abused (ie. by forcefeeding orally or intravenously, which is rarely legal, by clandestine harassment or torture, or by inappropriate and life-threatening food reintroduction after a voluntary end to the fast).

Injury prevention

One of the greatest assets medical providers can bring to action medical mobilizations is wise and strategic use of medical authority and social position.

At a large Occupy Wall Street action in New York City, a street medic buddy team was evacuating a patient with a head injury and altered mental status using a chair carry. Their goal was to get the patient clear of the crowd and outside police lines where they could transfer care to EMS. They grabbed two medical doctors in white coats who were protesting with a group of doctors and asked the doctors to help them negotiate through an otherwise impassable situation. Doctors who look like what people expect a doctor to look like can flag a cab in situations when it will not stop for anyone else.

In an unusual situation at a large anti-globalization protest in Philadelphia, a paramedic was waiting for ambulance backup, kneeling in the street and immobilizing the head of a downed patient with cervical spine crepitus and mechanism of injury for a c-spine fracture. He used his paramedic medical rank (higher than first-responder and EMT-B trained police officers) to order an advancing line of heavily-armed riot police to turn down a side street and re-form behind him. The line of police complied.

Similarly, an outraged medical doctor who looks like a medical doctor can work magic in a civil disturbance at times when a medic who looks like an outraged protester would become an additional casualty. At the Miami Republican National Convention in 1972, the police raided the truck street medics were using as a mobile staging unit. The police dumped all the supplies on the ground and were tossing lit matches on the pile. In the pile were two full O2 cylinders, and surrounding it was a dense crowd. A nurse practitioner in the crowd (who looked like a protester) found her way to a nearby hotel lobby, grabbed a bystander who had the look of medical authority about him, dragged him outside, and showed him the situation. The presumed doctor quickly went from fighting her off to full-blown outrage at the dangerous situation the officers were actively creating in the midst of a dense crowd. He took his outrage directly to the most in-charge-looking officer, who curbed his little pyromaniacs before anything exploded.

Spend enough time in the streets, and you will get your own story of a daring rescue using nothing but your posture of authority and negotiating skills, your courtroom testimony that changed the whole tone of a trial, or your neatly placed phone call or email that defused a situation before it ever happened. It is magical to be able to put your authority on to challenge illegitimate authority, and take it off to work in a horizontal organizing structure or provide care to a person who is extremely skittish after being brutalized by another authority figure. Using your authority strategically is a way of providing care.

Legal notes

This document is about roles, but most medical providers come to this work anxious about legal liabilities. Insurers want to scare doctors into thinking volunteer care is legally risky even when it isn't, because insurers benefit financially when anxious doctors give them money. Thus if you search the literature, you'll find a weird clash of strongly-worded suggestions that volunteer providers carry malpractice insurance and strongly-worded reminders that malpractice suits are vanishingly rare when it comes to volunteer doctors.

Federal protections for physician volunteers:

  • Volunteer Protection Act (VPA) of 1997.
  • Federal Tort Claims Act's (FTCA) Medical Malpractice Program, as extended by the Health Insurance Portability and Accountability Act (HIPAA) of 1996, and further extended by the Patient Protection and Affordable Care Act.

State protections for physician volunteers:

  • Good samaritan laws are on the books in all states; they generally apply to emergencies if the emergency wasn't caused by the good samaritan, care wasn't grossly neglegent or reckless, and care was given with permission if possible.
  • Some states immunize medical volunteers via the same apparatus used to immunize state employees from liability (operates similarly to federal FTCA Medical Malpractice Program, and usually includes a state-administered defense fund).
  • Some states (eg Michigan) immunize all volunteers from suit, including volunteer health practitioners (with exceptions, like surgery).
  • Some states (eg Virginia, Connecticut) immunize volunteer health practitioners by allowing them to purchase malpractice insurance with premiums paid by the state's department of health.

These laws come out of a recognition that states have abandoned their responsibility to serve the health needs of their population, and the unrealistic hope that volunteerism can somehow fill the gap.

There are still three things of which you must beware:

  • Records you generate must stay with patients — HIPAA still applies and fines start at $10,000.
  • You lose your license by forgetting to renew it, not by fulfilling your oath outside of your institution.
  • Protests are places of intense ethical conflict — you must struggle to be relentlessly ethical, not because you fear lawyers, but because your soul demands it. - Comments: 0

On affinity group medic trainings - 29 Nov 2016 08:03

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Dave P and I taught an Affinity Group Medic (AGM) training in Atlanta as part of the convergence against the Klan last April. Hopefully these reflections will contribute to the larger conversation about trainings that's been happening among street medics over the last year or so.

What is an Affinity Group Medic?

The purpose of an AGM training, as I see it, is to promote the assembly of affinity groups. I would wager that self-organization into affinity groups does more to improve health and political power than any other intervention we make.

The way the training promotes self-organization is by promoting a circumscribed goal. The AGM doesn't attend to the health of strangers; only the health of friends. In order to be useful in an AGM role, she has to assemble an affinity group.

I believe that, unlike street medics, AGM is not a basic scope of practice. It is a role, like comms or police liaison. I teach that the only requirements to be an AGM are the desire to fill that role and the consent of the group. The AGM training may make one a better AGM, but is not a prerequisite for the role.

In an action, an affinity group has a goal. That goal might be to cut a fence, block a road, provide safer space, do clinical support, carry water, do media, be marshals, spiral dance, scout, drop a banner, make lots of noise, cook and serve food, do childcare, do jail support, or whatever. The AGM's job is to help them achieve that goal without injury or illness. It is a before, during, and after role.

What are the core skills?

During a human barometer, people arrange themselves from "strongly agree" to "strongly disagree" in response to the statement "People come to me for help." This identifies natural AGMs, and leads to good conversations, especially between the agreers and the disagreers, about things like referrals and healthy boundaries.

I see the core of the ideal AGM skillset to be SAMPLE and confidentiality. When I taught an AGM training in Ferguson, we spent a lot of time on confidentiality. Unfortunately we breezed by it in Atlanta. This is in contrast to what I see as the core of the street medic skillset: initial assessment and consent. The difference: AGMs care for friends; street medics care for strangers.

SAMPLE helps the AGM start health conversations, build trust, and assess risks faced by group members before the action. If the medic knows group members' allergies, medications, and past pertinent medical history in advance, she can better assist when group members are trying to balance personal needs with group actions. Confidentiality is the ethical response to the trust that affinity group members extend to their medic.

During the post-training evaluation, students said they liked

  • PEARL1 buddy check-in
  • HALTS and "What did you do to take care of yourself today?"/"What do you need to do?"
  • Local resources: alternative to 911 mental health crisis line, peer support warmline, others.

I don't have the eval notes in front of me, but I remember people saying they had concrete situations in which they could immediately apply those assessments and resources.

A student raised how AGMs are prepared for acute first-aid, but recovery is a prolonged process. Some students wanted to improve their skillset for supporting post-action/post-crisis recovery. That stuff won't be included in the 6 or 8 hour AGM training as I teach it, but would be good to flesh out into a good-length training for the populations we serve.

The agenda for the 7-hour training in Atlanta

  • 2 hour health and safety (open to people who don't want to stay for the rest)
  • Affinity groups lecture, SAMPLE practice, and confidentiality discussion
  • Scene assessment and communicating about a scene practice sessions and debriefs
  • First aid lectures, demonstrations, and practice sessions (no initial assessment)
  • Lecture and discussion on local referral options.2

If we'd been able to do it on Thurs, the plan was to support AGMs in teaching the Health and Safety training Friday.

The 2 hour health and safety is is similar to this outline (which I use as a handout): Ferguson health promotion training outline. That whole training is fun and works well. Students do human barometers, paired buddy check-ins, eyeflushes, and a really fun "best-dressed protester" exercise.

The affinity groups lecture, SAMPLE practice, and confidentiality discussion used Sophia's SAMPLE training sheets

The scene assessment and communicating about a scene practice sessions and debriefs used Dick R's style of communicating about a scene: Scene safety training exercise) and a scene awareness exercise led by Dave P that I think I've seen Charles and Leah do in the past. Both exercises were hits.

For the first aid lectures, demonstrations, and practice sessions we worked through Colorado Street Medics' 2010 first aid zine,3 which all students got a copy of. We dumped fake blood on each other, students practiced gloving up, using roller gauze, walking assist, putting each other in shock position, etc. CSM's zine is pretty good because it has pictures. I'd like to start sending students to Where There Is No Doctor's new first aid chapter and Buttaravoli & Stair's Common Simple Emergencies on their phones during future trainings.4 I feel like otherwise they'll forget to look at it when they need it.5

There were no activities during the lecture and discussion on local referral options.

Four final comments

1. We should have integrated SAMPLE more deeply into scene assessment (give people cards with AMPs of their fictional affinity group before going outside for the exercise), first aid, and referral options. As it was we taught SAMPLE then never referred back to it.

2. Street medic trainings (because of the centrality of consent) provide lots of opportunity for practicing communication. AGMs don't need that much practice, but could use some. It should be adapted to mimic communication with someone the AGM knows.

3. We taught privacy circle but didn't emphasize how intensely a crowd mobs a casualty; wanting to help or protect the casualty, or just curious. I remembered this crowd behavior when, during the anti-Klan action, a person with a breathing difficulty was mobbed by a crowd (including two street medics who didn't recognize that a nurse was already on scene). The paramedics arrived promptly with oxygen, but that poor person needed space.

4. Scenarios adapted for caring for known friends instead of randos would be great.

Hope these reflections help someone :) - Comments: 0

SAMPLE training sheets - 30 Apr 2016 19:21

Tags: first-aid how-to protest training

I got these SAMPLE practice sheets from a training Sophia wrote for Chicago Action Medical around 2003ish. She may have gotten them from Black Cross Health Collective or may have written them herself. I love to use them for teaching students how to take a patient history. A fragment from one of my training outlines from 2013 is in this post below the practice sheets.

Besides seeing the utility of SAMPLE and learning the acronym, an objective I always have when teaching SAMPLE is to encourage students to suspend forming an opinion; to live in the question, not the answer.

Finally, I remind students to trust the people they help. Often this interview helps chronic illness sufferers or people with disabilities remember what they need to do. They are already the experts on their conditions! We assist them in locating the problem with SAMPLE. After they decide on an course of action, we may assist them in carrying out their plan.

In affinity group medic (AGM) trainings, I encourage students to talk with their affinity group members confidentially about members' allergies, medications, and past pertinant medical history before an action. This establishes knowledge that can help the AGM be a better wellness buddy, and also establishes trust. If you can keep group members' confidence before they're hurt, they'll trust you more later when they're hurt and scared.


S: Shortness of breath.
A: None.
M: Inhaler for asthma.
P: Diagnosed with asthma at age 15; no other medical problems.
L: Had nothing to eat today.
E: Running from cops; scared.


S: Headache around eyes.
A: Sulfa drugs.
M: Takes birth control pills.
P: Got hit on head one week ago, had a wrist fracture one year ago.
L: Nothing to eat today; has been drinking coca cola and water and peeing "a lot."
E: Went out on blockade at 7 AM; slept 3 hours last night.


S: Nausea and diarrhea.
A: Milk, nuts.
M: Epinephrine for allergic reactions.
P: Nut allergic reaction about 6 months ago; had to go to hospital.
L: "Shitting every 15 minutes," has not vomited; ate big chicken dinner last night but nothing today.
E: Chicken dinner; just been hanging around convergence center all day.


S: "Sprained" wrist with pain (hurts to move it).
A: None.
M: None.
P: Broke same wrist in 1996.
L: Ate oatmeal and drank tea about 2 hours ago, went to toilet a few minutes ago.
E: Fell on wrist, running around in crowd.


S: Fell down, dizzy, feel hot.
A: Aspirin.
M: Seizure medications.
P: Seizures since age 23.
L: Ate breakfast today at 8 AM, lunch at noon, went to toilet an hour ago.
E: Stood in sun at rally for about 6 hours now.


S: Itching on abdominal area.
A: Hay fever.
M: Homeopathic pills for hay fever.
P: Skin condition "with a name I donÕt recall" that cleared up with medication in 2003.
L: Ate pie for breakfast, drank coffee and later tea.
E: Used special soap meant to take oil from skin as protection from tear gas.


S: Drunk, dizzy, nauseous.
A: None.
M: "Just the whisky!"
P: "I drink all the time!"
L: 12 drinks in 3 hours, ate a pizza 2 hours ago, urinating constantly.
E: "Just felt like partying after the big riot."


S: Chest pain, with 'acidic' feeling.
A: None.
M: Rheumatoid arthritis medications.
P: "I have heartburn," denies history of heart problems.
L: "Deep fried Mars Bars" and a pizza for lunch today, no dinner yet, drinking water.
E: Ate about 60 minutes ago; no other events since then.

SAMPLE patient history

Refer students to SAMPLE on chart paper—students must see SAMPLE, not just hear it.

Facilitator says: Sometimes the SAMPLE history is over quickly. Sometimes it is a time consuming and detailed interview that begins in the first few moments of patient care and continues until you walk through the doors at the emergency room. Good SAMPLE histories can be disorderly and divergent. They go off on tangents. They explore deeper than the basic questions. They encourage the patient to talk and elaborate when the patient is able.

S: for Symptoms.
A: for Allergies.
M: for Medications.
P: for Past medical history.
L: for Last food and drink (and last shit and piss).1
E: for Events.

Facilitator says: Run through SAMPLE in your head every time you take a history to make sure you cover all your bases, even if you ask questions out of order. Memorize this acronym.

Trainers model SAMPLE and debrief

Facilitator says: Let's see what we can learn by taking a SAMPLE history.

3 students: volunteer. Each gets a Reader opened to Sophia's SAMPLE practice sheets. Each student gets to pick which patient they want to be without telling trainers.

Trainer buddy pair: interviews each student sequentially in front of class.2

After each interview, facilitator asks class: What did you learn about (patient's name) from the SAMPLE history? What do you still want to know?

Students model SAMPLE and debrief

6 more students: volunteer. They come up in front of the class in pairs and each of 3 students playing medics interviews each of 3 students playing Sophia's patients.

After each interview, facilitator asks class: What did you learn about (patient's name) from the SAMPLE history? What do you still want to know?

OPQRST pain history

You don't get much information by asking, "What are your symptoms?" There are lots of good questions for zooming in on the chief complaint. The most useful a string of letters from later in the alphabet.

O: for Onset.
P: for Provokes/Palliates.
Q: for Quality.
R: for Region/Radiates/Refers.
S: for Severity (1-10).
T: for change over Time. - Comments: 0

Scene safety training exercise - 30 Apr 2016 15:58

Tags: first-aid how-to protest training

This training exercise is based on the way that a long-time member of Chicago Action Medical mentors new medics when they buddy with him. As they walk around a protest, he asks questions like the ones below. One of his buddies suggested we drop most of our scene assessment lecture and replace it by assessing the actual scene (with some added imaginary elements) around the sketchy locations we hold trainings.

Actual scenes students have walked through at trainings I've led include loading docks, blind alleys, razor wire-topped fences, broken glass, no running water or handwashing stations, broken water filtration (contaminated water source), high-speed busy roads, dangerous banner drop locations, bus shelters, children and people with extremely limited moblity, and an approaching wildland fire. At several trainings, students used their breaks to control risks they had identified.

The below training text is from a 2013 training in the Piedra Wilderness Area of Colorado. It is not the whole Scene Assessment section, just the "good parts." Since 2013, I've used this exercise with modified questions in St Louis, Chicago, and Atlanta. It's always a hit!

Introduction to scene assessment

Facilitator says: Watch surroundings and communicate.

  • Look for danger.
  • Make the scene safer.
  • Be prepared for the scene to change.

Facilitator says: Scene assessment encompasses a lot of continuous observations:

  • Personal (Ethan’s here, he gets seizures).
  • Specific (the baby bloc pushing strollers is right next to the Commie bloc chanting about shooting Obama).
  • Big picture (open businesses, street grid, weather).

Facilitator says: Always assess scene and stay situationally aware—especially when things seem calm and no one is injured.

Practice communicating about a scene

Facilitator says: We’re going to practice doing scene assessment as medic affinity groups here at camp. An experienced medic will walk around camp with each group, and guide you to see the scene.

Proctors: identify selves.

Students: break into as many groups as there are proctors.

Facilitator says: before you head out, answer these questions:1

  • Who are the organizers and logistics people at this camp?
  • Is there cell reception in camp?
  • Who has a charged phone?
  • What is the local emergency number for medical/trauma emergencies? What resources exist for someone in camp who needs help with sexual/domestic violence, STI/blood-borne illness testing/treatment, mental health crisis, poisoning, or addictions recovery support?
  • If you call 911, what hospital will someone end up at?
  • What is our camp evacuation route?
  • How long would it take to evacuate one limping (assisted) or unresponsive (carried) person to a rendezvous point? All the way to definitive care?

Groups: Go assess the scene around the training location for 10 minutes. As they walk around, their proctor asks Dick Reilly-style questions like these:

  • Where are your exits?
  • Where are your treatment areas?
  • Where are the police?
  • Where are their bosses?
  • Where are the legal observers?
  • Where are children and elders?
  • Could the weather change?
  • Who is most at risk here and why?
  • What are the biggest dangers here and why?
    • What are choke points?
    • Obstacles for panicked crowd?
    • How can we calm crowd?
  • What is the state of food, water, and sanitation?
  • Where are alcohol and intoxication clustered?
  • Where can someone go to get away from all alcohol and intoxication all night?
  • Where can someone shelter-in-place out of weather?
  • How can someone leave camp to get care or go home?
  • If "…," then what would you do?2
  • If "…," who would you involve, where would you refer the person, or who could improve the situation?


Facilitator asks: How did communicating about the scene as a group change your individual perception of it?

If your team sees injured protesters

Facilitator says: Look for danger/needs/resources. Stop to decide plan and activate back-up. Scene assessment continues while your buddy team:

  1. Exits the scene,
  2. Uses available resources to control scene (but does not assesspatient or provide care),
  3. Or controls scene, engages patient, prepares to do advocacy.

Calling 911 to activate EMS

  • Know location; In city: exact address if possible, at least cross streets. In backwoods: know name of your area, directions to road-accessible rendezvous point, nearest highway mile marker, GPS coordinates.
  • If you’re a medical professional, identify your title, cert or shield number for authority drag purposes (or choose to remain anonymous).
  • Say patient’s chief complaint (if known). Follow dispatcher’s lead. Stay on phone. Response time depends on 911 dispatcher’s assessment of urgency and availability of responders.

Scene control options

Get to a safer scene by foot, car, transit, cab, or ambulance

  • Get out of cold, rain, wind, or heat.
  • Help someone back up from a fight
  • Get to wellness center or hospital.

Stay put; make scene safer around you

  • Calm, comfort, reassure: Sometimes the scene is safe but the injured person is so hyped he doesn’t recognize it is safe.
  • De-escalate and redirect hostile/nosy bystanders: Use humor, give something to do, be polite, firm, and cheerful.
  • Create privacy circle. - Comments: 0

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