Thread by @mspowahs

A thread about protest medics. It will not make you a medic, but might start your journey, and might also make you a little more useful in the streets in the short-term.

2/ CONTENT LEGEND
🔴 Background
⚫️ Training
⚪️ Ethics & Tactics
🎒 Supplies
👁️ Pepper Spray & Tear Gas
🐖 Police Engagement

🔴 This is a tricky topic to broach, and I waffled on making this thread. Folks calling themselves medics who don't have the skills to be out there can do far more harm than good, and I don't want to contribute to that. I'm asking you not to contribute to that. Know yourself. 3/

🔴 Ultimately, I'm going for harm reduction: I've been seeing a lot of "street medic info" posts flying around, some of it incomplete or inaccurate. I also know that feeling more like a "helper" might make some people more likely to show up to protests. It did for me. 4/

🔴 If you're a person of privilege new to protests, you can do more good than simply being a body, and provide a lot of care, without calling yourself a medic. Don't call or especially mark yourself as a medic unless you have, at minimum, first-aid training. 5/

🔴 If you know me, you know I hate gatekeeping. I'm emphasizing this kind of caution because I'd rather you be intimidated than feel empowered to provide inadequate care. If you can safely ignore what I'm saying, you'll know it. 6/

🔴 (But also, there's nothing wrong with being a body at a protest, especially if you're white. Put yourself between cops and Black people. Don't start shit. Take your cues from the people around you who stand the most to lose. Always, but especially now.) 7/

🔴 About me: I was trained by a street medic collective in 2017. I don't have as many demonstrations under my belt as I'd like, but I've successfully medic'd at a number of events and coordinated medic presence for an action my friends and I started in San Diego. 8/

🔴 The street medic movement started in the 60s during the Civil Rights movement, and a lot of the ethics and tactics involved were developed and pioneered by and in partnership with groups like the Black Panthers. It has always been a liberatory practice. 9/

⚫️ The gold standard for street medic training is called a "20-hour training", typically held over a very intense weekend, and they're surprisingly consistent across collectives. Identifying yourself as a "20-hour street medic" says a lot. 10/

⚫️ Street medic training is a lot like first aid training, but with the addition of protest-specific information. Treating pepper spray and tear gas, subverting police intimidation tactics and disinformation, how and when to engage with police presence, and so on. 11/

⚫️ Many major cities either have a medic collective of their own, or are regularly visited by other collectives to hold trainings. Inquire at your local anarchist bookstore, ask your radical friends, check Facebook. Travel if needed. Get. Trained. There's no substitute. 12/

⚫️ If you have first-aid training, you already know the most important part: how to provide minimally adequate medical care. But there's still a LOT of common wisdom in activist circles that you may not be privy to. Be prepared to follow, not lead. 13/

⚪️ Okay. You wanna get out there NOW, and you wanna be useful. Here's the minimum viable information to help you do that without fucking anything up. A lot of this stuff is useful even just as a person at a protest. 14/

⚪️ 15/ First, resources. The collective I was trained by doesn't want their medic handbook shared, for reasons I respect. Someone else compiled a similar one for open distribution, and I'm okay sharing that. READING THIS DOES NOT MAKE YOU A STREET MEDIC. riotmedicine.net

⚪️ If nothing else, use it as an example of the massive amount of shit you have to know to be truly effective. Read it cover-to-cover a couple times. Use it as a reference. And if you truly have zero access to proper training, you can use it to start your education. 16/

⚪️ 17/ The Rosehip Medic Collective in Portland has a handout on chemical weapons care, specifically tear gas and pepper spray. There's a lot of good information in it, some of which I'll repeat in this thread. [PDF link]
rosehipmedics.org/handouts/Actio…

⚪️ 18/ The Street Medic Wiki is another great resource that you should familiarize yourself with.
medic.wikia.org/wiki/Main_Page

⚪️ Next, ethics and tactics. Very very very first, all medical care—volunteer or otherwise, trained or otherwise—requires INFORMED CONSENT. Do NOT touch someone without asking, do NOT help yourself to their body, do NOT practice care without consent, even if they're in pain. 19/

⚪️ "I have medical supplies, can I help you? Okay, I'm going to [action], is that okay?": It's that simple. All of the situations where this advice might not apply or be ambiguous are not the ones you are going to learn anything about from reading this thread. I'm serious. 20/

⚪️ While we're at it: No "creepy-touch". Whenever you're interacting with someone's body, be gentle but decisive in your pressure. No lingering touch, no grazing. It weirds people out and drains their confidence in your ability to provide care. 21/

⚪️ Now, headset. As a medic, you are not a protestor. You have a job, which is to spread *calm* and *care*. Calm in this case means keeping a cool head and demeanor, aiding information flow, NOT aiding disinformation, and staying alert to your surroundings. 22/

⚪️ Spreading calm does *not* mean trying to "keep the peace" or control people's actions. That's white savior, agent suppressor shit. You are not running the show. You are causing enough trouble for the right people simply through your presence, effort, and facilitation. 23/

⚪️ A moment longer on this matter. I became a street medic because I recognized a discomfort with being at protests that I wanted to push past. I realized that, as with many things in my life, having a defined helper-type role made it easier for me to participate. 24/

⚪️ I also wanted to limit my liability to fuck up radical movements. At the end of the day, I'm a middle-class white lady who often takes up more space than I intend. I don't want any lingering hesitance to destroy systems that benefit me to get in the way of that happening. 25/

⚪️ So it appeals to me to be a facilitator, working neutrally in a decidedly non-neutral context. It's a character flaw that I probably don't have the guts to punch a cop—but while I work on that, I can sure as fuck bandage the hand of whoever does. Maybe so for you as well. 26/

⚪️ Neutrality is also pragmatic: if cops see you torching a cop car, they might be less willing to let you past a barricade with an injured person later. Your perceived relative neutrality is potential capital which may be spent in a time of genuine need. 27/

⚪️ (Obviously, with even the press being shot at and arrested right now, getting a "break" from the cops for being a medic seems far less likely than it ever has. Nonetheless, the less trouble you personally get into, the more trouble you can help get other people out of.) 28/

⚪️ In my personal opinion, this does NOT always apply to standing between cops and others, or otherwise putting your body on the line—especially as a person of privilege. You should always know before going to an action if you're willing to be arrested, and your plan for it. 29/

⚪️ But also, always consider where you can do the most good, and whether risking being arrested or hurt outside of a situation where you're refusing to leave the side of a person you're taking care of would overall help or harm your cause at the moment. 30/

⚪️ 31/ This touches on two important principles:
• DON'T BECOME A SECOND PATIENT. This applies to every aspect of your medic practice, from the risks you take to how you give care.
• KNOW YOUR ARREST TOLERANCE. It's okay to have "strong" or "soft" preferences for this.

⚪️ Aiding in both of those: ALWAYS MEDIC IN PAIRS. *Especially* if you're newer and have a more experienced medic buddy. Split up only as an absolute necessity, and have a plan for coming back together if separated. 32/

⚪️ Every time you buddy with a medic, start by disclosing your relevant training and experience, sync up on your arrest tolerance, arrest plan, and the contents of your packs, and make a plan for separation. 33/

⚪️ Medics should roam gently, following the flow of the crowd and assessing surroundings without getting in the way. If you see someone who might need something, ask them if they're okay, if they need a medic. Tell them you can help only if you feel comfortable doing so. 34/

⚪️ Don't swarm anyone already working trying to be helpful. Don't try and crowd control unless someone's asking for it. 35/

⚪️ As a volunteer street medic, in addition to not being a protestor, you are *also* not a medical practitioner. From a legal liability standpoint—if you care about such things, and it's possible you should—you cannot recommend or distribute medications, even ibuprofen. 36/

⚪️ What you CAN say is something to the effect of "I know people who have used ibuprofen to relieve headaches like the one you seem to be experiencing. I happen to have some." and go from there. 37/

⚪️ (I am not a lawyer, just parroting from medic training, and I may have missed some details. Feel free to add to, clarify, or contradict anything I say here.) 38/

⚪️ This is especially important, and also why distributing meds is tricky: when you're giving care, it's your responsibility to collect information about the person's symptoms, their medical history, and identify anything that might hurt them more if treated incorrectly. 39/

⚪️ 40/ Some first responders use SAMPLE to assess the person needing care:
Signs/Symptoms
Allergies
Medications
Past Pertinent medical history
Last thing ingested
Events leading up to present ailment

⚪️ 41/ Along with OPQRST for the nature of the ailment:
Onset of symptoms (suddenly or gradually)
Provokes/Palliates ("what makes the pain worse or better?")
Quality ("how would you describe it?")
Radiates ("where does it hurt most?")
Severity (0-10)
Time ("when did it start?")

⚪️ It all goes in SOAP notes: Subjective [pain/affect], Objective [injury], Assessment, Plan. It's a template for quickly taking medical paper notes in triage situations. All this sound daunting? Sure is, go get fucking trained. 42/

⚪️ All this leads up to another hugely important principle: STAY WITHIN YOUR SCOPE OF PRACTICE. An EMT isn't going to do heart surgery in the field, and you aren't going to do stuff you read about once on Twitter. 43/

⚪️ For serious injuries, even the most badass street medics (of which I am not one) are going to focus on keeping people stable until EMS arrives and takes over. 44/

⚪️ When do you call for an ambulance or hospital transport? It's not your call to make. Think about things like: medical expenses, possible undocumented status. 45/

⚪️ If the person is unconscious, it's especially not your call to make. It's okay to be in over your head, even if you've been doing fine up to that point. Raise your hands above your head in a cross and call, "MEDIC!". Collaborate with others around you. 46/

⚪️ Street medics often identify with a red cross, usually in colored tape on their bag or shirt. White cross is reserved for EMS professionals. Do NOT identify with any cross whatsoever if you're not a medic. 47/

⚪️ "Well shit, Powers, what CAN I do?"
Without any training? Stick to what you'd feel comfortable doing for a housemate who got hurt at home. Spread calm, water, food. Help people respond to tear gas and pepper spray. Find medics and be extra hands. It's truly not nothing. 48/

🎒 Okay, medical supplies. I'm starting with food, to make a point: if all goes well, 90% of your time as a medic will be spent providing nutrition and hydration. This is Good, Actually. Even if success for the action looks like a riot, we don't want to see anyone get hurt. 49/

🎒 Any bag will do for a medic bag as long as you can get quick access to everything inside. I accidentally discovered that diaper bag backpacks are surprisingly good for this. Bonus: use the wipe dispenser to store gloves, the changing mat as an emergency head cushion. 50/

🎒 Keep a mix of salty snacks and sugary snacks, as both have different uses. Keep a mix of long-acting sugars (e.g. granola bars) to maintain energy, and quick-acting sugars (juice boxes, fruit snacks, etc.) for blood sugar crashes. 51/

🎒 Bring WATER, especially on hot days. I also bring a few squeeze bottles of electrolyte juice, and offer to squirt some into people's bottles. As you might imagine, availability of water can truly make a difference. 52/

🎒 (I will never forget the moment I quietly glided up to my friend who was leading a march—yelling chants into a mobile PA all day—and pressed a bottle of electrolyte water into their hand. They took a deep swig, and an inspiring vigor IMMEDIATELY returned to their voice.) 53/

🎒 54/ You can also DIY electrolyte powder:
- 2tbs sugar
- 3/4tsp salt
- 1/4tsp potassium-based salt replacement (e.g. NuSalt, Morton Salt Substitute)
- 1/2tsp epsom salt (for magnesium)
- 3 0.13oz packets of unsweetened Kool-Aid
Mix in 6L water, or use ~1tsp per 16oz bottle.

🎒 55/ Basic aid kit: Tweezers, scissors, alcohol wipes, wound cleaning wipes + spray, antibiotic ointment, ace bandages, bandaids, gauze wrap, medical tape, hand sanitizer, sunscreen, eye protection, face masks (bring extra), gloves, superglue, masking tape, sharpie, and LAW.

🎒 Superglue is for emergency sutures. Masking tape and sharpie is for writing numbers, info, etc. on people you may have to leave. And LAW stands for Liquid Antacid and Water—mixed 1:1—which is how you address the use of chemical weapons. 56/

👁️ Time to talk about treating pepper spray and tear gas. First off, water works fine. Some medic collectives recommend only using water unless you're a trained medic. Gonna tell you that, but not gonna tell you what to do. 57/

👁️ 58/ Here are the important things. If you're using LAW, make sure your liquid antacid is *alcohol-free* and *UNFLAVORED*. You do NOT want to squirt menthol into someone's eyes.

Here's more on proper sourcing of liquid antacid: medic.wikia.org/wiki/L.A.W._(l…

👁️ LAW becomes ineffective if stored in its mixed state for too long. Keep your liquid antacid and a water bottle with an athletic pop-top cap in your medic bag, and mix on demand or at the beginning of your medic shift if you strongly suspect shit going south. 59/

👁️ Why an athletic pop-top cap? You need FORCE to flush people's eyes, and the difference in diameter aids that. Spray bottles won't cut it. You can find athletic caps on bottles of Propel, or perhaps sold separately. Keep a few in your medic bag. 60/

👁️ Flushing eyes: Blast a steady stream of LAW (or water) into the affected person's eyes from a side-angle, inside corner to out, while keeping their head lower than you and tipped towards the ground in the direction of the eye you're treating. 61/

👁️ 62/ You have to get real close, and flush with force, and it may feel like you're causing them further harm—but if your technique is good, you're not. It'll far more quickly neutralize the pepper spray.

Here's more info on eye flushing: medic.wikia.org/wiki/Eye_Flush

👁️ You can also flush with plain water or saline wash, and follow up with a little bit of LAW in a spray bottle (on mist setting only) or with an eyedropper. The Medic Wiki suggests that might be how medic practice is trending—feel free to correct me. This shit's important. 63/

👁️ Also in your bag: keep at least one change of clothes, and a plastic bag for putting clothes contaminated with gas or spray. Wear an extra layer under the BLACK, NONDESCRIPT CLOTHING THAT YOU ARE DEFINITELY WEARING in case you don't have time to duck somewhere to change. 64/

🐖 Okay. You're showing some leadership without being a leader. You're feeling helpful and actually helping people. Some shit goes down, and police are talking to you. Maybe they see you as a leader. What should you feel empowered to do or say? 65/

🐖 NOT A DAMN THING. This is not your show. You do not negotiate, or bargain, or agree to relay messages. You do not give ANY information. You do not escalate or instigate. Say nothing, or the minimum necessary to go back to saying nothing. 66/

🐖 The ONLY time it's acceptable to communicate with police is ask to CONTINUE CARE for someone you cannot leave, or who cannot move, and who the police are actively trying to separate you from. That's it. 67/

🐖 Fuck, you're getting arrested. Guess what? You can still spread calm. You can even medic in jail. Get trained to learn more about how. 68/

🐖 And finally, remember this: pain is temporary. Above all else, the number one weapon of the police is fear. 69/

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