Chem weapons

20 mins -- Purpose: By the end of this part, learners will be informed about common chem weapons and will have practiced eyeflush.

Trainer:            ; Timekeeper:            

K: walk don't run; dress for success; plan for aftercare; scene safety / de-escalation; have a buddy
A: do no harm; know what you dont know, and get help; calm comfort reassure; solidarity and advocacy
S: eyeflush; transport; red flags; calling 911; getting help in medic/herbalist community; using aftercare sheets

Stick to the outline or else this section will become a full hour! People understandably have lots of questions about this topic but these questions invariably lead us far astray. Remind them to keep their questions to clarifying. Other questions will have to wait.

  • We're talking about tear gas and pepper spray, sometimes combination of the two.

  • haven't seen other chemical weapons used in the US

  • aren't going to differentiate for purposes of training. Treat symptoms, don't guess chemicals, they reformulate frequently, and we can't always know.

How they're deployed:

  • canisters/grenades shot or dropped from helicopters, gas disperses widely. These canisters are very hot, don't touch them. Also can cause blunt trauma when projectile hits.

  • sprayed from a can (mace) or large container like fire extinguisher.

  • Paintball-like pellets

Prevention:

  • The only sure prevention is to stay home. Police are unpredictable.

  • We have tested many things and have not found anything that can prevent the effects.

  • Please don't cover your body in toothpaste, baking soda paste, raw egg, milk, Tecnu (Poison oak blocker stuff), onion, lemon, vinegar, or anything else as prevention.

Effects:

  • "Who here has been pepper sprayed or teargassed? Everyone pay attention to those hands, because these people can give you reports of their experiences."

  • Although there are varying symptoms for each chemical, we will not differentiate between them here. The reason is because there is crossover between effects, and because the technology is evolving and occasionally we see unusual symptoms that don't clearly match what we know about either chemical. Treat the symptoms, rather than trying to figure out what weapon was used. If you're curious, there is information on medic.wikia.com, or you can talk to people who have been attacked with these chemicals and hear what they say.

Chemicals are irritants to eyes, mucous membranes and skin and cause these effects:

  • eyes hurt

  • difficulty seeing or breathing

  • coughing

  • intense pain on skin -- it can cause a first degree burn, like sunburn

  • panic since they can't breathe or see

  • intense and unfocused rage

Your patient may be flailing, screaming, spitting and spluttering (remember BSIs -- their body fluids will cause you pain!)

Occasionally you may see: convulsions, shivering, and other strange things. As always, if you don't know what's going on, say that you don't know, and get help.

Higher risk factors:

  • asthma

  • condition (and recovery) affecting immune system, like HIV or medication; skin, like psoriasis or eczema; eyes, like corneal damage or infection; or respiratory tract, like bronchitis or emphesema.

  • Children, especially those under the age of 6 -- tiny airways.

  • elderly people

  • Pregnancy, nursing, or trying to get pregnant.

  • long-term steroid use (e.g. prednisone) for Crohn's disease, rheumatoid arthritis, and many other things

  • contact lenses

Police behavior is unpredictable and things can happen very fast. Avoiding contact with these substances not always possible. We're not trying to scare you, just prepare you. Fear is the police's number one weapon.

Treatment:

Chemical weapons are evolving so be prepared to change remedies/tactics as the weapons change.

  • Get consent. Remember patient may be blinded and enraged.

  • Encourage calm and steady deep breathing. This will lessen panic.

  • Move patient to an uncontaminated area if there's gas in the air.

  • Encourage coughing and spitting. Pt. doesn't want to swallow the chemicals.

Decontamination

We've already shown first aid, now we'll show external decontamination. We will follow up with internal, and emotional decontamination later in this training when we talk about aftercare.

  • avoid entering the house with contaminated clothing

  • Be aware of vulnerable people at home who you might easily expose.

  • Take clothes off outside and put them into a plastic bag. seal it, don't open until doing laundry.

  • Avoid touching anything -- pets, furniture, car, phone, etc.

  • Take a tepid shower (doesn't need to be ice cold, as some folks may have heard elsewhere). Heat will irritate the burn. If someone asks, pores do not actually open, and so there isn't a concern of increasing absorption this way.

  • Wash clothes immediately with detergents (aka -- not eco-friendly stuff, which may not cut through the oil), several times if need be.

Outside

Eye treatment:

  • LAW is 50% Maalox brand liquid antacid and 50% water. Put it in a squirt top water bottle.

  • In the US we recommend Maalox because we know what the ingredients are. They may vary in other countries. Some liquid antacids contain alcohol. Alcohol is bad for the eyes. Check for alcohol. Use Maalox brand, any flavor. active ingredients to look for are magnesium hydroxide and aluminum hydroxide. Nothing with ending "ol" because it's alcohol

  • If someone asks, the anti-gas ingredient simethicone is not known to be dangerous.

  • Approach, consent, ask about contact lenses, patient kneels or stands, tilts head to side, hold eye open -- ask patient to help, squirt LAW from nose side of eye to outside. Tell patient repeatedly to blink. Try not to drip LAW and OC onto patient. Remind patient not to touch eyes.

  • Find out who has contacts. These people don't have to get their eyes flushed in practice.

  • Make sure everyone can do a decent eyeflush. Make sure that the students are telling the patients all the right things, i.e., asking about contact lenses, not rubbing eyes, keep blinking, etc.

  • STUDENTS should be giving decontamination-at-home information as part of this practice.

Fun fact: You can also squirt LAW into patient's mouth, have him swirl it around, and then spit it out. Repeat. After several rounds, if patient's mouth feels better, she can swallow some LAW to help innards. This also seems to help people breathe more easily.

Red flags:

  • patient leaves the tear gas area and doesn't quickly breathe more easily

  • patient doesn't respond to treatment

  • unusual symptoms that don't quickly improve

  • In these cases, get more help and/or call 911

Stuff: pre-mixed bottles of LAW, 15 eyeflush handouts