Bay Area Radical Health Collective

Health & Safety for Activists

Version 1, November 2002


Basic Assessment & Emergencies

Imagine one of your friends is suddenly injured or sick. Or maybe you're the first one to find a person "down" at a protest. What do you do? Well, don't panic! Take a deep breath and think.

Remember, your brain is your best first aid kit!

Survey the scene:

Eliminate or prepare for potential hazards to the victim, to yourself, and to bystanders. Try to make sure that whatever happened to your friend or comrade doesn't happen to you too!

Use the crowd for moving obstacles, directing traffic, getting help, and keeping a safe space around injured people. Try to speak in a calm voice to help keep others calm. Remember, most people want to help.

Universal Precautions

While providing emergency care for others, it is important to also protect yourself from blood-borne diseases like HIV and hepatitis B or C. Wear latex or plastic gloves when touching blood. No gloves? A plastic baggie or a piece of plastic food wrap will work in a pinch. Be aware that some people are allergic to latex; because of this more and more health-care providers are switching to plastic (nitrile) gloves. Remember, diseases are rarely spread through rescue breathing (mouth-to-mouth resuscitation).

Next, determine if the person is conscious and alert by asking:

If the person does not respond to normal conversation, shout and tap-but do not shake, since this could make a neck or spine injury worse.

Neck and Spine Injury Precautions

Neck and spine injuries can be very serious, even leading to paralysis. When helping a person who has been injured, your first goal should be do no harm!

If the person is conscious:

Introduce yourself. Say who you are, that you want to help, and what your qualifications are, if any. Ask for consent before you do any further assessment or treatment.

If the person is unconscious:

Call 911. If other people are present, send someone else-two people if possible-to call 911 or look for help. Tell them to come back and let you know they did it. If they don't come back in 10 minutes, send more people. Sometimes emergency services personnel will not respond to what they consider an unsafe scene, or police may keep them away. If a person needs more help and emergency services are not available, send people out to look for someone with more medical training, ask the police for help, or try to find a car to transport the person to a hospital.

Check ABCs:

Put your face next to the injured person's and look, listen, and feel for breathing for 15 seconds:

Try to check for breathing without moving the person. If she is not breathing, carefully log roll her onto her back.

If you do not detect breathing, thrust the jaw forward. With the person lying on her back, put your fingers under the corner of the jawbone on both sides (below and slightly in front of the bottom of the earlobe) and push up. Look, listen, and feel again. Check the mouth for vomit, blood, knocked-out teeth, or debris. If visible, remove with your fingers (covered with a glove or cloth if possible). Look, listen, and feel again.

If a person is breathing, you can be sure she has a pulse. Finding a pulse can be difficult...don't waste your time unless you know how.

If the person is not breathing:

Start rescue breathing. Pinch the nose and breathe into the person's mouth. Look to see if the breath goes in (the chest rises). Give one slow breath about every 5 seconds to an adult, or one shallower breath about every 1 second to a child. Mouth-to-nose rescue breathing may also be done. Keep the jaw thrust forward while doing rescue breathing.

Start CPR if you know when and how to do so If you don't know CPR, search the crowd for someone who does


If the person is breathing (conscious or unconscious):

Check for bleeding. Even if you find one bleeding injury, keep looking-there may be other hidden injuries that are more severe (see "Dealing with Injuries").

Look for a MedicAlert tag around the neck, wrists, or ankles.

If the person is conscious, ask for more information:

If she is not conscious, friends can be a good source of information about medical conditions and what the person is usually like. Witnesses may be able to describe how an injury happened.

If you know how and it seems useful, you can do a more thorough physical exam. Look for:

If something looks unusual on one side of the body, compare with the other side. Ask the person or a friend what is normal for her. For example, some people naturally have pupils that are different sizes; others have congenital abnormalities or abnormalities due to previous injuries.

It can be hard for someone without medical training to tell what's wrong. For example, breathing problems may be due to asthma, chemical weapons, or an anaphylactic reaction. Confusion could be due to diabetes, dehydration, psychological stress, or a head injury. Do not attempt to provide treatment beyond your level of skill and training.

Recovery Position

If an unconscious person has vomited or is bleeding from the mouth and you do not suspect a neck or spine injury, roll him onto his side to prevent choking. He should be supported on one bent knee and one arm. Put a person in this recovery position if you must leave him alone.


Preparing for an Action

Being well prepared for an action can mean the difference between having a safe, empowering experience and having an unhealthy, frustrating one.

What to wear:

If you carry just one supply, it should be water. Use it to prevent dehydration, for cleaning wounds, and for flushing eyes and skin after tear gas or pepper spray exposure.

What to bring:

What to avoid:

Tear Gas and Pepper Spray

When most people think about health and safety for activists, they think of chemical weapons-tear gas and pepper spray-thanks to the rude awakening delivered during the 1999 Seattle WTO protests. But despite the hype, exposure to tear gas and pepper spray are not the worse thing that can happen. Most people in good health experience only brief effects. These weapons were developed by the military to control crowds, and they are used by cops to produce fear and disorientation. While they can have immediate incapacitating effects, for most people the effects are only temporary!

Tear Gas

Tear gas-various formulations include CN, CS, and CX-is dispensed from canisters that are thrown into crowds, releasing white or invisible smoke. The canisters are very hot-do not pick them up with your bare hands! Tear gas irritates the eyes and mucous membranes such as the linings of the nose, mouth, and lungs, causing increased fluid production. Some people find it hard to breathe. Effects may last as little as 5 minutes or as long as 30 minutes. Tear gas is mixed with various solvents and propellants.

Pepper Spray

Pepper spray-also known as oleoresin capsicum or OC-is derived from hot peppers. It is a liquid or foam usually sprayed at close range, either from a small dispenser or from a larger tank with a nozzle that looks like a fire extinguisher. Pepper spray burns the eyes, skin, and mucous membranes, causing pain. Effects last longer than those of tear gas-an average of about 20 minutes-and it is harder to remove. The Black Cross Collective conducted controlled trials of different pepper spray remedies, and their results provide the basis for some of the treatments most often used by street medics. Other remedies were developed during protests in the 1960s and remain the "state of the art" today.

Effects of Chemical Weapons

While pepper spray generally only affects the people on whom it is directly sprayed, a canister of tear gas can affect a large number of people within an area about the size of a block. People may even be affected well after a canister was released and all visible signs of gas are gone. Many of the effects of tear gas and pepper spray are similar, but some are more often associated with one or the other:

Advance Preparation

What about Contact Lenses?

There has been much debate about contact lenses. It is usually recommended that people not wear contact lenses if there is a risk of tear gas or pepper spray exposure, since the lenses might trap chemicals and cause eye damage. Also, wearing lenses can make treatment more difficult. Many people recommend that contact lenses be removed before an eye flush-which can be hard to do on the street with contaminated fingers. On the other hand, some people report that wearing contact lenses doesn't seem to make much of a difference.

Protective Gear

High Risk Groups

Some people are more at risk than others from exposure to chemical weapons. They may suffer more severe initial effects and are more likely to experience long-term problems. The following people should be extra cautious and consider carefully whether they want to be at an action where tear gas or pepper spray may be used-remember, the behavior of the police is often unpredictable! Be responsible for children and pets who can't make this decision for themselves.



For eyes:

For skin:

Commercial Products

Commercial products such as BioShield and Sudecon are sold by police suppliers to neutralize tear gas and pepper spray. They are usually a mixture of sugar and baby shampoo, and are sold in spray bottles or as individual wipes. Reports are mixed about how well they work. The Black Cross Collective did not find them effective in their pepper spray trials. But others have said the products work for them. A major disadvantage is their high cost-especially when dealing with a large number of exposed people. An advantage is that the wipes can easily be used by individuals on themselves, even while running.

Treatment Myths

Over the years, numerous different tear gas and pepper spray remedies have been circulated. Many are merely useless, but some can be harmful or make the pain last longer. Some are based on misinformation and miscommunication, but others have no clear origin. The following are not recommended:


Once you're away from the action, wash your body, hair, and clothes to remove the chemicals. Tear gas and pepper spray can linger for a long time in clothes. People can even suffer the effects of exposure if a contaminated person walks into an enclosed room. Before you enter a convergence center or clinic after an action, you'll probably be asked to remove your clothes if they're contaminated.

For you:

For your clothes:


The effects of tear gas and pepper spray are usually temporary. Seek medical attention if you experience any of the following:

Many people feel fatigued or ill after chemical exposure. This is a good time to take extra good care of yourself. Drink a lot of water, eat nutritious food, and get enough sleep. Many different herbs can help detoxify the body-ask an herbalist for recommendations. Some people experience critical incident or post-traumatic stress after exposure to chemical weapons and will need additional care (see "General Aftercare").

Chemical crowd control weapons are banned in some countries because of their potentially dangerous effects. Use of tear gas and pepper spray in protest situations has not been well studied. But pepper spray has been associated with numerous deaths of people in police custody. The long-term effects of propellants and other chemical additives in tear gas are not known.

Climate: Heat, Cold & Dehydration

Heat-Related Illnesses

There are two major types of heat-related illness (hyperthermia): heat exhaustion and heat stroke. Heat exhaustion indicates that your body is getting too warm. Heat stroke happens when the body's temperature regulation mechanism is overwhelmed and it can no longer cool itself down. Heat stroke is the more serious condition, and can be life-threatening. In addition, some people also get painful muscle cramps due to heat.

Preventing heat-related illness:

Heat exhaustion symptoms:

Heat stroke symptoms:

Treating heat exhaustion:

Treating heat stroke:

Aftercare for heat-related illness:


Any time you're exposed to the sun-especially if you're not used to it-you risk getting sunburned. This is especially true in the summer, during the middle of the day, and at high altitudes. Protect yourself by wearing long sleeves, long pants, and a hat. Or, use sunscreen or sunblock. Sunscreen lets you stay in the sun longer without getting burned. The higher the Sun Protection Factor (SPF), the more protection a product provides. Some people have found that oil-based products can worsen the effects of pepper spray. If there's a risk of chemical weapons exposure, use a water-based sunscreen.

Don't forget that a sunburn is a burn. Treat it as you would any other kind of first or second degree burn. If you get a mild sunburn, use water to cool the skin. Aloe vera can also help cool the skin, and moisturizing lotion can help prevent peeling. If you get a serious sunburn (bad blisters, fever, chills), seek medical care.


Dehydration occurs when your body does not get enough fluids. This can happen if you are not drinking enough, or if you are losing a lot of fluids through vomiting or diarrhea or heavy sweating. Dehydration often happens when it's hot out, but can also happen when it's cold.

Preventing dehydration:

Dehydration symptoms:

Treating dehydration:

Aftercare for dehydration:

Cold-Related Illnesses

Hypothermia is the name for cold-related illness. People can get hypothermia even if the temperature is above freezing, especially if they are not used to the cold. Different people may experience hypothermia at different temperatures. In very cold conditions, "chillblains," frostnip, or frostbite may occur. Chillblains refers to red, tender skin that may later blister. Frostnip is freezing of the outer layer of skin. Frostbite is when ice crystals form in deeper layers of tissues. The areas most often affected are the toes, fingers, tip of the nose, and tips of the ears. Severe frostbite can lead to gangrene, and may necessitate amputation of the affected body part.

Preventing cold-related illness:

Hypothermia symptoms:

Treating hypothermia:

Aftercare for hypothermia:

Chillblains, frostnip, and frostbite symptoms:

Treating chillblains, frostnip, and frostbite:

Aftercare for chillblains, frostnip, and frostbite:

Dealing with Injuries


After ensuring that an injured person is breathing, the next important step is to stop bleeding. Loss of blood can lead to shock and eventually death.

To stop bleeding:

Seek immediate medical care (call 911) if:

Head Injuries

Head injuries can be among the most serious of all injuries. They can cause brain damage and swelling inside the skull.

Signs of possible head injury:

The symptoms of a head injury can resemble many other things, so it's important to rule out other possible causes. If a person is confused or seems to be acting strangely, try to find out if they have other medical conditions (diabetes, dehydration, intoxication, psychiatric conditions). Ask her friends what she is usually like.

Head, neck, and spine injuries often occur together. If a person has a head injury, follow precautions for neck and spine injuries. Remember, sometimes head injury symptoms do not appear right away, but may develop quickly and become life-threatening. Although a minor concussion is not that serious, more severe problems could develop. If you think a person has a head injury, call 911 or bring them to a hospital.

Aftercare for head injuries:

Seek medical care if a person:

Eye Injuries

Eye injuries can be serious, and are distressing since the person may not be able to see. If the eyes are exposed to tear gas or pepper spray, flush them out with water or liquid antacid mixed with water (see page 11). If a person has an object impaled in an eye, do not attempt to remove it. Stabilize the object (a Dixie cup over the eye works well), cover the eye, and get medical help. Many experts recommend covering both eyes, since the eyes move together and the goal is to prevent movement of the injured eye. Make sure someone stays with a person who cannot see.

Soft Tissue Injuries and Wounds

There are many different types of soft tissue injury:


Blisters are a type of soft tissue injury caused by repeated pressure or rubbing. Prevent foot blisters by wearing comfortable, well-broken-in shoes and socks and keeping your feet dry. Bandaids, tape, mole skin, or "second skin" products can help if a "hot spot" is developing. If a blister forms, try not to break it (to reduce the chance of infection). If the blister will be under continued pressure and you think it will burst, you can release the fluid by poking a small hole at the edge of the blister with a sterile needle and pressing gently to drain the fluid. Cover with a Bandaid.

Treating wounds:

Seek further medical care for:

Aftercare for wounds:

Tetanus Shots

Tetanus, or lockjaw, is a disease caused by bacteria that can contaminate wounds. It is most likely with deep puncture wounds, injuries from dirty knives or nails, and foot wounds that become contaminated with soil. Tetanus can cause convulsions and death, but can be prevented with a vaccine. For any open wound, get a tetanus shot if you haven't had one in more than 10 years. For more serious injuries, get a tetanus booster if you haven't had one in more than 5 years. A booster shot should be given within 48 hours after the injury.


Burns can be caused by heat or chemicals. Burns have different levels of severity:

Many activists have been badly burned at actions due to picking up hot tear gas canisters. Only handle canisters if you are wearing thick work gloves.

Treating burns:

Seek further medical care for:

Aftercare for burns:

Sprains and Strains

Sprains and strains are types of blunt trauma injury. Although these injuries are usually closed (don't break the skin), they may be accompanied by internal injury and bleeding.

Symptoms are similar, including mild to moderate pain and swelling. Bruising is often seen. The person may be able to walk or move the injured part, but doing so will usually hurt, sometimes severely.

Treating sprains and strains:

Seek further medical care if:

Aftercare for sprains and strains:


A fracture is a broken bone. Usually fractures are very painful and the person generally cannot walk or move the injured part. A compound fracture is when a severed bone end pokes through the skin. A dislocation is when a joint gets popped out of its socket or becomes misaligned.

Treating fractures:

Circulation and sensation

Various signs can help you assess whether circulation is impaired or nerves are damaged. Check circulation and sensation before and after applying an elastic bandage or splint to make sure it's not too tight.


Any wound or injury in which the skin is broken can lead to infection. This is most likely to happen within 48 hours. Be on the lookout for the following signs and seek medical care if infection seems to be developing:

General Aftercare

After an intense action or time in jail, people often experience physical and emotional stress. Experiencing brutality-whether it happened to you or to someone else-can bring on critical incident stress or post-traumatic stress disorder. Symptoms of emotional distress may include:

The following steps can help you recover, but you may also need additional medical care or professional counseling.






Many different herbs can help detoxify, strengthen, and tonify the body. Herbs that detoxify the liver (for example, milk thistle, burdock root, dandelion) may be especially helpful after chemical weapons exposure. Rescue Remedy can often help reduce distress. Place a few drops directly on the tongue or mix with drinking water. Ask an herbalist for more recommendations.

Activist Systems of Care

Activists are working to develop systems of care, ranging from healing spaces at actions to supportive aftercare in local communities. For more information, see or

Bay Area Radical Health Collective
Text: Liz Highleyman
Medical Editor: Lysa
Thanks to Michael Greger for aftercare information

Version 1, November 2002

Last updated: November 2002