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Riot medicine

A guide for first aid and street medics at protests
6 min read
Last update: May 18, 2024
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This page is meant as a starting point for anyone who wants to learn more about providing first aid at protests. Start by reading the introduction below, or explore the various topics about street medics further down. If you need a quick reference during actions, make sure to check out the FIELD GUIDE.

This section of Activist Handbook was derived from the book Riot Medicine, which the author Håkan Geijer generously published under a Creative Commons Zero 1.0 Universal license.

Introduction

I can also tell in whose hands I am. Do these hands tremble? There can be no doubt: these are the hands of a military officer. Is it a firm pulse? I say without vacillating: these are the hands of a liberator.

Ricardo Flores Magón, The Rifle

Riot medicine is the practice of medicine in an adversarial environment. It exists outside of formal and state-sanctioned medical services. Practitioners of riot medicine go by many names (riot medics, street medics, demonstration medics, action medical), but at the end of the day, their goals are the same. They take to the streets as part of the diverse system of mutual aid that allows individuals to engage in protest. The duties of a riot medic may include handing out water during a peaceful demonstration, providing late-night jail support for arrested comrades, caring for injured protesters and bystanders during a riot, or extracting and providing lifesaving interventions for combatants during an armed uprising.

Illustration by Eldridge Misnomer from Mediawiki

The lens of riot medicine rather than street medicine was chosen to help you focus more on how to provide medical care during demonstrations and physical engagements rather than to inform you on how to run a volunteer clinic or provide care for injuries sustained outside of short-lived confrontations (1). The aim is to provide enough medical and tactical knowledge to enable riot medics to support short mobilizations on the scale of several hours to several days.

If you are an experienced medical professional, this book will guide you on how to safely operate during a protest. However, this book assumes that medicine may not be your primary occupation or field of study. Both the common and more formal medical terms are included as well as a glossary for reference. The foundational medical theory has been provided to give context for various treatments, and as such, not all information in this book needs to be memorized. Some information may seem obvious, but what is obvious to you is not obvious to others. In-depth information is provided to help demystify seemingly esoteric practices and address common misconceptions.

Because of the exceptionally diverse conditions under which riot medicine is practiced, this book generally avoids making absolute statements about how an individual or group must act. Riot medics may be part of the Black Bloc or may act as seemingly neutral third parties. They may be uncertified or may be practicing physicians. How they choose to act depends on many factors including the nature of the action, the legality of protest, the legality of practicing medicine, and the overall political climate of the region where an action is taking place. This book will provide you with a toolbox that will help you make operational decisions using your own experiences and context-specific information.

Riot medicine incorporates elements of wilderness medicine and combat medicine, but it is still a distinct practice. Often the riot medic is only equipped with what they can carry in a backpack. What they choose to pack is limited by multiple factors, the major one being that their gear can be confiscated or destroyed during the course of their work. They need to carry provisions to survive the day and personal protective equipment to keep themselves safe enough to do their job. The riot medic needs to take a highly practical approach to medicine knowing that they will not be able to operate under ideal conditions. Hospital-quality diagnostic equipment will not be available, materials may be limited, and care rendered often will only be “good enough” to get a restless comrade back into the fray.

Code Rood action near Groningen – Farmsum. Peaceful activists raise their hands after being attacked by police forces with dogs, batons and pepper spray as hundreds of climate activists block the tanker park (Pierre Crom, 2018)

Riot medics comfort traumatized comrades as much as they heal their bodies. Protests and confrontations with fascists and the State can be stressful and even traumatizing. Even in the nonideal environments you will be working in, it is your responsibility to keep calm and help calm those around you. Nervous and stressed-out comrades can be liable to make mistakes that lead to more injuries. Reading this book will help enable you to act confidently and therefore help others act confidently, contributing toward successful demonstrations and insurrections.

This book is written from an autonomous, anarchist perspective. However, the information and tactics described within will be useful to all participants in the struggle for liberation. State-imposed laws and regulations are a reality, and where it is relevant, it is noted where your work may intersect with the legal system to highlight what legal risks there may be. This book was written in 2019–20, so as you are reading this, be wary that medical best practices, legal considerations, and all other information may have become out of date.

The act of challenging the State is dangerous, but with some basic knowledge, medics can drastically reduce the repercussions protesters face. The goal is that by reading this book, you will be able to provide care for and support to comrades known and unknown, all in the pursuit of a world free of domination.

(1) Riot medics are strongly encouraged to apply their medical knowledge by providing aid in other contexts such as caring for houseless persons and providing disaster relief.

Organize

Medicine

  • Patient Assessment

  • Patient Evacuation

  • Psychological Care

  • Medication

  • Alternative Medicine

  • Basic Life Support

  • Wound Management

  • Riot Control Agent Contamination

  • Shock

  • Brain and Spinal Cord Injuries

  • Chest Injuries

  • Fractures and Dislocations

  • Athletic Injuries

  • Burns

  • Combat Injuries

  • Cold Injuries

  • Heat Illness

  • Respiratory and Cardiac Emergencies 24 Allergies and Anaphylaxis

  • Blood Glucose Disorders

  • Drug Overdoses

  • Unresponsive States

Equipment

  • Medical Supplies

  • Personal Protective Equipment 30 Other Gear

  • Packing Your Bag

Tactics

  • General Tactics

  • Action Tactics

  • Operational Security

  • Radio Operation

Afterword

Further Reading

Acronyms

Glossary

Index

References

Disclaimer

This will provide an overview of the knowledge needed to provide basic medical care during protests and civil unrest using incomplete and improvised equipment. This book is not a substitute for professional medical training, so you are strongly encouraged to supplement the knowledge from this book with outside resources.

Additionally, the legality of protest, practice of medicine, and their intersections varies from region to region, so there will be no attempt to make absolute statements about what is legal or illegal. Statements about the law are meant to guide you in the right direction, however, they are not qualified legal advice. It is up to you to research the political and legal climate where you will be operating and make your own decisions.

Acknowledgements

This book was not the product of one individual, and I extend my gratitude to those who provided illustrations, taught me, inspired me, and gave me encouraging words. My thanks go out to the following (in alphabetical order):

  • Anonymous comrades for their illustrations and help with editing

  • Audrey Huff for her illustrations

  • Bizhan Khodabandeh for his illustrations

  • Cat Paris for her illustrations

  • Citriii for her illustrations

  • drnSX42 for their illustrations

  • snailsnail for his illustrations

  • ZEROC0IL for his illustrations

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