Archive for July, 2010

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Some Thoughts About Safety and the 29th.

July 27, 2010

 

As the State of Arizona prepares to begin implementation of SB1070 on July 29th, there is much talk in the local immigrant’s rights community about civil disobedience and escalation.  So far as the PUHC is aware, all plans for escalation are non-violent in nature.  Yet just as we recommend wearing seatbelts whether or not one anticipates a car accident, it seems prudent to prepare for contingencies whether or not we expect such preparation to prove necessary.

Thermal injuries

In Phoenix this time of year, the most dangerous thing out there is the pavement; if the temperature is 110 degrees Fahrenheit, expect the asphalt to reach temperatures in excess of 225.  This is hot enough to cause second degree burns almost immediately, and third degree burns with exposure times of under two minutes. 

Often, people are told not to move a patient who has been injured, lest they complicate an undiagnosed spinal cord injury.  This is good advice for when the patient has been in a car accident, where the kinetic forces result in a high risk of this type of injury.  If someone passes out from the heat however, the risk of spinal cord injury is very low, and is far outweighed by the danger of serious burns.  Unless there was a strong kinetic element to the injury, get the patient off the pavement as quickly as possible.

If you are planning on sitting on the pavement for any reason, don’t assume that a given form of insulation (eg. a piece of corrugated cardboard) will be adequate.  Go out the day before, find an empty parking-lot in full sun, and test it.

Be aware that burns continue to get worse for as much as 48 hours after the exposure that caused them.  If you or someone you know sustains a burn that looks like it may need medical attention, please get it looked at.  If you don’t have easy access to medical care, and would like someone to help you decide whether the burn is serious, call us and we’ll send someone to check it out. 

Chemical Agents

There are two types of chemical agents that may be deployed in protest situations: pepper spray (OC gas) and tear gas (CS gas).  If you are healthy,  CS exposure doesn’t usually cause any serious lasting effects, with symptoms generally subsiding within an hour of the removal of contaminated clothing.  Pepper spray (OC gas) is a bit more serious, and much more painful.  It’s known to cause severe exacerbation of asthma, and heavy exposure can occasionally cause blistering and pulmonary edema (a potentially life threatening complication).  Pulmonary edema secondary to OC exposure is very rare, but it can arise as much as 48 hours after exposure.

The first thing you should know about these agents, is that neither one is really a gas – they’re lipid-soluble  aerosolized particulates.  This means that bandannas or cheap droplet masks (available at your friendly neighborhood Wallgreens) actually do provide some protection.  Being an aerosol, these agents are much heavier than air.  When a person is in respiratory distress and having  difficulty seeing, one of their first instincts is to sit down; as understandable as this is, remember that the closer you are to the ground, the greater your exposure.  Try to make it out of the area before sitting.

Management of exposure

  1.  Stay calm.
  2. In any medical situation (not just pepper spray exposure), THE FIRST CONCERN IS ALWAYS THE PATIENTS AIRWAY.  Everything else can wait until after that.  If pepper spray is deployed, there will be a lot of people running around screaming in pain.  Ignore them for now; if they can scream, or even talk, their airway is fine.  You can come back to them later.  The person who is sitting quietly on the curb is likely to be gasping for air.  No one who’s been hit with pepper spray should be sitting quietly unless something is very wrong.  If they’re having trouble breathing, call one of us right away, or call 911.
  3. Remove children from the area.
  4. If you’ve been exposed, and are wearing contact lenses, they need to come out right away — and tell your friends to do the same.  Better yet: don’t wear contacts if you believe there may be a chance of exposure.
  5. Don’t pour water on pepper spray; it only makes the pain worse.  But do flush out the eyes with water, saline, or milk of magnesia.
  6. Remove contaminated clothing as soon as possible.  Bring a spare shirt if you think you may be exposed.  Heavily contaminated clothing should be cut off, rather than pulled over the face.
  7. Rinsing exposed skin with a solution of milk of magnesia helps with the pain a little, but not much. 

Heat Distress

  1. Please bring twice as much water as you think you’re going to need.  Several groups are working together to provide water, but don’t count on there being enough.   
  2. If you’re feeling overheated, get inside for a bit — even if you’re only inside for fifteen minutes, it could make a big difference.
  3. If you see someone else who looks like they might be overheated, take care of them.  Ask how they feel, offer them water, suggest they go somewhere air-conditioned for a bit — anything.  We really do need to take care of each other.
  4. Remember that kids are proportionately closer to the hot pavement, and overheat faster.  Take care of them.

We’ll have a presence at Cesar Chavez Plaza, and others out biking around.  Look for the red shirts with black crosses. 

In Solidarity,

–The Phoenix Urban Health Collective