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ED Operations During Mass Protests and Civil
UnrestJames Phillips, MD, FACEP
Chief, Disaster and Operational Medicine
Department of Emergency Medicine
@DrPhillipsMD
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Medical Intelligence
• Nature of the event • planned vs not, permit, size, location, purpose
• Presence of opposition counter-protestors
• Present of large police force
• Medical Threat Assessment• Weather, threats of violence, etc.
• Medical resources available
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Hospital Preparation
• SPACE – surge capacity, alternate care sites,
segregation of patient groups, decon plan
• STAFF – additional MD & RN, security,
environmental services, EOC activation
• STUFF – decontamination, eye treatments,
nebs, clothing, trauma supplies
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Crowd Dispersal
• Chemical Agents
– Tear Gas (CS)
– Pepper Spray (OC)
– Mace (CN)
• Less Lethal Projectiles
GARY CHALKER/GETTY IMAGES
[Roberto Schmdt/AFP]
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Decontamination
• Receiving and Decontamination Process
– Avoid exposing staff and ED to chemicals
• Shower Plan
– Decontamination agents (soap and water)
– Includes clothing replacement
– Plastic bags for contaminated clothing
• Eye Wash and Exam Plan
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Trauma
• Potential for trauma varies.
• Plan for more staff
• Blunt injuries
• Projectile injuries
• Face, eyes, genitals
• Burns
• Expect the unexpected
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Charlottesville, VA August 12, 2017
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A Case Study
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