This is a safety guide I have written for PTI members to use for the Azadi March, I have taken great care in sharing advice which is tried and tested. If you have any feedback please leave in the replies. If this guide helps you- please consider sharing.
1. Planning:
Planning is good. It gets you in the right state of mind. Decision‐making is much quicker and when the unexpected happens, you are better able to handle it. No plan is perfect, and you should be prepared for things to go wrong. Hence have backup plans for when things do go pear‐shaped, such as alternative meeting points, and when just to cut your losses and leave.
Buddy Up:
If you are attending the march go in a group - the saying "strength in numbers" is very accurate and helps you look after each other and present a harder target.
Before you leave share you itinerary with at least
2 trusted contacts - this should include your route and mode of transport, your time of departure, estimated time of arrival and a safe word which can be shared via sms or over the phone to indicate you are in distress during a conversation. Make sure you consider your route planning to and from the venue to avoid harassment.
I have included a small map of the known road closures and checkpoints (These are subject to change)
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As part of your route planning have at least 2 or more exit routes - plan early to avoid an inconvenience on the day.
Maps are your friend:
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Maps aren’t just good for navigating, they can help you learn the ingress and egress routes, points of interest and emergency resources of an area that you’re planning to visit. You don’t even need a physical map, (though one is good for backup) most of this area familiarisation can be done using Google Maps or another online navigational resource in advance of your visit.
With all the advancements in technology today, there’s even a way to get a three-dimensional view of the area with online map views and Google’s Street View can be an invaluable resource to learn about terrain features in the immediate vicinity, sadly street view is not available in Pakistan, but it doesn't hurt to do a recce of an area prior to visiting it.
This is all about knowledge work. Knowledge is power and the more familiar you are with the places you visit, or even intend to visit, the more prepared you’ll be for responding to threats that could occur and where you should go during an emergency.
Make a grab-bag:
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Prepare to stay awhile. Bring energy-rich snacks, like mixed nuts or protein bars, and plenty of water. Items to consider in your rucksack:
- Water in a plastic bottle with squirt top, to drink and to wash off your skin or eyes
- Scissors and a multitool
- Flashlight
- Power bank for mobile phone
- Charger and usb cable
- Umbrella or Poncho
- Spare socks, and over shirt
- Small towel
- Whistle
- Energy snacks / Chocolate / Glucose Biscuits
- Identification and/or emergency contact information
- Enough money for easy load, food, transportation
- Wristwatch, paper, pen for accurate documentation of events
- Personal Medication such as Inhaler, insulin & prescription medication
- Basic First Aid Kit
- Wet Wipes and tissues
- Plastic Hard Hat / Baseball Cap
- Shatterproof Wrap around googles (Swimming goggles work too)
- Parna/Shawl (to be used to cover your face)
- N95 Facemasks ( Not very effective against tear gas but they provide a basic barrier for smoke)
2. Travelling to the march:
When travelling - try to travel in groups - if you are travelling on your own consider the risk of placing posters or stickers on your vehicle which may expose you to the risk of being stopped at police check posts. If you are taking protest signs and flags, consider folding these or concealing them until you get in a convoy of vehicles to avoid being singled out by police.
When approaching a police check post:
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- Slow down
- Avoid any brusque movements in the car, and keep your hands clearly up and visible.
- Stop the car a few yards from a barrier, but always keep the engine running unless ordered otherwise.
- If there is more than one vehicle, the next one keeps a certain distance
- Take off sunglasses so that people can see your face and eyes
- Put the window down; just about 2/3” enough for you to pass your id badge if needed.
- After dark, avoid using High-Beam headlights when approaching check posts
- After dark turn on the light inside the car cabin so that all passengers are clearly visible
- Be polite and comply with the officer's questions. No need to get offended and be rude.
What to wear:
- Comfortable, protective shoes that you can run in.
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- Clothing covering all your skin to protect from sun and CS gas exposure
- Shatter-resistant eye protection (i.e. sunglasses, swim goggles, or gas mask)
- Parna/Shawl to cover nose and mouth soaked in water, lemon juice or vinegar, it can aid in breathing during chemical exposure
- Fresh clothes in plastic bag (in case yours get contaminated by CS Gas)
- A hat to protect you from the sun and from CS Gas
- Earplugs
AVOID WEARING CONTACT LENSES & MAKE UP ( Contact lenses especially can soak up any oil based chemical irritants used by police such as OC spray which can increase pain and discomfort).
3. Personal Safety:
- Stay focused and aware of your surroundings at all times.
- Wear a mask and avoid touching your face.
- Stay at least 6 feet apart from others to maintain physical distancing.
- Stay hydrated by frequently drinking water.
- Don’t shake hands, hug, share drinks or engage in long face-to-face conversations.
- Cover your cough and sneeze into your elbow.
- Document injuries caused by police with photos and note the time and location.
- Turn off Face ID and Touch ID, switch to Airplane Mode and disable data.
- Enable a passcode on your phone.
- Do not share any images of protesters on social media to protect their identities.
- If your eyes exposed to pepper spray or tear gas:
- Do not rub them; blinking and rinsing are most effective.
- Tilt head sideways and rinse each eye with water (and diluted baby shampoo if available).
- Do not flush with milk, because the goal is to flush, not neutralize.
Avoiding Crush Injuries:
- If you are caught up in the crowd, stay clear of glass shop fronts, stay on your feet and move with the flow
- If you are swept along in the crush, create a space for yourself by grasping your wrists and bracing your elbows away from your sides; bend over slightly – this should allow you breathing room
- If pushed to the ground, try to get against a wall and roll yourself into a tight ball and cover your head with your hands until the crowd passes
- Remember to keep calm – the crowd should sweep past in a short space of time
- If there is gun fire, drop to the ground and cover your head and neck, and lie as flat as you can
If possible, move away from any walls, pillars and fences.
View attachment 847048
Figure 1: High pressure zones (in red) during a crowd crush. Always avoid walls/barriers/ corners during a large crowd!
Stay vigilant and help others, if you spot someone acting suspiciously or any unattended items follow these simple rules:
- Stay Alert: Referred to as Situational Awareness
- Avoid Risky Situations: No need to be a Hero
- Trust Your Instincts: If it does not feel right…avoid it
Scenario:
You notice an unattended bag left behind in the crowd:
Do you:
A) inspect it?
B) call for help?
If you chose option B, well DONE!
Slow motion footage of a briefcase bomb explosion generated by 2 oz (57 grams) of military plasticized explosive
Remember that unlike the movies it takes lengthy training and use of correct PPE and tools such as x-ray, hook, and line etc to safely dispose of an IED. If you cannot identify something, you CANNOT handle it! Simple as that.
- Vacate the area and inform security/police
- Do Not use cell phones or CB radios in close proximity to the device
- Evacuate the area minimum 200 meters, try to get behind a solid building away from any glass or falling hazards and do not return until the police have made the area safe. Terrorists are known to use primary explosions to stage an assault or gather a crowd before detonating a secondary IED.
First Aid Kit
Real medical supplies, such as gauze and instant cold packs, are best to have on hand; however, you can improvise a basic first aid kit with the following items:
- Unscented menstrual pads and tampons — can be used for bleeding control
- Gaff tape — used for securing bandages around wounded limbs. (do not stick directly to skin.)
- Sharpies — for making notes, like time of injury occurrence, person’s name and information, allergies, etc. on their skin.
Also consider bringing the following supplies for trained medical caregivers on the scene:
- Alcohol Prep pads (Box of 100 for 250 rupees)
- Surgical/Disposable gloves * Min 5 pairs
- Sterile gauze pads and wrap bandages
- 1 long strip of cardboard folded (to be used as an emergency splint)
- Medical tape
- Eye pads
- Butterfly bandages
- Instant cold packs
- Neosporin (Chipipore)
- Bandage scissors and tweezers
Emergency First Aid:
General Injuries
*Even before you ask for consent to administer first aid, always ensure that your surroundings are safe — a first aid provider that is hurt cannot help others.
Bleeding Control
The main idea for bleeding control is to prevent significant blood loss and encourage the natural clotting behaviour of blood. Procedures are generally the same for major and minor types of bleeding.
Minor Wounds — Cuts and Abrasions
Non-serious wounds, like cuts and abrasions that affect the capillaries (very small blood vessels) near the surface of the skin can be treated with simple gauze and pressure, and should generally stop bleeding after a few minutes.
To treat, cover the wound with a clean cloth or gauze and apply pressure to the wound by pushing directly on it with a single or both hands.
It is important that you do not lift the cloth or gauze (as in to check the wound) because this interrupts the body’s natural clotting process. As tempting as it is
DO NOT LIFT THE GAUZE.
For very minor wounds, the person may apply pressure to the wound themselves — just be sure that they are applying adequate pressure.
Note:
Cuts or abrasions to the face and scalp will bleed a lot, even if minor (due to the sheer amount of blood vessels that are close to the surface)
Nothing to be alarmed of unless the bleeding does not stop and the person exhibits symptoms of traumatic head injury, such as nausea, vomiting, disorientation, etc.
Major Traumatic Bleeding
If you come across major traumatic bleeding such as large gashes and punctures affect the more major blood vessels in the body, you must act immediately and seek advanced medical care.
There are two types of bleeding you may encounter: arterial versus venous bleeding.
Human Physiology in a Nutshell:
The human body has two sets of blood vessels,
arteries (carry blood from the heart to the rest of the body) and
veins (carry blood from body tissue back to the heart).
Arterial bleeds occur when arteries are damaged. These wounds
spurt blood due to the strength of the person’s heart beat pushing the blood. Bleeding from these types of wounds appear
bright red.
Venous bleeding occurs when veins are damaged. Similar to arterial bleeding, it is also more severe than capillary bleeding; however, these wounds exhibit a
steady stream of
darker red blood.
View attachment 847050
Treating Major Traumatic Bleeding
Both types of bleeding require strong compression. Following the same guidelines as above, cover the wound with gauze or cloth and apply manual pressure directly over the wound. This will cause the person pain, but understand that it is necessary.
If blood soaks through the initial gauze or cloth, again,
DO NOT LIFT THE DRESSING.
Stack more dressings on top of the wound. Repeat these steps if blood still soaks through.
Wipe away any excess blood and continue to apply pressure until more advanced medical care.
Concussion
A concussion is a (relatively) mild traumatic brain injury caused by a blow to the head or violent shaking (whiplash) of the head and body, which can vary from mild to severe, either with or without loss of consciousness.
You may encounter people with concussions due to the use of police batons or protesters being pushed to the ground.
In determining if concussion has occurred, ask the person directly, or inquire from witnesses if they saw a head injury occur.
Symptoms to watch out for: nausea, headache, fatigue, poor balance, mental confusion, or loss of consciousness.
To treat, immobilize the person’s head and do not move unless absolutely necessary for their safety. Apply ice to reduce swelling if possible.
Severe Head Injury
- In the most severe cases of head injury, brain damage is very likely, as well as spinal injury.
- Look for clear or yellow, milky fluid leaking from the ears and nose.
- This person should not be moved, as they have most definitely suffered severe head trauma.
- An ambulance must be called, as this person must be treated by a professional. While you wait for help, ensure that the person is not moved or their head disturbed in any way.
Treating for Shock
Shock occurs when the organs do not receive blood, and thus oxygen, a physiological response to trauma. If left untreated, the condition can be fatal.
The person needs professional medical care fast.
Symptoms include:
- rapid, weak, or absent pulse
- rapid, shallow breathing
- light-headedness
- cool, clammy skin
- nausea
- confusion
- anxiety
- thirst and dry mouth
Until a trained medic arrives:
- Lay the person down, if possible.
- Elevate their feet 12 inches unless they have a suspected injury to neck, head, spine, or hips. This allows blood to flow closer to their vital organs in their torso. Do not raise the person’s head.
- Turn the people on their side if they are vomiting or bleeding from the mouth.
- Keep the person comfortable and warm by loosening restrictive clothing, covering them with a coat or blanket, and keeping them still.
- DO NOT provide the person with anything to eat or drink. Someone in shock may vomit, which can result in chocking. Wait for advanced medical personnel to administer any fluids via IV.
Attenuating Energy Projectile / Rubber Bullet!
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Treating Injury from Rubber Bullets
- In the event that you are struck by a rubber bullet, two cases could be true.
- The first, no skin is not severely broken, resulting in bruising, which can be treated immediately with a cold pack.
- Second, the skin is broken. For abrasions, any bleeding should be stopped first, then should be cleaned with disinfectant, such as rubbing alcohol or Betadine.
- If the wound is deep and bleeding, follow the procedures for bleeding control. If you suspect a fracture or embedded particles, seek professional medical attention.
Oleoresin Capsicum / Pepper Spray
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Treatment for Pepper Spray
- Move the person to an isolated area, away from where pepper spray may be lingering.
- Flush the eyes and mouth with milk. The reason for this being that certain proteins in milk bind to the molecules of capsaicin, lifting them off the surface of your mouth/eyes and allowing them to be flushed away.
- Follow up by flushing with clean water to remove milk residue.
- Flush affected skin as well.
- Remove any contaminated clothing. It is best to avoid pulling clothes over the head, where they can re-contaminate the eyes and nose; however, do whatever is possible at the moment.
2-chlorobenzylidene malononitrole / Tear Gas
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Treatment for Tear Gas
- Move to a ventilated area, away from tear gas immediately. Fresh air is vital to steadying respiratory distress.
- Flush the eyes, mouth, and nose, out with clean water. It is not required that you use milk, as there is no capsaicin chemical in tear gas to break down.
- Flush the skin with water. It is important to flush away any and all traces of the powder, which can cause burns left on the skin for extended amounts of time.
- Remove contaminated clothes. As similar to pepper spray, avoid pulling over the head.
WARNING: It is important that you do not attempt to pick up a deployed tear gas grenade without proper protection. It is important that you do not attempt to pick up a deployed tear gas grenade without proper protection.
Shrapnel
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Treating Shrapnel Injuries
It is important that you
DO NOT TOUCH THE SHRAPNEL and seek advanced medical care.
Your first instinct may be to remove the embedded object(s); however, in most cases, the shrapnel is providing pressure against the blood vessels, preventing any bleeding. (This concept also holds true for any type of impalement.)
For injuries with small pieces of shrapnel, stop the bleeding by following the procedures discussed in the section: Bleeding Control, and seek a medic.
Do not apply direct pressure to wounds with large impaling objects. Place two rolled up pieces of gauze/cloth at the base of the object — one on each side — to immobilize the object, and seek advanced medical care.
Medical Conditions
Under the stress, adrenaline, and exhaustion of being on the streets for long hours at a time, pre-existing medical conditions may pose issues up while at a protest.
Diabetes
People with diabetes are often very diligent with self-care. However, the dangers of insulin shock can occur if they do not eat at regular intervals.
Insulin shock occurs when a diabetic person is hypoglycaemic, meaning their blood sugar has dropped below safe levels. These people can become unconscious and slip into a seizure or coma if left untreated.
Because people with diabetes are often self-aware, they most likely know the treatment they need. It is best to listen to them and offer any help they tell you they need.
Treating Insulin Shock
If the person is coherent and conscious, provide them with high-sugar food to raise their blood sugar level back up.
If the person is unconscious, seek immediate medical help. Do not attempt to administer anything orally, as they may choke.
Anaphylactic Shock
You may come across someone suffering from anaphylactic shock as part of a severe allergic reaction.
A person with known allergies should carry an epinephrine pen (EpiPen). So in this case,
- summon a medic
- ask if the person is carrying an EpiPen with them and if they need help administering it. (In most cases, they can do it themselves.)
View attachment 847057View attachment 847058
Image: Standard Epipen prescribed in Pakistan.
While it is best to find someone trained to administer an EpiPen, anyone can do it.
If the person needs help administering, follow these steps. (Clear instructions are marked on the EpiPen itself.)
- Carefully remove the EpiPen from its clear carrier tube.
- Remove the blue safety release on the back end of the EpiPen by pulling straight up.
- Grip the barrel of the EpiPen in your hand with the orange tip pointing to the person. Make sure not to touch either end of the EpiPen with your fingers, doing so could result in accidentally stabbing yourself.
- Firmly inject the orange tip into the middle part of your upper thigh, pushing until it “clicks.” It sounds violent, but you really need to stab firmly. If the orange tip does not depress, the drug is not being administered.
- Hold the EpiPen in place for at least 10 full seconds.
- Remove the EpiPen and gently massage the area of the injection for about 10 seconds.
- Seek medical help by dialling 1122/911
Heart Attack
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Important: Symptoms can manifest differently in (at-birth-assigned) males versus (at-birth-assigned) females.
Symptoms in Males:
- discomfort/tingling in arms, back, neck, shoulder, or jaw
- chest pain
- shortness of breath
Symptoms in Females:
- sudden dizziness
- heartburn sensation or chest pressure
- nausea
- sudden tiredness
- cold sweat
- sudden paleness
What to Do:
- Act quickly to summon a medic.
- Be ready to perform CPR if you know how, or find someone who can until help arrives.
Compression Only CPR Video:
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Heatstroke and Heat Exhaustion
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Heatstroke and heat exhaustion are similar, yet two different things.
Symptoms of Heat Exhaustion:
- moist and clammy skin
- pupils dilated
- normal or subnormal temperature
Treating Heat Exhaustion:
- Rest in a cool place, preferably air-conditioned but at least in the shade
- Lie the person on their back and raise their legs above their heart level
- Drink cool fluids. Sports drinks with electrolytes aid in treating dehydration, which may be a factor in the cause.
- Remove any unnecessary clothing to help cool temperature
Symptoms of Heatstroke:
- dry hot skin
- appears to have a fever
- very high body temperature
- no sweating — this is a characteristic symptom
Heatstroke is an emergency. A person can go into a coma and die if left untreated.
Treating Heatstroke:
- Call 1122/911 immediately. Heatstroke requires hospital treatment.
- Move the person to a cool place
- Remove any unnecessary clothing (clear unnecessary bystanders, for privacy, and strip them to their underwear.)
- Take any action to reduce their body temperature, such as spraying them with cold water or fanning them.
- If possible, apply ice packs to the groin, armpit, and neck regions, but cover their body as much as possible in any case.
- If the person is conscious, you can offer them cool fluids (water, sports drink) to drink while sitting up. However, most people suffering heatstroke are not in a mental headspace to safely accept fluids orally.
- Again, call 1122/911. This person needs to be taken to the hospital.
Seizure/Epilepsy
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For this section, I am referring to a grand mal seizure; the one where the person falls to the ground, shaking, limbs rigid, eyes rolling back, clenched jaw.
If the person knows themselves to have epilepsy or seizure spells, they may feel it before it happens, but sometimes, there may be no signs at all.
Treating for Seizures:
- get a medic
- clear the area of objects and people that the person could hit during the seizure
- do not intervene, let the seizure run its course. Do not try to restrain the person or put something between their teeth.
- After the seizure stops, turn the person on their side in case they vomit, which can be dangerous if inhaled
- When the person regains consciousness, the may be disoriented and/or exhausted. They may also be embarrassed for having urinated or defecated themselves. Offer covering and a change of clothes if possible.
- If they tell you they have never experienced a seizure before, they need medical attention immediately.
Emergency Telephone numbers:
- Police 911 / 15
- Ambulance / Rescue 1122/911
- Fire 16/911
- Bomb Disposal Squad 15/911
- Asma Jahangir (AGHS) Legal Aid Cell 042-35842256-7 (If wrongfully arrested/detained)
@ghazi52 @Ghazwa-e-Hind @Norwegian @LeGenD
Please feel free to share with anyone who may benefit.
