การจลาจล?

RIOT ?

Civil unrest ?

การจลาจลและระบบบญชาการ(RIOT)

Prasit Wuthisuthimethawee, MD, FRCSTDepartment of Emergency Medicine, Faculty of Medicine, Prince of

Songkla University, Hatyai, Thailand

A crowd of population

Specific population or mixed depend on activity or purpose

Type of crowd- Casual crowd

- Group of people without organized- No common interest or purpose- No leader

- Cohesive crowd- Some specific purposes and common

interest- Not well-defined leadership

Type of crowd- Expressive crowd

- Group of people with well-organized- Common purposes e.g. against something- Well-defined leadership

- Aggressive crowd- Positive leadership and strong emotion- Aggressive action and possibly destruction

Full scale riot- Demonstrator- Opposing groups- Law enforcement

Toxicol Rev. 2006;25(3):155-97.

There is no riot without rumor

Multiple casualties

Significant challenge to local health care institutions

Riot and civil unrest increasing worldwide

Community needed to be prepare

National and international societies

Political and discriminating problems

Economic problems

Circumstance of riot- Cause- Overall magnitude- Frequency- Timing- Geographic location- Number of persons involved

Circumstance of riot- Demographic of participants- Influence of extremist- Confrontation with opposing groups- Control measures used by law

enforcement agencies

Methods used by law enforcement

- Negotiation- Verbal warning

Methods used by law enforcement

- Physical measure- Restraint holds- Truncheon- Batons- Mounted horse- Projectiles- Water cannon- Taser - Plastic or rubber bullets

Associate with pain and immobilization

Soft tissue and bone injury

Death

Methods used by law enforcement- Chemical measure

- Screening smoke- Malodors- Peripheral chemosensory irritants (PCSIs)- Smoke, powder cloud, aerosol, vapour,

solution

Cause distraction, Transient harassment

Incapacitation

Temporary impairment of the conduct of coordinated tasks

Eye, respiratory tract and skin

Lacrimation, blepharospasm, rhinorrhea, sialorrhea, cough and breathing difficulty

Brief exposure can resolve

Long term and high concentrate exposure can cause tissue injury and systemic toxicity

Injury are inevitable

Slight trauma

Severe physical and chemical injury

Psychological injury

Death

Medical requirement

Stampede and crushes

Special requirement

Attractive for terrorist attack

Hospital should prepare for wide range of casualties

Heterogeneous groups

Wide range of age, gender

Individual underlying dis

Decontamination

Triage

Medical perspectives- Assurance- Evaluation for possible ocular, skin,

respiratory and GI effects - Psychological support

Medical perspectives- Effects

- High blood pressure- Increase intra-ocular pressure- Bradycardia

Hospital planning- Good information- Preparation for medical and support

staff readiness- Equipment- Medicine

Both local and government levels

Local preparedness- Information gathering- Education- Training- Ensure facilities and staffing- Equipment and medicine- Coordination with local police and

others and also central or government

Central preparedness- Information gathering- Audit- Support regional- Cooperative interaction

ResponseSafetySearch and rescueDecontamination; primary and secondaryInitial management esp life threathening conditionsPrimary careTransportationCommunicationMorgueForensic

Distribution of injury• Distribution of injury

– Severe 8-10%– Moderate 20-30%– Mild 60-70%– Dead < 5%

• Preparedness procedure including security

Psychological problem

• Procedures– Family coping– Religion– Community self help group– Relaxation exercise– Cultural and spiritual– Counseling– Adequate service provided

D-I-S-A-S-T-E-R

• D-detection• I-incident command system• S- safety and security• A-assess hazards• S-support• T-triage, treatment, and transport• E-evacuation• R-recovery

Communication- M-major incident- E-exact location- T-type of incident- H-hazards- A-access- N-numbers of casualties- E-emergency services

C-S-C-A-T-T-T

• C-command and control• S- safety• C-communication• A-assessment• T-triage• T-treatment• T-transport

AmbulanceCollecting point

Ambulance

Decontamination

Triage, Treatment

InOut

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ระบบบงคับบญชา

Plan of disturbance- Identify critical areas or possible

trouble spots- Code signals for immobilization of

the force- Coordination with other municipal

agencies

Communication equipment - Public address system- Mobile telephone- Bullhorn- Walky-talky- Radio telephone- Amateur radio- Satellite system

(i) Oxygen equipment (ii) Police barriers and ropes (iii) Vehicles for transportation of personnel,

equipment and prisoners. (iv) Stretchers, cots, blankets, first aid

equipment. (v) Photographic equipment to document the

action for future reference.

Other equipment

Intelligence (i) Every sources of information must be

cultivated.(ii) The temper of the community must be known.(iii) Rumors must be reported (iv) Names and description(v) Factual and opinion data should be collected.(vi) Time and location of the gathering as well as the purpose.(vii) A reasonable estimate of the estimate of the expected attendance and the identification of likely antagonistic groups.

Strategy to followed - Overall strategy should be based on the precept

“contain, isolate, disperse”. - Special zone from which all unauthorized

vehicular traffic proceed may be excluded. - The requirement of the situation coupled with

the availability of personal, space, and equipment will serve as limiting or modifying factors in the preparation of any plan.

- The innermost area is the critical area surrounded by isolation zone. The strategy here is to prevent the curios from joining the disorderly and thereby contain the existing situation.

Tactic to employ (i) Speed and Decisiveness

(ii) Field commander will not use his first tactics until sufficient force is available.

(iii)Should arrive and form out of the mob’s sight, to prevent attack by the mob before they got organized.

(iv) May now issue over the public address system his proclamation to disperse.

(v) Foot patrol at strategic places will tactfully and firmly.

(vi) A divided and leaderless mob is a far less formidable adversary.

(vii) Agitators who are strategically placed throughout the mob should be identified and removed as soon as the opportunity to do so presents itself.

Dealing with the crowd and riot can be challenge and dangerous

Crowd and RIOT management- Calming the crowd- Providing security- Setting up barricades- Coordinating people esp leader at

activities

Crowd and RIOT management- Search and rescue- Triage, Basic treatment and

transportation- Managing unhurt people- Managing shelter- Distribution of food, water, etc

Crowd and RIOT management- Traffic control and management- Provide direction and assistance- Communicate with team leader and

chain of command- Maintain orderly scene

Basic components- Incident command system (ICS)- Scene sizeup- Maintaining scene safety- Team communication

Purpose of scene management- Maintain safety to responders- Provide clear leadership and

organizational structure- Improve effectiveness of rescue

efforts

Scene sizeup- Gathering the facts- Assess and communicate situation

or damage- Consider probabilities- Assess your own situation- Establish priority

Scene sizeup- Make decision- Develop a plan of action- Take action- Evaluate progress

Communication- Heart of scene management- Vital for safety- Radio is usually used- Inform each others while situation

change- Leader make decision based on

team input

Squad Line - Used in a small areas. Usual purpose: holding

formation; to block entrance to a building; deny area to a crowd; block a street; clear a crowd out of a confined area. Commands: Verbal – SQUAD LINE, MOVE! The command may be given by arm signal.

Specific riot control formations

Squad Wedge. - Generally used as a striking force. It should not move so far into a crowd as to permit the crowd to encircle the formation. Command: SQUAD WEDGE, MOVE! May also given by arm signal.

Do not use force or violence to manage the crowd

Do not jeopardize your own and others safety

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