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Riot-related injuries managed at a hospital in Beirut, Lebanon

  • Author Footnotes
    1 Authors had equal contributions to the manuscript and are co-first authors.
    Tharwat El Zahran
    Correspondence
    Corresponding author at: Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
    Footnotes
    1 Authors had equal contributions to the manuscript and are co-first authors.
    Affiliations
    Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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  • Author Footnotes
    1 Authors had equal contributions to the manuscript and are co-first authors.
    Hala Mostafa
    Footnotes
    1 Authors had equal contributions to the manuscript and are co-first authors.
    Affiliations
    Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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  • Hani Hamade
    Affiliations
    Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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  • Zeina Mneimneh
    Affiliations
    Quality Accreditation and Risk Management Program, American University of Beirut Medical Center, Beirut, Lebanon
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  • Ziad Kazzi
    Affiliations
    Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Department of Emergency Medicine, Emory University, Atlanta, GA, USA
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  • Mazen J. El Sayed
    Affiliations
    Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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  • Author Footnotes
    1 Authors had equal contributions to the manuscript and are co-first authors.
Published:January 04, 2021DOI:https://doi.org/10.1016/j.ajem.2020.12.084

      Highlights

      • Riot control agents can lead to mortality and permanent morbidity.
      • Appropriate training of personnel on the use of riot control agents is direly needed.
      • Directing the scarce resources of hospitals especially during pandemics is crucial.
      • The safety profile of teargas and rubber bullet use needs to be revisited.

      Abstract

      Background

      Between October 2019 and February 2020, massive crowds protested in Lebanon against economic collapse. Various less than lethal weapons including riot control agents and rubber bullets were used by law enforcement, which led to several traumatic and chemical injuries among victims. This study describes the clinical presentation, management, outcome, and healthcare costs of injuries.

      Methods

      A retrospective review of the hospital records of all the casualties presenting to the Emergency Department of the American University of Beirut Medical Center between October 17th, 2019, and February 29th, 2020, was conducted.

      Results

      A total of 313 casualties were evaluated in the ED, with a mean age of 30.2 +/− 9.6 years and a predominance of males (91.1%). Most were protestors (71.9%) and arrived through EMS (43.5%) at an influx rate of one patient presenting every 2.7–8 min. Most patients (91.1%) presented with an Emergency Severity Index of 3. Most patients (77.6%) required imaging with 10% having major findings including fractures and hemorrhages. Stones, rocks, and tear gas canisters (30.7%) were the most common mechanism of injury. Musculoskeletal injuries were most common (62.6%), followed by lacerations (44.7%). The majority (93.3%) were treated and discharged home and 3.2% required hospital admission, with 2.6% requiring surgery.

      Conclusion

      Less-than-lethal weapons can cause severe injuries and permanent morbidity. The use of riot control agents needs to be better controlled, and users need to be well trained in order to avoid misuse and to lessen the morbidity, mortality, and financial burden.

      Keywords

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