Disaster Preparedness and Management
Disaster Preparedness and Management
Disaster Preparedness and Management
Welcome to Chapter 4!
In the previous chapter, you have learned much about the different issues and
problems that concern us, citizens and our country as a whole. You are now aware of the
Millennium Development Goals (MDG) as it calls us to do our part whether big or small
action to respond to the world’s main development challenges.
In this chapter, you will be re-introduced to the current Philippine disaster situation,
how our government, local sectors and private institutions work together for a cohesive
Disaster Risk Reduction Management Program. Also prepare to be trained in basic first aid
and immobilization procedure, a necessary preparation in disaster prone country like the
Philippines.
LESSON 1:
At the end of this lesson, the students will be able to:
Let us see how much you know about the current situation of our country
specifically to Metro Manila. If your familiar with the facts that will be
detailed below, that’s a good job. For those who encounter these for the
first time, this is a moment for you to reflect on the things that might
happen to us if a disaster will happen in the country. The important
question that we need to answer is…
It lies in the path of turbulent typhoons, with an average of 20 typhoons crossing the
Philippine area of responsibility. The archipelagic nature of the Philippine coastal areas
increases susceptibility to storm surges, tsunamis and sea level changes.
The country experiences floods and landslides which are common due to rains brought
by typhoons and monsoon. Located in the western part of the Pacific Ocean, the
country is also vulnerable to the El Niño Southern Oscillation (ENSO). The El Niño of
1997-98 induced drought and delayed the onset of monsoon, which resulted to a
scarcity in drinking water in urban areas and shortfalls in hydro-electricity generation
because of reduced water levels in major dams.
Thus, the potential for natural disaster in Metro Manila is high and the reduction of
its vulnerability is a pressing issue for the safety of residents.
Now you see how much our country is prone to a lot of disasters! In an effort to prepare
for such disasters, the Philippines and Japan government worked
together to come up with a comprehensive study called Metropolitan
Manila Earthquake Impact Reduction Study (MMEIRS). Isn’t this exciting!
Let us see how the study went.
MMEIRS results
Take note and study the DOMINANT DISASTER MANAGEMENT POLICIES IN THE
COUNTRY. Reflect on it and verify with your own experience how true and relevant this is.
Try to analyze its effectiveness in managing impending disaster. Do you find it useful and
effective?
All attention of disaster response is focused on the hazard and the disaster
event itself
Reactive, response-oriented
Disaster preparedness is inadequately integrated into the overall
development planning process
Non-participatory
It follows a top-down, control of policies
It is also interesting to note how an ordinary Filipino views disaster. These prevailing views
and attitude is a relevant principle in our assessment of our vulnerability and our capacity to
cope and respond.
These common notions about how we view disaster are not flattering at all. In fact one
expert in disaster management cited that “disasters in developing countries were
caused by people’s lack of knowledge of natural hazards, absence of monitoring
system, failure of warning system, weakness of emergency preparedness, the
disorganization of post –disaster management and lack of security measures”
(Berbilidin:1990)
http://www.rivertoncity.com/community.emergency.html
Before we get our gears ready, let us first define some important terms and
concepts:
Hazards
any phenomenon, substance or situation,
which has the potential to cause disruption
or damage to infrastructure and services,
people, their property and their environment.
Can be:
NATURAL (i.e. earthquakes, droughts)
HUMAN INDUCED ( i.e. industrial
accidents, armed conflicts)
ENVIRONMENTAL (i.e. loss of
biodiversity,
ozone depletion, deforestation)
http://www.onsafelines.com/new-international-coshh-symbols.html
Vulnerability (weaknesses)
A concept which describes factors or constraints of an economic, social,
physical or geographic nature, which reduce the ability of a community to
prepare for and cope with the impact of hazards
Capacities (strengths)
The resources and skills people possess, can develop, mobilize and
access which allow them to have more control over shaping their own
future and coping with disaster risks
The existing strengths in individuals and social groups – related to
people’s material and physical resources, their skills, their social resources
and their beliefs and attitudes (e.g. ownership of land and safe location of
homes, adequate income, adequate food resources, savings etc.)
(Anderson:1989)
These are various activities, projects and programs that the communities
may identify after assessing and analyzing the risks that they face. These
measures are specifically intended to reduce the current and prevent future
risks in the community.
TAKE tfOTE: Adisaster resilient community (individual has the capacity or ability to anticipate, prepare for, respond to
and recover quickly from the impacts of disaster.
Now let us move on to the natural disasters that commonly hit the Philippines. As the
cliché goes information is knowledge, so let us be guided by the following
disaster guidelines and be familiar with it. It would be helpful if you don’t
keep these information to yourself, share it with your friends, families and
neighbors. It is better to be prepared than sorry!
A. Earthquake
(http://www.ompongplaza.org.ph/MMEIRS/02_VOL2_MAIN1/MAIN1_02.PDF)
B. Tsunami
Tsunamis are giant sea waves
generated by the under-the-sea earthquakes
and volcanic eruptions. Not all underwater
earthquakes and volcanic eruptions,
however, can cause the occurrence of
tsunamis. Tsunamis can only occur when the
earthquake is shallow-seated and strong
enough to displace parts of the seabed and
disturb the mass of water over it. Although
tsunamis may be triggered in various ways, Japan Tsunami[Image](n.d.). Retrieved from:
their effects on coastal areas are similar. http://www.cartoonaday.com/tag/japan-tsunami-
cartoon/
1. A felt earthquake
3. Rumbling sound of
approaching waves
1. When you’re in a building (such as offices, malls etc.), make sure to know where the
“FIRE EXIT” is located.
2. Use a fire extinguisher to put out small fires. You can also use water if the fire is not
electrical or chemical. Do NOT try to put out a
fire that you can’t control.
3. If there’s a fire that is too big to put out, leave the
place immediately.
4. If you can see smoke in the house, stay low to
the ground as you make your way to the exit.
5. Do not run, if your clothes catches fire but “Stop
Drop and Roll” instead.
6. When you’re trap in a room, do the following:
a) Check to see if there’s heat or smoke
coming in the cracks around the door.
b) Don’t open the door when you the
smoke coming under the door.
c) Touch the door if you don’t see the smoke. If it’s hot or very warm then
don’t open it.
d) If you don’t see smoke and the door isn’t hot, then slightly use your fingers
to lightly touch the doorknob. If it’s hot, don’t open it.
e) If the doorknob feels cool and you don’t see any smoke around, only then
you can open the door slowly and carefully.
f) When you open the door and you feel a burst of heat or see smoke pours
into the room, quickly close the door and make sure it is really closed.
g) If there’s no smoke or heat when you open the door, quickly make your
way out.
h) Yell for help.
Sources:
Bureau of Fire Protection. (2009). Fire code of the Philippines. Retrieved from:
http://www.bfpresponse.gov.ph/RA9514%20IRR%20Signed%20by%20SILG.pdf
1. If there has been a period of heavy rainfall and you are in a landslide prone area, you may
be at risk of a landslide.
2. If you remain or are caught suddenly at home, move to a second story if possible. Staying
out of the path of a landslide or debris flow saves lives.
3. Listen for any unusual sounds that might indicate moving debris, such as trees cracking or
boulders knocking together. A trickle of flowing or falling mud or debris may precede larger
landslides. Moving debris can flow quickly and sometimes without warning.
4. If you are near a stream or channel, be alert for any sudden increase or decrease in water
flow and for a change from clear to muddy water. Such changes may indicate landslide
activity upstream, so be prepared to move quickly. Don't delay! Save yourself, not your
belongings.
5. Be especially alert if you are driving. Embankments along roadsides are particularly
susceptible to landslides. Watch the road for collapsed pavement, mud, fallen rocks, and
other indications of possible debris flows.
6. Whenever you are in the path of a landslide or debris flow, move away as quickly as
possible. If escape is not possible, curl into a tight ball and protect your head with your
hands or a helmet.
7. Landslides are extremely dangerous, so it is far better to evacuate immediately if you
suspect imminent danger than to ponder the potential.
Sources:
Centers for Disease Control and Prevention. (n.d.). Key Facts About Protecting Yourself During a Volcanic Eruption. Retrieved
from: http://www.bt.cdc.gov/disasters/volcanoes/during.asp
Ezine Articles. (n.d.). Volcano Eruption - 15 Important Factors To Prepare. Retrieved from: http://EzineArticles.com/1662110
Philippine Institute of Volcanology and Seismology. (2008). Active Volcanoes. Retrieved from: http://www.phivolcs.
dost.gov.ph/index.php?option=com_content&view=article&id=57:active-volcanoes&catid=55&Itemid=114
. (n.d.). Safety During Volcanic Eruptions. Retrieved from
: http://www.healthypinoy.com/health/articles/disaster-preparedness- volcanic-eruption.html
G. Typhoon
The Philippines’ geographical location and physical environment make it
vulnerable to natural hazards such as tropical cyclones, floods, extreme rainfall,
thunderstorm (TSTM), storm surges, strong winds, tornado and others. Every year,
these hazards bring havoc to life
and property, seriously disrupt our
agriculture-based economy and disturb
the lives of millions of Filipino families. In
2009, a series of typhoons hit the
country over a five-week period.
Typhoons Ondoy, Pepeng, Ramil and
Santi brought flooding,
extensive
destroyed properties and caused
number of casualties in different regions a
of the country as many were caught
unaware of intensity of
typhoons the Source: Typhoon [Image](n.d). Retrieved from: these
. http://ecohope.blogspot.com/2009/09/typhoon-ondoy-in-manila-philippines.html
Source: Philippine Institute of Volcanology and Seismology (PHILVOLCS). (n.d.). The Philippine Storm Warning
Signals. Retrieved from: http://kidlat.pagasa.dost.gov.ph/genmet/psws.html
1. Listen to the radio or local news for updates on the direction and strength of the typhoon.
2. Secure or move inside outdoor items such as toys, grills, bicycles, furniture, plants and
anything moveable on the balcony. Move potted plants and other heavy objects away from
windows inside as well.
3. If you live in a two-storey home, stay on the first floor in an interior room. If you live in a
multiple-story building and are away from storm surges, take refuge on the first or second
floors in the hallways.
4. Turn the refrigerator and freezer up to the highest setting. In the event that electricity is cut
off your refrigerator and freezer will stay colder longer.
5. Fill your bathtubs, sinks, and other containers with potable water for using if water service is
disrupted and contaminated by flooding.
6. Keep flashlights, candles and battery-powered radios within easy reach.
7. Prepare foods that need not be cooked.
8. Should you need to evacuate, evacuate calmly. Close the windows and turn off the main
power switch; put important appliances and belongings in a high ground; and avoid the way
leading to the river. Bring clothes, first aid kit, candles/flashlight, battery-powered radio and
food.
9. After the typhoon, if your house was destroyed, make sure that it is already safe and stable
when you enter.
10. Watch out for live wires or outlet immersed in water; report damaged electrical cables and
fallen electric posts to the authorities.
11. Do not let water accumulate in tires, cans or pots to avoid creating a favorable condition for
mosquito breeding.
Sources:
CHED Memorandum Order No. 34. (2010) Commission on Higher Education (CHED). Retrieved from:
http://202.57.63.198/chedwww/index.php/eng/Information/CHED-Memorandum-Orders/2010-CHED-Memorandum-Orders
DepED Guidelines on the Suspension of Classes. (2005). Department of Education. Retrieved from:
http://www.deped.gov.ph/e_posts.asp?id=475
Philippine Institute of Volcanology and Seismology (PHILVOLCS). (n.d.). The Philippine Storm Warning Signals. Retrieved from:
http://kidlat.pagasa.dost.gov.ph/genmet/psws.html
CHAPTER 4:
Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: SingaporeDISASTER RISK REDUCTION MANAGEMENT
Government. IN
Typhoon Preparedness. (n.d.). Retrieved from: http://www.pdfio.com/k-430968.html# THE PHILIPPINES Page 17 of 46
Dealing with an impending disaster is a responsibility that is dealt NOT
solely by a single family or the community leaders or the government.
Managing disaster is encompassing to all sectors of the society. In
managing disaster a careful analysis of the community must be done.
Earlier in this chapter you have learned that a community that has high vulnerabilities
when hazard is experienced, a DISASTER is very likely to happen.
http://pinoyexpat.net/%E2%80%9860-of-ofw-families-are-
poor%E2%80%99/
This process determines how people respond in time of crisis to reduce the damaging
effects of hazards. Also it determines the coping strategies and resources of the
communities.
http://www.pfpi.org/about.html
A. Physical / Material
Cash, land tools, food, jobs Asset Pentagon
HUMAN
B. Social / Organizational
Social Networks
Extended Family SOCIAL NATURAL
Local and National welfare Institutions
C. Attitudinal / Motivational
Sense of Control
Power PHYSICAL FINANCIAL
Confidence
Skills
If you combine the data you gathered from the vulnerability and capacity
assessment you will come up with this matrix below.
This is the most usable tool in PCVA.
Vulnerabilities Capacities
Physical /Material
What productive resources,
skills and hazard exist?
Social/Organizational
What are the relations and
organizations among people?
Motivational/Attitudinal
How does the community view
its ability to create change?
Aside from the PCVA matrix tool above, the facilitator may also choose to use any of the
following tools whenever it deemed appropriate.
Seasonal
Calendar
http://www.fao.org/docrep/V1490E/v1490e02.htm
Our history has been a witness to the shifts and developments of disaster
management of the country. The most notable has been the shifts of focus from disaster
response to the recognition and strengthening of mitigation measures. These points to the
commonly held misconception that disaster management involved only with response,
whereas, in fact, response constitutes only one phase of the whole disaster management
continuum (Rosales, 2001). Now, formal structures, offices and organizations are in place
to manage disaster that comes our way.
Rather than being on the reactive gear, you should start working
the anticipatory measures and strategies that will further facilitate the
Philippines shift from a culture that concentrate on response (eg. mass
collection for relief operation) during actual disaster to one that actually
pays attention to equally significant considerations like preparedness,
mitigation, recovery and rehabilitation
1. Discuss the importance of first aid, its definition and aims, and the need for
properly prepared first aiders.
2. Explain how to recognize a medical emergency and demonstrate the sequence
of first aid response upon recognition of the emergency.
3. Describe and conduct:
a. Scene survey of an emergency.
b. Primary survey or initial assessment of a victim in an emergency using the
ABCD approach.
4. Exercise good-decision making in prioritizing the needs of a victim in an
emergency.
5. Demonstrate ways to establish and maintain an open airway
6. Use the “look, listen, feel” assessment method of determining breathlessness.
7. Demonstrate skills in recognizing and managing internal and external bleeding
8. Demonstrate skills in recognizing and managing fractures including the use of
splints
9. Demonstrate the different methods in transporting a victim in an emergency
setting.
I. INTRODUCTION
This illustration clearly demonstrates the need for first aid training. It’s better to know it
and not need it than to need it and not know it. How people respond to an
CHAPTER 4: DISASTER RISK REDUCTION MANAGEMENT IN
THE PHILIPPINES Page 24 of 46
emergency before medical help arrives often determines how well a victim recovers. In
extreme cases, it can spell the difference between life and death.
First aid is the temporary and immediate care given to a person who is injured or who
suddenly becomes ill. It can also involve home care if medical assistance is delayed or
not available. First aid includes recognizing life-threatening conditions and taking
effective action to keep the injured or ill person alive and in the best possible condition
until medical treatment can be obtained or until the chance for recovery without medical
care is assured.
First aid does not replace the physician, nurse, or paramedic. In fact, one of the primary
principles of first aid is to obtain medical assistance in all cases of serious injury.
Everyone should be able to perform first aid since most people will eventually find
themselves in a situation requiring it, either for another person or for themselves. Since
you might be the person to respond first at the scene of an emergency, you need to
know how to recognize emergencies and how to respond in a way that best protects
and aids the victim.
The initial step in recognizing an emergency is noticing that something is wrong. But
generally, you will know when an emergency happens. You can tell by the type of
injuries or by how the victim looks.
Of greatest concern to First aiders and others in emergency setting are infectious
diseases especially Hepatitis B, meningitis, tuberculosis and AIDS. You can minimize
your risk of infection by wearing protective gloves; wearing other protective gear as
appropriate; using pocket mask during mouth-to-mouth resuscitation; and washing your
hands thoroughly after any contact with a victim.
You are a vital link between the EMS system and the victim. Delaying these actions
presents significant dangers to the victim.
Your first priority when preparing to perform first aid is to ensure your own personal
safety. Never risk your own personal safety. Next, you will ensure the safety of the
victim and any bystanders at the scene. Always assess the situation from a safety
standpoint first. Do a 10-second survey that includes looking for three things:
If at all possible, put on protective gloves to guard against exposure to any blood or
bodily fluids. Prior to approaching the victim, quickly scan the area for any hazards
such as downed power lines, spilled fuel, weapons, and an unstable vehicle or
structure. If the scene is not safe, you can either make it safe by removing the
hazard, if possible, or retreat from the scene and get help before proceeding. Never
attempt a rescue that you have not been specifically trained to do. Remember,
staying safe is your first priority; you won’t be able to help someone else if you
become victim yourself.
The scene can also provide clues to whether the victim is injured or ill. For example,
if you note a ladder next to a person lying on the ground, you would assume the
victim is injured from a fall. This is referred to as the mechanism of injury. If a person
is found sitting in a chair in a restaurant, you would assume the victim is ill.
Knowing the mechanism of the injury will allow you to give useful information to the
EMS personnel who will later attend to the victim. This will enable the physician to
fully recognize the extent of injuries.
Also determine the number of injured people. Once you have determined the
number of victims, you can then have a bystander contact the necessary resources.
You may request more than one ambulance if you find several people who are
injured or ill. And also, if there is more than one victim, you will have to prioritize
To begin, establish rapport with the victim by introducing yourself and explaining that
you are there to help. It would be very helpful to demonstrate competence,
confidence and compassion. Obtain consent to treat before assessing the victim.
During the first minutes of an emergency, it is essential that the EMS system be
activated. Calling anyone else first only wastes time. If the situation is not an
emergency, call your doctor. However, if you are in any doubt as to whether the
situation is an emergency, activate the EMS system.
As a general rule, activate EMS whenever a situation is more than you can handle.
If you are in at UST here are the important numbers that you can contact in case of
emergencies:
Assessing the victim is one of the most important and critical parts of first aid. The
assessment is conducted to identify and care for immediate life threats to the airway,
breathing and circulation. Some injuries are obvious; others are hidden. A conscious
victim may be able to guide you to the problem – but an unconscious victim will be of
no help at all.
The respiratory, circulatory and nervous systems include the most important organs
in the body: the heart, lungs, brain and spinal cord. A serious problem in any of
those three body systems generally produces a serious threat to life. And if any one
of those systems stops functioning, death occurs within minutes. The goal of the
primary survey is to quickly assess the three most important body systems to
determine any life-threatening condition so that it can be corrected immediately.
Unless you find a life threatening situation that needs to be treated immediately, you
should be able to complete the primary survey in approximately 60 seconds. The
effectiveness of your first aid will depend on effective assessment – you need to find
what is wrong before you can treat it.
These steps provide a quick assessment of the victim’s overall condition. The rest of the
primary survey consists of evaluating the ABCDs- airway, breathing, circulation (pulse and
bleeding), and disability (nervous system disability or altered responsiveness).
a. Establish Airway
Determine whether the airway is open. If the victim is conscious or talking, the
airway is open. If the airway is not open, use either the head-tilt/chin lift maneuver or
the modified jaw thrust maneuver to open it (see later discussions). Use only the
modified jaw thrust maneuver if a spine injury is suspected.
If the victim is unconscious, the tongue can relax, fall back, and block the airway; the
epiglottis can also relax and block the throat. Sometimes, the victim’s efforts to
breathe can create negative pressure that draws the tongue or the epiglottis, or both
into the airway. In these cases, opening the airway may be all that is needed to
restore breathing.
If you see liquids (such as vomitus) in the mouth, wrap your index and middle fingers
in cloth and sweep the liquid out. If you can see solid foreign objects (such as
broken teeth), quickly hook them out with your index finger.
Head-Tilt/Chin-Lift Maneuver
5. Place one hand, palm down, on the victim’s forehead and apply firm, backward
pressure to tilt the head back.
6. Place the index and middle finger of the other hand under the bony part of the
lower jaw near the chin; be careful not to compress the soft tissues underneath
the chin.
7. Lift the jaw to bring the chin forward while avoiding complete closure of the
victim’s mouth and maintaining pressure on the victim’s forehead to keep the
head tilted backward. Leave dentures in place if they are secure in the mouth.
If the head-tilt/chin-lift position is unsuccessful or if you suspect a spine injury, first try to
open the airway by lifting the chin without tilting the head back. If the airway remains
blocked, perform the jaw thrust maneuver.
1. Facing the top of the victim’s head, place one hand on each side of the victim’s
head, resting your elbows on the surface on which the victim is lying.
2. Place your fingers under the angles of the victim’s lower jaw and lift with both
hands, displacing the jaw forward.
3. If the lips close, retract the lower lip with your thumb.
A. Obstructed airway
B. Head-tilt/Chin-lift Maneuver
C. Jaw Thrust Maneuver
B
C
b. Breathing Assessment
To place the victim in the recovery position, roll her or him onto one side, moving
head, shoulders, and torso simultaneously without twisting. Then flex one leg at the
knee. Place the bottom arm behind the back. Flex the top arm, placing the hand
under the cheek. Continue with your primary survey.
If the victim is breathing and has a pulse, continue by checking for serious or profuse
bleeding. Check for bleeding by looking over the victim’s entire body for blood
(blood-soaked clothing or blood pooling on the floor or the ground) and by
thoroughly and quickly, but gently, running your gloved hands over and under the
head and neck, arms, chest and abdomen, pelvis and buttocks, and legs. Check
If you find major bleeding – blood that is spurting or flowing freely – control it by
direct pressure, use of pressure points, or elevation. Spurting or steady flow
bleeding is the only kind of bleeding that should be treated during the primary
survey.
Finally, check the victim’s skin condition. Skin color, especially in light-skinned
people, reflects the circulation under the skin as well as oxygen status. In darkly
pigmented people, changes may not be readily apparent but can be assessed by the
appearance of nail beds, the inside of the mouth and the inner eyelids. If there is
decreased circulation or slow pulse, the skin becomes cool and pale or cyanotic
(blue-gray color).
Head injuries serve as a clue since the head may have been snapped suddenly in
one or more directions, endangering the spine. Other signs and symptoms include
the following:
- Painful movement of the arms and legs
- Numbness, tingling, weakness, or burning sensation in the arms or legs
- Loss of bowel or bladder control
- Paralysis of the arms or legs
- Deformity (odd-looking angle of the victim’s head and neck)
If you suspect the victim has any possibility of a spinal injury, establish manual in-
line spinal stabilization by bringing the victim’s head into a neutral in-line position.
Have someone in the scene hold the victims head so that the nose is in line with the
navel (belly button) and the neck is not bent forward or backward. Instruct the victim
not to move his or her neck.
Caution! DO NOT move the victim, even if the victim is in water. Wait for the EMS to arrive – they have the
proper training and equipment. Victims with suspected spine injury require cervical collars and stabilization on a
spine board. It is better to do nothing than to mishandle a victim with a spine injury.
The life processes depend on an adequate and uninterrupted supply of blood. The loss
of 2 pints in an adult is usually serious; the loss of 3 pints of blood can be fatal if it
occurs over the course of a few hours. Bleeding in certain parts of the body – such as
from the large blood vessels in the neck – can prove fatal within just a few minutes.
1. External Bleeding
Severity of bleeding depends on how fast the blood is flowing, whether it is flowing from
an artery or vein, where the bleeding originated and whether the blood is flowing freely
externally or into a body cavity. Bleeding from an artery is always more serious than
bleeding from a vein or capillary. Arterial blood is bright red and spurts or pulsates out.
But regardless of the type, in controlling external bleeding, the first aid is the same.
Whenever you help a victim who is bleeding or losing other body fluids, take the
following precautions to protect yourself against transmission of infectious disease:
Place a barrier between you and the victim’s blood. If you can, wear protective
gloves; if not, use plastic wrap, aluminium foil, extra gauze bandages, or a clean,
thick, folded cloth. As a last resort, use the victims own hand.
Avoid touching your mouth, nose, or eyes or handling food while providing first
aid care.
As soon as you finish treating the victim, wash your hands thoroughly with soap
and hot water or an antiseptic cleanser, even if you wore gloves. Use a fingernail
After taking infection-control precautions, follow these steps in controlling the bleeding.
1. Expose the wound by removing or cutting the clothing to see where the blood is
coming from.
2. Place a sterile gauze pad or a clean cloth (such as handkerchief, sanitary napkin
or towel) over the entire wound and apply direct pressure with your fingers or the
palm of your hand. The gauze or cloth allows you to apply even pressure. Be
sure the pressure remains constant. Do not remove blood-soaked dressings;
simply apply new dressings over the old ones.
3. If bleeding does not stop in 10 minutes, the pressure may be too light or in the
wrong location. Press harder over a wider area for another 10 minutes. If the
bleeding is from an arm or leg, while still applying pressure, elevate the injured
area above heart level to reduce blood flow. Elevation allows gravity to make it
difficult for the body to pump blood to the affected extremity. Elevation alone,
however, will not stop bleeding and must be used in combination with direct
pressure over the wound.
4. If bleeding continues, apply pressure at a pressure point, in combination with
direct pressure over the wound. The two most accessible pressure points are:
the brachial point in the upper inside arm and the femoral point in the groin.
5. After the bleeding stops or to free you to attend to other injuries or victims, use a
pressure bandage to hold the dressing on the wound. Wrap a roller gauze
bandage tightly over the dressing and above and below the wound site.
6. The use of tourniquet to control bleeding should be a last resort only, when all
other methods have failed. It can be used only on an extremity; using it may lead
to amputation of the extremity below the tourniquet.
Internal bleeding generally results from blunt or penetrating trauma or certain fractures
(such as pelvic fracture). Though not visible, internal bleeding can be very serious –
even fatal – because shock can develop rapidly. You should suspect internal bleeding
based on signs and symptoms as well as the mechanism of injury.
The signs and symptoms of internal bleeding are similar to those of shock: restlessness
and anxiety; cool clammy skin; weak rapid pulse; rapid breathing; and ultimately, a drop
in blood pressure. There may be additional signs and symptoms depending on the
source of bleeding some of which are:
Internal bleeding may not cause signs or symptoms for hours or days and it may be
occurring even if there are no signs and symptoms. For victims of internal bleeding,
activate the EMS system, then:
Internal bleeding can be a serious cause of shock, and almost always requires surgical
intervention.
With rare exceptions, fractures and other bone injuries are not life threatening. And
although they are often the most obvious and dramatic injuries a victim suffers, fractures
may not necessarily be the most serious. Therefore, it is important that you complete the
primary survey and manage any life threatening conditions before you look for the signs
It is difficult to tell whether a bone is broken, so when in doubt, always treat the injury as
a fracture. Fractures should be treated in priority order:
1. Spinal fractures
2. Fractures of the head and rib cage
3. Pelvic fractures
4. Fractures of the lower limbs
5. Fractures of the upper limbs
The most important first aid care is immobilization of any suspected fracture or
extensive soft-tissue injury. You should immobilize before you apply ice or elevate the
injured part. Treat fracture as follows:
2. Support the injured part; gently remove clothing and jewelery around the
injury site without moving the injured area.
3. Cover any open wounds with sterile dressings to control bleeding and prevent
infection. Gently wipe away dirt and debris, and irrigate the exposed bone end
with clean water.
3. Assess blood flow by checking the distal pulse of the suspected fracture site
and also check the capillary refill by pressing on the nailbeds. Gently squeeze
the victim’s fingers or toes to assess for nerve function. There may be nerve
damage if the victim cannot feel the squeeze.
4. Immobilize joints above and below the fracture. Wrap from the distal end of
the splint to the proximal end. Splint firmly enough to immobilize but not tightly
7. Splinting
Splints are used to support and immobilize suspected fractures, dislocations, or severe
sprains; to help control bleeding; to help control pain; and to prevent further damage to
tissues from the movement of bone ends. Any victim with suspected fracture,
dislocation, or severe sprain should be splinted before being moved.
Regardless of where you apply the splint, follow these general rules:
b. Improvised Splints
You may have access to commercial splint, but it is much more likely that you will
need to improvise at the scene. A splint can be improvised from a cardboard box,
cane, ironing board, rolled-up magazine, umbrella, broom handle or any other similar
object.
You can also use a self-splint (also called an anatomical splint) by tying or tapping
an injured part to an adjacent uninjured part. For example, splint a finger to a finger,
a toe to a toe, a leg to the other leg, or an arm to the chest. An effective improvised
splint must be
Compress the nerves, tissues and blood vessels under the splint,
aggravating the existing injury and causing new injury
Delay the transport of a victim who has a life-threatening injury
Reduce distal circulation, threatening the extremity
Aggravate the bone or joint injury by allowing movement of the bone
fragments or bone ends or by forcing bone ends beneath the skin surface
Cause or aggravate damage to the tissues, nerves, blood vessels, or
muscles as a result of excessive bone or joint movement
Guidelines
Emergency Move
Under life threatening conditions, you may have to risk injury to the victim in order to
save his or her life. You should make an emergency move only when no other options are
Uncontrolled traffic
Physically unstable surroundings (such as a vehicle that you cannot stabilize and
that it in danger of topping off an embankment)
Exposure to hazardous materials
Fire or threat of fire (always considered a grave threat)
Hostile crowds
The need to reposition the victim in order to provide life-saving treatment (such as
moving to a firm, flat surface to perform CPR)
The need for access (you may need to move one victim to gain access to another)
Weather conditions (you need to control exposure if the weather is very cold, wet or
hot, or windy enough to turn objects into projectiles)
a. Moving Victims Using The Backboard
If there is a suspected spine injury, you need to immobilize the spine. Manually
support the victim’s head and neck in normal anatomical position until the victim is
supine on the backboard; apply a rigid cervical collar to the victim’s neck. But before
you move the victim into the backboard, stabilize airway, breathing, circulation, and
hemorrhage; correct any life threatening problems, then provide other care as
needed. Bandage all wounds, splint all fractures, and give psychological support. To
get the victim onto a backboard, follow these steps:
A rescuer may be required to move a victim on his own during flood, fire, building
collapse, or other life threatening situations.
Walking Assist
1. Stand at the victim’s side and drape the victim’s arm across your shoulder.
2. Support the victim by placing your arm around his or her waist
3. Using your body as a crutch, support the victim’s weight as you both walk.
Blanket Drag
1. Spread a blanket alongside the victim; gather half the blanket into lengthwise
pleats.
2. Roll the victim away from you, then tuck the pleated part of the blanket as far
beneath the victim as you can.
3. Roll the victim back onto the center of the blanket on his or her back; wrap the
blanket securely around the victim.
4. Grab the part of the blanket that is beneath the victim’s head and drag the
victim toward you; if you have to move on a stairway, keep the length of the
victim’s body in contact with several stairs at once to prevent the victim from
bouncing on the steps.
Shirt Drag
A method of moving a victim in which a single rescuer uses the victim’s shirt
as a handle to pull the victim (except for a T-shirt).
1. Fasten the victim’s hands or wrists loosely together, then link them to the
victim’s belt or pants to keep the arms from flopping or coming out of the shirt.
2. Grasp the shoulders of the victim’s shirt under the head; use your forearm to
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support both sides of the head.
3. Using the shirt as a handle, pull the victim toward you; the pulling power should
engage the victim’s armpits, not the neck.
Sheet Drag
1. Fold a sheet several times lengthwise to form a narrow, long “harness”; lay the
folded sheet centered across the victim’s chest at the nipple line.
2. Pull the ends of the sheet under the victim’s arms at the armpits and behind
the victim’s head; twist the ends of the sheet together to form a triangular
support for the head. Be careful not to pull the victim’s hair.
3. Grasping the loose ends of the sheet, pull the victim toward you.
Firefighter’s Carry
A method of lifting and carrying a victim in which one rescuer carries the
victim over his or her shoulder, is not as safe as most ground level moves because it
places the victim’s center of mass high-usually at the rescuer’s shoulder level- and
because it requires a fair amount of strength. It is, however, preferred if a rescuer will
move a victim over irregular terrain. Unless there is life threatening situations, do not
attempt this move especially if neck or spinal injuries are suspected.
1. Position the victim on his or her back with both knees bent and raised; grasp
the back side of the victim’s wrists.
2. Stand on the toes of both the victim’s feet; lean backward and pull the victim
up toward you. As the victim nears a standing position, crouch slightly and
pull the victim over your shoulder, then stand upright.
3. Pass your arm between the victim’s legs and grasp the victim’s arm that is
nearest your body.
Seat Carry
A method of lifting and moving a victim in which two rescuers form a “seat”
with their arms.
1. Raise the victim to a sitting position; each First Aider steadies the victim by
positioning an arm around the victim’s back.
Extremity Lift
A method of lifting and carrying a victim in which two rescuers carry the victim
by the extremities. Do not use this method if the victim has back injuries.
4. One First Aider kneels at the victim’s head; the other kneels at the victim’s
knees.
5. The First Aider at the victim’s head places one hand under each of the
victim’s shoulders, the second First Aider grasps the victim’s wrists.
6. The First Aider at the victim’s knees pulls the victim to a sitting position by
pulling on the victim’s wrists; the First Aider at the victim’s head assists by
pushing the victim’s shoulders and support his back.
4. The First Aider at the victim’s head slips his or her hands under the arms,
grasps the victim’s wrists.
5. The First Aider at the victim’s knees slips his or her hands beneath the
victim’s knees.
6. Both First Aider crouch on their feet and then simultaneously stand in one
fluid motion.
If the victim does not have contraindicating injuries and if a chair is available,
you can use the chair lifter carry. Sit the victim in the chair. One First Aider then
carries the back of the chair while the other carries the legs; the chair itself is used
as a litter. Be sure the chair is sturdy enough to support the weight of the victim.
This method has the advantage of permitting you to move the victim through
narrow passages and down stairs. Use this method only if the victim does not have
spinal injuries.
7. Three First Aiders line up on the least injured side of the victim; if one First
Aider is noticeably taller, that person stands at the victim’s shoulders; another
stands at the victim’s hips, and the third at the victim’s knees.
8. Each First Aider kneels on the knee closest to the victim’s feet.
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3. The First Aider at the victim’s shoulder works his or her hands underneath the
victim’s neck and shoulders; the next First Aider’s hands go underneath the
victim’s hips and pelvis; and the final First Aider’s hands go underneath the
victim’s knees.
4. Moving in unison, the First Aiders raise the victim to knee level and slowly
turn the victim towards themselves until the victim rests on the bends of their
elbows.
5. Moving in unison, all three rise to a standing position and walk with the victim
to a place of safety or to the stretcher. To place the victim on the stretcher,
simply reverse the procedure.
This may also be done by four rescuers positioned at the victim’s head, chest,
hips and knees. Support is then given to the head, chest, hips, pelvis, knees and
ankles.
Illustrations (From US National Safety Council. “First Aid and CPR 3rd Edition”.1999.
Jones and Bartlett)
Websites
http://www.mmda.gov.ph/
http://www.phivolcs.dost.gov.ph/
http://www.jica.go.jp/english/index.html
http://www.euronews.net/nocomment/2011/03/13/latest-201103130913-japan/
http://www.imageblogs.org/huge-disaster-japan-tsunami-part1
http://www.imageblogs.org/huge-disaster-japan-tsunami-part2
http://japantsunaminow.wordpress.com/2011/03/20/38/
http://news.nationalgeographic.com/news/2011/03/pictures/110315-nuclear-reactor-japan-tsunami-
earthquake-world-photos-meltdown/
http://pubs.usgs.gov/gip/dynamic/fire.html
http://www.ompongplaza.org.ph/mmeirs.php
http://www.phivolcs.dost.gov.ph/images/IEC/tsunami_poster_english.pdf
Text
Hafen, B., Karren, K., Limmer, D., Mistovich, J. “An Introduction to First Aid for Colleges and Universities Eight
Edition”. 2004. Pearson
US National Safety Council. “First Aid and CPR 3rd Edition”.1999. Jones and Bartlett
Singapore Civil Defence Force. “Emergency Handbook”. 2005.
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