CCHHAAPPTTEERR 44:: DDiissaasstteerr RRiisskk RReedduuccttiioonn MMaannaaggeemmeenntt ((DDRRRRMM)) iinn tthhee PPhhiilliippppiinneess

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: ASSESSMENT AND APPROACH At the end of this lesson, the students will be able to:

1. Analyze the current disaster situation in the Philippines;

2. Identify the recent disaster risk reduction management program in the

Philippines and how it adapts to the changing disaster situation of the country.

3. Gain knowledge and ski lls in assessing capacity and vulnerability of a

disaster prone community.

4. Integrate the knowledge and skills learned in this module in the community

fieldwork

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…

Why is the Philippines VULNERABLE to disaster??

I. Geographical and physical features

According to the Office of Civil Defense, the Philippines

because of its geographical location, is considered one of

the most disaster- prone countries in the world. It lies

along the western segment of the Pacific Ring of Fire, a

most active part of the Earth characterized by an ocean

encircling belt of active volcanoes and earthquake

generators. The Philippines has approximately 400

volcanoes, of which 23 are known to be currently active.

A. Philippines: Facts and Figures

The Philippines is situated at the junction of two

large converging tectonic plates - the Pacific

plate and the Eurasian plate.

It has experienced the most destructive

earthquake in July 1990 with a death toll of

approximately 1,666 and 12.2 billion pesos in

damages. Geological Disasters in the Philippines:

The July 1990 Earthquake and the June 1991 Eruption of Mount Pinatubo

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 Oscil lation (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.

B. Metro Manila: At a glance

is composed of 16 cities and 1 municipality by its administrative boundaries, is the

political, economic, and cultural center of the Philippines.

(Source:http://www.phivolcs.dost.gov.ph/)

Distribution of Faults and Trenches around Metropolitan Manila

has approximately 11.9 million and it is now one of the most densely populated areas in

Southeast Asia. (http://www.nscb.gov.ph/)

has resulted in unsatisfactory infrastructure construction, poor housing condition, highly dense areas, and areas characterized by mixed land use and other inappropriate conditions because of its rapid urbanization.

is located in and around numerous

earthquake generators, such as the Valley

Fault System (VFS), Philippine Fault, Lubang Fault, Manila Trench, and Casiguran Fault. Among these faults, the Valley Fault System

is considered to potentially cause the largest

impact to the Metropolitan Manila area should it generate a large earthquake.

is topographically composed of coastal lowlands, a central plateau where the central

district including Makati is located, as well as alluvial lowlands along the Marikina River and the Laguna Lake. In case of an earthquake, liquefaction in these lowland areas

may cause damage to bui ldings and infrastructure. In addition, tsunami can also occur along the Manila Bay.

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.

The Metropolitan Manila Earthquake Impact Reduction Study (MMEIRS)

In August 2002 to March 2004, the Government

of Japan through the Japan International

Cooperation Agency (JICA) granted an aid to

the Philippines to study for Metropolitan Manila

Earthquake Impact Reduction Study

(MMEIRS). It focuses on how to manage

potential earthquakes in Metro Manila.

The objectives of this study

are: (1) to formulate a

master plan for earthquake impact reduction in

Metro Manila; and, (2) to carry out technology

transfer to Metro Manila Development Authority

(MMDA) and Philippine Institute of Volcanology

and Seismology (PHIVOCS) in the course of the

study.

Major contents of the study which are notable to the current Philippine situation is the preparation of disaster management

plan for Metropolitan Manila , and community based disaster management activities.

MMEIRS results

As a result of the study, there were 105 recommended action plans which the Metropolitan

Manila Disaster Coordinating Council (MMDCC) members should implement within 3 to 6 years. Also, based on the damage estimation by MMEIRS Study:

There is a potential rupture of West Valley Fault,

approximately 40% of the total number of residential buildings within Metropolitan Manila will collapse or be affected.

This building collapse directly affects large numbers of people, since it is

estimated to cause 34,000 deaths and 1,144,000 injuries.

Moreover, additional 18,000 deaths are

anticipated by the fire spreading after the

earthquake event. This human loss, together with properties and economy losses of

Metropolitan Manila will be a national crisis.

To know more about this study, follow this link

http://www.phivolcs.dost.gov.ph/index.php?option=com_content&view=article&id=419%3Ammeirs&catid=66&Itemid=300083.

Now that you are updated with the current disaster situation of our

country, it is time to ask ourselves, how prepared are we? How does our country respond and manage these threats?

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.

Disasters are unforeseen events People affected are helpless victims and passive recipients

Donors decide what victims need Responses are on individual families and on restoring

infrastructure

Key players are government, aid agencies, scientist, experts and disaster managers

Top-down approach

What are your thoughts about this? Too passive? Is this also how your family or community views disaster?

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)

Now, given these concepts how do you think an individual can prepare for a potential disaster? Yes, that is right! We can actually do something to prepare so that the impact of the disaster will be lessened. Now, continue reading to find out

how to mitigate a disaster.

Prevention and preparedness need to be the cornerstone of any emergency plan.

Anticipating the level of damage supported by geographical information systems, early warning devices etc. are also critical elements of a good disaster preparedness and

mitigation plan. This has to be integrated with a post-disaster assessment, which can be used to draw lessons for preparedness and mitigation.

http://www.rivertoncity.com/community.emergency.html

Now, let us define some important terms:

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

Risk

The probability that negative consequences may arise when hazards interact with vulnerable areas, people, property and environment

The probability of harmful consequence or expected losses resulting from the interactions between hazards and vulnerable conditions

To understand better, check out this diagram:

RISK = HAZARD X Vulnerability

CAPACITY

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.)

“Disaster is primarily a question of vulnerability. A disaster

occurs as the result of a hazard that strikes a vulnerable

community or group whose inherent capacity is not enough to

withstand or cope with is adverse effects and impacts. “

The diagram below will clearly state my meaning:

(Anderson:1989)

Disaster

The serious disruption of the functioning of society, causing widespread

human, material or environmental losses, which exceed the ability of the

affected communities to cope using their own resources. Disasters occur

when the negative effects of the hazards are not well managed.

Risk Reduction Measures

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.

PRE-DISASTER DISASTER RESTORATION LONG-TERM RECOVERY

RESILIENT COMMUNITY NON RESILIENT COMMUNITY

TAKE NOTE: A disaster 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

An EARTHQUAKE is feeble shaking to violent trembling of the ground

produced by the sudden displacement of rocks or rock materials below the earth’s

surface. Sudden displacements along fault fissures in the solid and rigid layer of the

earth generate TECTONIC EARTHQUAKES. Those induced by rising lava or

magma beneath active volcanoes generates VOLCANIC EARTHQUAKES.

(http://www.ompongplaza.org.ph/MMEIRS/08_BOOKLET/05_MITIGATION_HANDBOOK.PDF)

The destructive effects of earthquakes are due mainly to intense ground

shaking or vibration. Because of severe ground shaking, low and tall buildings may

tilt, split, topple or collapse, foundation of roads, railroad tracks and even bridges

may break, electric posts may tilt or topple, water pipes and other utility installations

may get dislocated, dams and similar structures may break and cause flooding,

landslides and other forms of mass movement may occur in hilly and mountainous

areas and tsunamis may be generated. These destructive effects of earthquake may

cause many casualties and short to long term socio-economic disruptions. The

following figures show the historical distribution of earthquakes recorded in some

parts of the country for the past decades.

Distribution of Historical earthquakes from 1608 to 1895

Distribution of Instrumentally recorded Earthquakes from 1907 to 2002

(http://www.ompongplaza.org.ph/MMEIRS/02_VOL2_MAIN1/MAIN1_02.PDF)

3. If you take cover under a sturdy piece of furniture,

HOLD on to it and be prepared to move with it. Hold

the position until the ground stops shaking and it is

safe to move.

Sources:

1. California Governor’s Office of Emergency Services.(2003). Earthquake Preparedness Tips. Retrieved from:

www.oes.ca.gov/CEPM2003.nsf/htmlmedia/dch.../dch_drill.pdf 2. Earthquake and Tsunami.(1990). Department of Science and Technology- Philippine Institute of Volcanology and

Seismology. Quezon City: DOST-PHILVOLCS. 3. National Disaster Risk Reduction and Management Council. (2005). Philippine Disaster Management

Framework. Retrieved from: http://www.ndcc.gov.ph/ 4. Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.

What to do during earthquakes? Duck, Cover and Hold

2. Take COVER under a sturdy desk, table or other

furniture. If that is not possible, seek cover against

an interior wall and protect your head and neck with

your arms. Avoid danger spots near windows,

hanging objects, mirrors or tall furniture.

1. DUCK or DROP down to the floor.

Japan Tsunami[Image](n.d.). Retrieved from:

http://www.cartoonaday.com/tag/japan-tsunami-

cartoon/

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, their effects on

coastal areas are similar.

Some Natural Signs of an approaching Local Tsunami:

1. A felt earthquake

2. Unusual sea level change:

sudden sea water retreat or rise

3. Rumbling sound of

approaching waves

Sources:

Earthquake and Tsunami.(1990). Department of Science and Technology- Philippine Institute of

Volcanology and Seismology. Quezon City: DOST-PHILVOLCS.

PAGASA

Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.

What to do during tsunamis?

1. Know your local community's suggested evacuation

routes to safe areas.

2. If you are at the beach or near the ocean and feel the

earth shakes, run immediately to higher ground.

3. Beware of the tidal conditions around your area. The

most notable and very distinguishing factor for a

tsunami is the occurrence of highly unusual tidal

levels before the large waves arrive. The sudden

draw down of sea level resulting in a receding shoreline, sometimes by a kilometer

or more, is a sign of a preceding or in-between crest of tsunami waves.

4. Do not approach the beach to investigate.

5. Homes and bui ldings located in low lying coastal areas are not safe. The upper

floors of a high multi-storey, reinforced concrete bui lding can provide refuge if there

is no time to move inland or to higher grounds.

6. A tsunami is not a single wave but a series of waves that can vary in size. Whenever

a tsunami strikes, stay out of the danger area until absolutely sure that the last wave

had passed.

C. Storm Surge

Storm surges are abnormal rise

of water generated by storms, over

and above the predicted astronomical

tide. It’s the change in the water level

that is due to the presence of a storm.

Storm surge is produced by water

being pushed toward the shore by the Retrieved from: http://voices.nationalgeographic.com/2012/12/08/geography-in-the-

news-storm-surge-thr eats/

force of the winds moving cyclonically around the storm. The impact on surge of the low

pressure associated with intense storms is minimal in comparison to the water being

forced toward the shore by the wind.

The maximum potential storm surge for a particular location depends on a number of

different factors. Storm surge is a very complex phenomenon because it is sensitive to the slightest changes in storm intensity, forward speed, size (radius of maximum winds-RMW), angle of approach to the coast, central pressure (minimal contribution in

comparison to the wind), and the shape and characteristics of coastal features such as bays and estuaries.

WHAT TO DO DURING A STORM SURGE:

1. Monitor the storm’s progress and listen for further warnings or instructions from local

officials.

2. Flood waters can be dangerous to drive and walk through. It is best to listen carefully

to rescue officials, who will be coordinating evacuation plans, before going

anywhere.

3. Be prepared to evacuate at a moment's notice. When a storm surge, flood, or flash

flood warning is issued for your area, follow your evacuation plan and head for

higher ground, and stay there.

4. Stay away from floodwaters. If you come upon a flowing stream where water is

above your ankles, stop, turn around, and go another way. Six inches of swiftly

moving water can sweep you off your feet. Be especially cautious at night when it is

harder to recognize flood danger.

5. If you come upon a flooded road while driving, Do Not attempt to cross flowing

water. If you are caught on a flooded road and waters are rising rapidly around you, get out of the car quickly and move to higher ground. Most cars can be swept away by less than two feet of moving water.

6. Make sure you take your emergency supplies kit with you.

7. If you are evacuating your home, leave a note there stating your whereabouts.

Register at any local registration and inquiry center so you can be contacted when it

is safe to return home.

D. Fire

According to the Fire Code of the Philippines, fire is the active principle of burning,

characterized by the heat and light of combustion. Fire can cause major disasters and

loss of lives in buildings such offices, hotels, hospitals, schools and homes. Such

disasters can be avoided if proper fire safety practices are observed.

Sources:

Bureau of Fire Protection. (2009). Fire code of the Philippines. Retrieved from:

http://www.bfpresponse.gov.ph/RA9514%20IRR%20Signed%20by%20SILG.pdf

Bureau of Fire Protection. (n.d.) Fire Safety Tips. Retrieved from:

http://www.bfpresponse.gov.ph/downloads.html

Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.

What to do to during fire:

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:

Federal Emergency Management Agency. (2010). Landslide. Retrieved from

http://www.fema.gov/hazard/landslide/ls_before.shtm

Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.

United States Search and Rescue Task Force. (n.d.)What are Landslides?. Retrieved from:

http://www.ussartf.org/landslides.htm

E. Landslide

Landslides are rock, earth, or debris that

flow on slopes due to gravity. They can occur on

any terrain given the right conditions of soil,

moisture, and the angle of slope. Integral to the

natural process of the earth's surface geology,

landslides serve to redistribute soil and

sediments in a process that can be in abrupt

collapses or in slow gradual slides. Such is the

nature of the earth's surface dynamics.

What to do to during landslide:

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.

Source: Landslide [Image](2008). Retrieved from:

http://www.uwec.edu/jolhm/EH3/Group3/New%

20website/Home.htm

Source: Pyroclastic flows at Mayon Volcano [Image](n.d.).

Retrieved from: http://es.wikipedia.org/

wiki/Archivo:Pyroclastic_flows_at_Mayon_Volcano.jpg

F. Volcanic Eruption

A volcano can be simply defined

as a rupture or an opening on the crust of

a planet like earth. This opening allows

hot ash, molten rock and gases to blow

off from the underground spaces.

Volcanoes generally acquire shape of a

mountain. Volcanoes are usually found at

places where tectonic plates get

converged or diverged. The common

features of volcanic eruptions are lava

and release of poisonous gases from the

crater situated at the summit of the

volcanoes. If a volcano erupts where you

live follow the evacuation order issued by

authorities and evacuate immediately from the volcano area to avoid flying debris, hot

gases, lateral blast, and lava flow.

What to do to during volcanic eruptions:

1. Avoid the declared permanent danger zones in your locality. Also, rivers where

hazardous volcanic substances can flow should be avoided.

2. Leave the area immediately. If you are warned to evacuate because an eruption is

imminent, evacuate.

3. Be aware of mudflows. The danger from a mudflow increases near stream channels

and with prolonged heavy rains. Mudflows can move faster than you can walk or run.

Look upstream before crossing a bridge, and do not cross the bridge if a mudflow is

approaching.

4. Avoid river valleys and low-lying areas.

5. If you are along the path of potential lahar flows, move to higher ground or to a

designated evacuation site.

6. Remember to help your neighbors who may require special assistance – infants, elderly

people, and people with disabilities.

7. If you have a respiratory ailment, avoid contact with any amount of ash.

8. Food should always be covered to prevent contamination.

9. Wear long-sleeved shirts and long pants.

10. Use goggles and wear eyeglasses instead of contact lenses.

11. Use a dust mask or hold a damp cloth over your face to help with breathing.

12. Stay indoors until the ash has settled unless there is a danger of the roof collapsing.

13. Close doors, windows, and all ventilation in the house (air conditioners, fans, and other

vents.)

Sources for the Guidelines on Volcanic Eruptions:

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

14. Always clean your roof when heavy ash fall occurs to prevent collapse.

15. Avoid running car or truck engines. Driving can stir up volcanic ash that can clog

engines, damage moving parts, and stall vehicles.

G. Typhoon

The Philippines’ geographical location and physical environment make it

vulnerable to natural hazards such as tropical cyc lones, 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 extensive flooding,

destroyed properties and caused a

number of casualties in different regions

of the country as many were caught

unaware of the intensity of these

typhoons.

A typhoon is a type of tropical cyclone, which is a general term for a circulating

weather system over tropical waters. The eye of the typhoon is the center and is very calm.

The most dangerous area is the eye-wall. At 50,000 feet the air is moved outward and that

increases the upward motion. Typhoon force winds can topple poorly constructed buildings

and mobile homes. Debris becomes flying missiles and wind gusts can down trees and

Source: Typhoon [Image](n.d). Retrieved from:

http://ecohope.blogspot.com/2009/09/typhoon-ondoy-in-manila-philippines.html

power lines causing disruption in the basic utilities. Rains moving inland can produce 10

inches or more and cause deadly flooding.

The classification of tropical cyclones according to the strength of the associated winds as

adopted by PAGASA as of May 01, 2015 are as follows:

1. Tropical Depression (TD) - a tropical cyclone with maximum sustained

winds of up to 61 ki lometers per hour (kph) or less than 33 nautical miles per

hour (knots)

2. Tropical Storm (TS) - a tropical cyclone with maximum wind speed of 62 to

88 kph or 34 - 47 knots.

3. Severe Tropical Storm (STS) - a tropical cyclone with maximum wind speed

of 89 to 117 kph or 48 - 63 knots.

4. Typhoon (TY) - a tropical cyclone with maximum wind speed of 118 to 220

kph or 64 - 120 knots.

5. Super Typhoon (STY) - a tropical cyclone with maximum wind speed

exceeding 220 kph or more than 120 knots.

Source: Philippines Atmospheric, Geophysical and Astronomical Service Administration. Retrieved from:

http://www.pagasa.dost.gov.ph/index.php/learning-tools/94-weather/479-tropical-cyclones#classification-of-tropical-

cyclones

What to do to during typhoons:

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

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

Philippines Atmospheric, Geophysical and Astronomical Service Administration Retrieved from:

http://www.pagasa.dost.gov.ph/index.php/learning-tools/94-weather/479-tropical-cyclones#classification-of-tropical-cyclones

Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.

Typhoon Preparedness. (n.d.). Retrieved from: http://www.pdfio.com/k-430968.html#

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.

H. Climate Change

One of the pressing issues that countries have been dealing with in recent time is

Climate Change. According to the United States Environmental Protection Agency, Climate

change “refers to any significant change in the measures of climate lasting for an extended

period of time. In other words, climate change includes major changes in temperature,

precipitation, or wind patterns, among other effects, that occur over several decades or

longer”.

Most climate scientists agree the main cause of the current global warming trend is

human expansion of the "greenhouse effect", i.e. warming that result when the atmosphere

traps heat radiating from Earth toward space. Certain gases in the atmosphere block heat

from escaping. Long-lived gases that remain semi-permanently in the atmosphere and do

not respond physically or chemically to changes in temperature are described as "forcing"

climate change. Gases, such as water vapor, which respond physically or chemically to

changes in temperature, are seen as "feedbacks." (http://climate.nasa.gov/causes/)

There are several and compelling evidences proving the current state of climate

change around the world from the rising of our water levels, the global rise in temperature,

the worldwide shrinking of ice sheets, extreme typhoons and hurricanes experienced

around the world, etc. These reasons alone should make one be wary of the dangers of

climate change. The graph below, based on the comparison of atmospheric samples

contained in ice cores and more recent direct measurements, illustrates the sudden rise of

carbon dioxide in the atmosphere since the dawn of industrial age.

Retrieved from: http://climate.nasa.gov/evidence/

Below is another graph illustrating an increase of 0.74 C in the global mean temperature for

the last 150 years compared with the 1961-1990 global average.

Retrieved from: Climate Change in the Pilippines (2011). Philippine Atmospheric, Geophysical and Astronomical Services Administration

Here in the Philippines, an increase in temperature was also observed. A study made by

PAG-ASA yielded adverse results. The graph shown below indicates an increase of 0.648

C or an average of 0.0108 C per year increase from 1951 to 2010.

Retrieved from: Climate Change in the Pilippines (2011). Philippine Atmospheric, Geophysical and Astronomical Services Administration

The Impacts of Climate Change:

In the study by PAG-ASA entitled “Climate Change in the Philippines”, it highlighted

the likely impacts of climate change in different sectors and systems; although the

magnitude of these impacts will depend on a community’s adaptive capacity to these

climate risks. For one, intense typhoons and rainfall caused by global warming would

endanger the lives of people from different communities especially those who are most

vulnerable. Destruction of properties and loss of lives are inevitable when heavy flooding,

storm surges, landslides and mudslides occur because of this. Another severe effect of

climate change is in “Health”. The continuous rise of temperature and changes in rain

patterns would result in the outbreak and spread of water-based and vector-borne diseases

that might result in the death of many people. Pulmonary diseases amongst children and

cardiovascular diseases among the elderly are some examples. Disease outbreaks such

as malaria, dengue fever, diarrhea and cholera and linked with climate events such as

droughts and floods. In the agricultural sector, the large decrease in rainfall and longer dry

periods will affect our agricultural outputs, thus affecting our whole economy. Climate

change will have a significant impact particularly in rice and corn production because they

are very susceptible to climate variability such as floods, typhoons and el-niño induced

droughts. Not only are we humans affected by climate change, but so do different species.

The combination of human stresses and climate change is expected to increase the

incidence of forest fires. Furthermore, the destruction of forest habitat is expected. These

changes in forestry and vegetation due to climate change will likely impact species

biodiversity. Climate change and temperature increases could lead to a change in our

forest ecosystem. Areas that will be affected may result in unfavorable conditions for

thriving species and forests could face die-back.

What to do as a country:

1. Develop our emergency management plans for climate hazards

2. Develop early warning systems for extreme weather events

3. Rehabilitate existing water supply and transport system

4. Implement water management measures

5. Invest in water saving technologies/ methods

6. Change farming practices

7. Develop drought management and relief protocols

8. Develop aquaculture and plantation forestry instead of exploiting native resources

9. Develop coastal zone management plans

10. Design infrastructure to accommodate sea-level rise

11. Bolster public health institutions

12. Improve access of individuals and communities to medical and public health

agencies

13. Provide education in disease prevention

Sources:

United States Environmental Protection Agency. Retrieved from: www.epa.gov/climatechange/basics/

National Aeronautics and Space Administration. Retrieved from: http://climate.nasa.gov/evidence/

Climate Change in the Philippines (2011). Philippine Atmospheric, Geophysical and Astronomical Services

Administration

Climate Change in Southeast Asia and the Pacific Islands (2011). Edited by Gilbert, Jeremy L.

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.

The key is PARTICIPATORY!

This analysis was first developed as a research methodology to assess

disaster-prone communities in Oxfam Great Britain’s programmed

areas in the Philippines such as the provinces affected by the eruption

of Mt. Pinatubo in the ‘90s and recently in the communities affected by

natural calamities and armed conflicts in Maguindanao and North

Cotobato.

PCVA also known as Participatory

Capacities and Vulnerabilities

Assessment is a research methodology

that is both an analysis and a learning

tool.

This method provides an opportunity for

the people in the community to express its

own perceptions and understanding of

disasters and its impact.

PCVA will help us:

Understand the existing capacity and vulnerability of the communities http://krishanagyanwali.b logspot.com/

Identify long and short term needs of the communities

Identify possible options to address the needs and aid in formulating an efficient

disaster risk reduction management program

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.

A. Vulnerability Assessment

VULNERABILITY is a condition which increases the susceptibility of a community to the

impact of hazards. The community’s vulnerability is affected by the following factors:

1. Physical / Material Vulnerability

http://article.wn.com/view/2009/10/09/Fresh_floods_swamp_Philippines/

Location

Hazard prone location

Design and construction materials

Lack of basic services

Violence (domestic and conflict)

Lack of access and control over means of production

Environmental degradation

etc

2. Social and Organizational Vulnerability

http://anakbayannynj.wordpress.com/2012/06/02/anakbayan-usa-

tribute-to-ernesto-ka-erning-gulfo/

Family and kinship structures

Lack of leadership and initiatives

Neglected by government and administrative structures

Conflicts, cast system, ideology

Unequal participation of community affairs

Exclusion of certain groups from decision-making

Isolation

3. Motivation and Attitudinal Vulnerability

http://pinoyexpat.net/%E2%80%9860-of-ofw-families-are-

poor%E2%80%99/

Negative attitude towards change

Passivity, fatalism, hopelessness

Lack of initiative or “fighting spirit”

Dependency on external support

http://www.pfpi.org/about.html

B. Capacities Assessment

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.

TThhee kkeeyy pprriinncciippllee iinn aasssseessssiinngg ccaappaacciittiieess iiss tthhaatt eevveenn tthhee WWEEAAKKEESSTT hhaavvee ssoommee sskkiillllss,, rreessoouurrcceess,, ssttrreennggtthhss ttoo hheellpp tthheemmsseellvveess aanndd aallssoo ootthheerrss..

If we ignore rather than support, the capacities

and coping mechanisms might be undermined and weakened and eventually

increase vulnerability

A. Physical / Material Cash, land tools, food, jobs

B. Social / Organizational

Social Networks Extended Family Local and National welfare Institutions

C. Attitudinal / Motivational

Sense of Control Power 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?

Asset Pentagon

NATURAL SOCIAL

HUMAN

PHYSICAL FINANCIAL

L

Motivational/Attitudinal

How does the community view its ability to create

change?

Participatory Capacities and

Vulnerabilities Assessment as the

name of the method implies invokes

the participation of every single

member of the community, even the

children. All of them has the right to be

heard in planning for their community.

Depending on the need and extent of

the research for the community’s disaster

risk reduction management plan, the tool may vary or sometimes modified.

The purpose is to generate discussion and analysis by the community residents

themselves. After all this, plan would be beneficial to their community as part of the

mitigation measure in disaster planning.

Aside from the PCVA matrix tool above, the facilitator may also choose to use any of the

following tools whenever it deemed appropriate.

Community Disaster Evacuation Map Social Organization Map

http://www.mercycorps.org/julierogers/blog/24801

©UST-NSTP 2011

Hazard Map

Seasonal

Calendar

http://www.fao.org/docrep/V1490E/v1490e02.htm

CONCLUSION

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

LESSON 2: BASIC FIRST AID AND IMMOBILIZATION USING BACKBOARD

At the end of the lesson, you are expected to:

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

Imagine a 10-wheeler truck crashes into an automobile and pushes it over an

embankment. Bystanders rush to the rescue. They remove the driver of the car, stop a

passing car, lift him to his feet, and send him in a sitting position to a nearby hospital.

The driver lived but he remained paralyzed for the rest of his life.

The permanent disability could have been prevented by knowledge of what to do in an

emergency. The unskilled and improper handling of the victim has caused the victim’s

spinal cord to be punctured by the sharp edge of his broken vertebrae thus causing

lifetime paralysis.

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

emergency before medical help arrives often determines how well a victim recovers. In

extreme cases, it can spell the difference between life and death.

II. DEFINING FIRST AID

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.

III. RECOGNIZING A MEDICAL EMERGENCY

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.

In general, laypersons have a great deal of difficulty deciding when an emergency

exists. This difficulty can lead to delays in providing the necessary first aid and

contacting the Emergency Medical Service (EMS).

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.

IV. PREVENTING TRANSMISSION OF INFECTIOUS DISEASES

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.

V. BASIC LIFE SUPPORT

Basic life support is the act of sustaining life-

sustaining functions after events which may have

rendered a victim unresponsive with no visible

breathing or gasping breathing. This is

accomplished with CardioPulmonary Resuscitation

or CPR.

In the period of 2005 to 2009, traditional CPR

required formal training and was almost limited to

professional health care providers. In 2010,

revision of the guidelines for CPR included

instructions for lay bystanders (people with no

formal training of CPR). This enabled ordinary

people to perform Compression-only CPR,

possible increasing the rates of bystander CPR.

Also, in the 2010 guidelines several steps in traditional CPR were removed while some

were improved. The summary of major changes are the following:

A simplified universal adult BLS algorithm was created.

Refinements were made for recognition of victims in need of CPR from

unresponsiveness, absence of pulse and breathing to unresponsiveness and

absence of breathing or no normal breathing (victim is gasping).

Look, listen, and feel for breathing has been removed.

Emphasis was placed on high-quality CPR (Adequate rate and depth, complete

chest recoil after each compressions, minimal interruptions in compressions and

avoiding excessive ventilation).

A change from Airway-Breathing-Compression (ABC) sequence to Compression-

Airway-Breathing (CAB) sequence.

Compression rate should be at least 100/min rather than approximately 100/min.

Compression depth was increased from 1 ½ inches to at least 2 inches.

The change in the application of CPR aims to increase the speed, efficiency and quality

of response of health care providers or bystanders to the victim. It is assumed that

before collapse or state of unresponsiveness the victim was breathing normally and

ample oxygen is present in the blood to sustain him/her for a few minutes therefore

compressions were prioritized over airway and breathing.

Updated Traditional C.P.R. for trained providers

1. Survey the scene

2. Check unresponsiveness then pulse

3. Call for medical assistance (activate Emergency Medical Services or EMS)

4. Proceed to CPR 30 compressions to 2 rescue breaths (Head Tilt\Chin Lift) *Continue compressions until victim is revived (check every 2 minutes), medical team arrives or rescuer

is exhausted

5. Perform the ABCD assessment of First Aid

Hands Only C.P.R. for lay bystanders

a. Survey the scene

b. Check unresponsiveness then pulse

c. Call for medical assistance (activate Emergency Medical Services or EMS)

d. Do high-quality 100/min or more chest compressions *Continue compressions until victim is revived (check every 2 minutes), medical team arrives or rescuer

is exhausted

e. Perform the ABCD assessment of First Aid

Note: Ask for consent and introduce yourself after checking unresponsiveness and

preparing for CPR

Conducting a Scene Size-Up (Survey the Scene)

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:

a. Hazards that could be dangerous to you, the victim(s), or bystanders

b. The mechanism or cause of the injury or injuries

c. The number of victims

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 i ll.

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

which one you should give attention first.

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.

Checking for Unresponsiveness

Determine unresponsiveness by tapping the victim on both shoulders and ask

loudly, “Are you okay?” You are not looking for an answer as much as you are any

kind of response – fluttering eyelids, muscle movement, turning to the sound, and so

on. If there is no response, the victim is unresponsive.

Checking for Pulse

Check for the pulse using the carotid artery by the following these steps:

1. Maintain head ti lt with your hand nearest the victim’s head on forehead.

2. Locate the Adam’s apple with 2 or 3 fingers of hand nearer victim’s feet.

3. Slide your fingers down into the grove of neck on side closest to you (do

not use your thumb because you may feel your own pulse).

4. Feel for carotid pulse (take 5-10 seconds).

The carotid artery pulse is used and preferred due to its proximity to the heart and

accessibility to the rescuer.

Head-Tilt/Chin-Lift Maneuver

If you do not suspect cervical spine injury

1. Place one hand, palm down, on the victim’s forehead and apply firm,

backward pressure to tilt the head back.

2. 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.

3. 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.

You will be able to form a better seal for ventilation with the dentures in place.

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.

Activating the Emergency Medical Service (EMS) System

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.

VI. GENERAL SEQUENCE OF FIRST AID RESPONSE

First aid is the immediate help provided to a sick or injured person until professional or

better equipped team arrives. Although mostly associated with physical injuries it also

deals with the psychosocial support needs and the emotional distress suffered from

witnessing traumatic events.

Specifically first aid aims to accomplish the following objectives:

1. Save/Prolong life

2. Prevent further injury

3. Lessen human suffering

4. Lessen medical expense

Typically it is you who recognize a situation as an emergency and decide to intervene to

help the victim. After recognizing the emergency and deciding to help, you must perform

the following actions quickly and reliably:

1. Survey the scene of the emergency

2. Activate the EMS system, if needed

3. Assess the victim

4. Provide first aid

Note: Refer to the BLS for the discussion of Steps 1 and 2

You are a vital link between the EMS system and the victim. Delaying these actions

present significant dangers to the victim.

Conducting the Primary Survey (Initial Assessment)

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.

Start with the following steps:

1. Determine unresponsiveness by tapping the victim on both shoulders and

ask loudly, “Are you okay?” You are not looking for an answer as much as

you are any kind of response – fluttering eyelids, muscle movement,

turning to the sound, and so on. If there is no response, the victim is

unresponsive. If conscious proceed to step 2 immediately.

2. Ask, “What happened?” The response will tell you the airway status, the

adequacy of breathing, mental status, and the mechanism of injury or

nature of illness.

3. Ask, “Where do you hurt?” The response will identify the most likely points

of injury.

4. Visually scan the victim of general appearance, cyanosis (blueness from

lack of oxygen), and sweating.

A. Obstructed airway

B. Head-tilt/Chin-lift Maneuver

C. Jaw Thrust Maneuver

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.

Use one of the following methods to open the airway.

Head Tilt/Chin Lift Maneuver

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

B

C

After you have displaced the jawbone forward, support the head carefully without

tilting it backward or moving it side to side.

b. Breathing Assessment

A responsive person is typically breathing adequately.

To determine whether a victim with an altered mental

status is breathing

This process should take only three to five seconds. If

the victim is breathing, maintain an open airway and

place the victim in recovery position. This position helps

both conscious and unconscious victims maintain an

open airway. If you suspect trauma or cervical spine

injury, do not move the victim.

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 not breathing spontaneously or not breathing adequately, begin

artificial breathing immediately (Basic Life Support training needed); continue

until the victim is breathing spontaneously or until you are relieved by trained

emergency personnel.

c. Circulation and Bleeding Assessment

If the victim has no pulse, not breathing or

gasping breathing and unresponsive, begin

cardiopulmonary resuscitation or CPR (Basic Life

Support) immediately.

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 your gloves often for blood.

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).

d. Disability (Spine Injuries) Check

A mistake in the handling of a spine-injury victim could mean a lifetime in a

wheelchair or in a bed for the victim. Therefore, it is very important to carefully

assess all conscious victims sustaining injuries from falls, collapsed structures, or

motor vehicle crashes for possible breaks on the vertebra or damage on the

spinal nerves before being moved. All unconscious victims should be treated as

though they have a spine injury. Suspect a spine injury in all head-injury victims.

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.

Stabilize against movement by

holding onto shoulders and gently

squeeze head between arms

Stabilize against movement by

holding the head

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.

Stabilize against movement by

placing objects on each side of the

head.

Stabilize against movement by

holding the head

Stabilize against movement by

holding the head

Stabilize against movement by

placing objects on each side of the

head

VII. FIRST AID FOR BLEEDING

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, aluminum 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

brush to clean thoroughly under your fingernails.

Wash all items that have the victim’s blood or body fluids on them in hot, soapy

water. Rinse well.

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, wi ll 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.

Control of external bleeding

by direct pressure.

2. Internal Bleeding

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:

Bruises or contusions of the skin

Painful, tender, rigid, bruised abdomen

Fractured ribs or bruise on the chest

Vomiting or coughing up blood

Stools that are black or contain bright red blood

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:

1. Secure and maintain an open airway, and monitor the ABCDs.

2. Check for fractures; splint if appropriate.

3. Keep the victim quiet. Position and treat the victim for shock by elevating the

feet 8 to 12 inches and covering him or her to maintain body heat. (Do not

elevate the feet if you suspect leg or spine injuries.) If the victim starts to

vomit, position his or her side with face pointing downward to allow for

drainage.

4. Monitor vital signs every 5 minutes until emergency personnel arrive.

Internal bleeding can be a serious cause of shock, and almost always requires surgical

intervention.

VIII. BONE INJURIES

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

and symptoms of bone and joint injury:

Deformity, shortening or angulation

Pain and tenderness on the site of injury

Increased temperature on the injury site

Crepitus, a grating noise that can be heard or sensation that can be felt as

broken fragments of bone grind against each other

Rapid swelling

Discoloration or redness followed by bruising 2 or 3 days later

Open wound, with or without exposed bone ends; it may be a punctured wound

Joint locked into position

Guarding behaviour (victim tries to hold the injured area in a comfortable position

and avoids moving it)

Possible loss of function

1. First aid care

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:

1. Support the injured part; gently remove clothing and jewelry around the injury

site without moving the injured area.

2. 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

enough to stop blood circulation. Follow specific guidelines for splinting listed

in the next section.

5. Check distal pulses and capillary refi ll after the splint is in place to make sure

circulation is still adequate.

6. Use cold compresses and elevation to relieve pain and reduce swelling.

2. 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.

a. General Rules of Splinting

Regardless of where you apply the splint, follow these general rules:

Do not splint if it will cause more pain for the victim.

Both before and after you apply the splint, assess the pulse and sensation

below the injury. You should evaluate these signs every 15 minutes after

applying the splint to make sure the splint is not impairing circulation,

Measure the splint to make sure it is the right size. The splint should be long

enough to immobilize the entire bone plus the joints above and below the

fractured site. For example, in immobilizing the leg, ideally, the outside splint

should be long enough to reach from the victim’s armpit to below the heel.

Secure the entire injured

extremity. Wrap roller

bandages around

improvised splints and

secure them with cravats.

Splint the injury in the

position you found it. If

there is no distal pulse or

movement, you may

attempt to return the bone

to its normal alignment by

placing one hand above

the injury and another

below. Then pull with

gentle traction while

Splinting of a femur fracture.

moving the injury back toward the correct anatomical position.

In splinting the hand or foot, immobilize in the normal position of function.

Make sure you can still see and feel the hand or foot so you can assess pulse

or sensation.

Remove or cut away all clothing around the injury site to prevent accidentally

moving the fractured bone ends and complicate the injury. Remove all jewelry

around the fractured site.

Cover all wounds, including open fractures, with sterile dressing before

applying a splint, the gently bandage. Avoid excessive pressure on the

wound.

If there is a severe deformity or the distal extremity is cyanotic or lacks

pulses, align the injured limb with gentle traction before splinting, following the

guidelines above.

Never intentionally replace

protruding bone ends.

Pad the splint to prevent pressure and discomfort to the victim.

Apply the splint before trying to move the victim

When in doubt, splint the injury.

If the victim shows signs of shock, align the victim in the normal anatomical

position and arrange for immediate transport without taking the time to apply

a splint.

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

Light in weight, but firm and rigid

Long enough to extend past the joints and prevent movement on either

side of the fracture

As wide as the thickest side of the fractured limb

Padded well so the inner surfaces are not in contact with the skin

c. Hazards of improper splinting

Improper splinting can

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

IX. TRANSPORTING VICTIMS IN AN EMERGENCY

Although speed is important in cases where a victim is exposed to hazards, it is

always more important to accomplish the handling and moving of a victim in a way that

will not further injure the victim. As a basic rule of thumb, you should not move a victim

until you absolutely have to or until you are completely ready to-and, if you can avoid it,

you should not try to move a victim by yourself if you can wait and get help.

Guidelines

1. If you find a victim in a facedown position, move the person to an assessment

position after the ABCD assessment and checking for possible neck and spinal

injury.

2. Generally, you should not move a victim if moving the person will make the

injuries worse.

3. Provide all necessary emergency care; splint all fractures, especially those of the

neck and back.

4. Move the victim only if there is immediate danger. Only when there is a threat to

life should a victim be moved before the ABCD are completed.

5. If it is necessary to move the victim, your speed will depend on the reason for the

move. For example, a victim who needs to be moved away from a fire should be

moved as quickly as possible; a victim who needs to be moved so you have

access to others victims should be moved with due considerations to his or her

injuries before and after the move.

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

available, such as in conditions involving:

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 unti l 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:

1. Bring a long board to within arms

reach.

2. Kneeling at the victim’s side, reach

across the victim and grab his or

her shoulder and hip. With another

first aider stabilizing the head and

neck, log roll the victim toward you.

3. With the victim on his or her side,

examine the victim’s back; then pull

the backboard toward you and

place it on edge against the

victim’s back. Roll the victim onto

the board.

4. Make sure that the victim is at the

center of the backboard. Use the push and pull technique in moving the

victim; lifting should be avoided.

5. Strap the victim securely to the board using cravats.

6. In moving the victim, make sure to go about it in a synchronized manner.

7. Continue to monitor the victim’s ABCDs until he or she is completely

transported to a medical facility.

b. One Rescuer Techniques

A rescuer may be required to move a victim on his own during flood, fire, building

collapse, or other life threatening situations.

Walking Assist

A method of moving a victim in which a single rescuer functions as a

“crutch” in assisting the injured victim to walk

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

A method of moving an injured victim in which a rescuer places the

victim on a blanket and drags the victim to safety.

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 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

A method of moving a victim in which a single rescuer forms a drag

harness out of a sheet, passes it under the victim’s arms at the armpits, and

uses it to pull the victim.

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.

c. Two and Three-Rescuer Techniques

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.

2. Each First Aiders slips his or her other arm around the victim’s thighs,

then clasps the wrist of the other First Aider. One pair of arms should

make a seat, the other pa a backrest.

3. Slowly raise the victim from the ground, moving in unison. In one

variation, the First Aiders make a seat with all four hands; the victim

then supports him or herself by placing his or her arms around the First

Aider’s shoulders.

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.

1. One First Aider kneels at the victim’s head; the other kneels at the

victim’s knees.

2. 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.

3. 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.

Chair Lifter Carry (Two Rescuers)

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.

Flat Lift and Carry (Three Rescuers)

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.

1. 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.

2. Each First Aider kneels on the knee closest to the victim’s feet.

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 unti l 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)

One Rescuer Moves

Drags

Two or Three Rescuer Moves

REFERENCES

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

http://www.ifrc.org/Global/Governance/Policies/firstaid -policy-en.pdf

http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_317350.pdf

http://www.philheart.org/documents/cprhandsonly.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 3

rd Edition”.1999. Jones and Bartlett

Singapore Civil Defence Force. “Emergency Handbook”. 2005.