Sei sulla pagina 1di 55


Disa ster Risk Reduction Management ( DRR M) in the Philippines

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 worlds 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


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 skills in assessing capacity and vulnerability of a
disaster prone community.
4. Integrate the knowledge and skills learned in this module in the community

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, thats 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
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 Nio Southern Oscillation (ENSO). The El Nio 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.

has approximately 11.9 million and it is now one

of the most densely populated areas in
Southeast Asia.

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.
Distribution of Faults and Trenches around Metropolitan Manila

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

district including Makati is located, as well as alluvial lowlands along the Mari kina River
and the Laguna Lake. In case of an earthquake, liquefaction in these lowland areas
may cause damage to buildings 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). Isnt this exciting! Let us see ho w 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
(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
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, si nce 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
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?
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
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
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
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 peoples 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
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.

Now, let us define some important terms:

Before we get our gears ready, let us

first define some important terms and

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)


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:




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

peoples 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:


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.






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 clich 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 dont 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 earths
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.

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


What to do during earthquakes?

Duck, Cover and Hold
1. DUCK or DROP down to the floor.
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.
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.

1. California Governo rs Office of Emergen cy Services.(2003). Ea rthquake Preparedness Tips. Retrieved from: ch_d rill.pdf
2. Earthquake and Tsunami.(1990). Department of Scien ce and Technology- Philippine Institute of Volcanology and
Seismology. Quezon City: DOST-PHILVOLCS.
3. National Disaster Risk Reduction and Management Council. (2005). Philippine Disaster Managemen t
Framework. Retrieved from: http://www.nd
4. Singapore Civil Defence Fo rce. (2005). Emergency Handbook.Singapore: Singapore Governmen t.

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.

Japan Tsunami [Ima ge](n.d.). Retrieved from: rtoonada ca rtoon/

Some Natural Signs of an approaching Local Tsunami:

1. A felt earthquake

2. Unusual sea level change:

sudden sea water retreat or

3. Rumbling
approaching waves


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 buildings located in low lying coastal areas are not safe. The upper
floors of a high multi-storey, reinforced concrete building 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.

Earthquake and Tsunami.(1990). Depa rtment of Scien ce and Technology- Philippine Institute of
Volcanology and Seismology. Quezon City: DOST-PHILVOLCS.

Singapore Civil Defence Fo rce. (2005). Emergency Handbook.Singapore: Singa pore Governmen t.

C. Storm Surge
Storm surges are abnormal rise
of water generated by storms, over
and above the predicted astronomical
tide. Its 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://voic 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 windsRMW), 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.
1. Monitor the storms progress and listen for further warnings or instructions from local
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
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.

What to do to during fire:

1. When youre 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 cant control.
3. If theres 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
5. Do not run, if your clothes catches fire but
Stop Drop and Roll instead.
6. When youre trap in a room, do the following:
a) Check to see if theres heat or
smoke coming in the cracks
around the door.
b) Dont open the door when you the smoke coming under the door.
c) Touch the door if you dont see the smoke. If its hot or very warm then
dont open it.
d) If you dont see smoke and the door isnt hot, then slightly use your fingers
to lightly touch the doorknob. If its hot, dont open it.
e) If the doorknob feels cool and you dont 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 theres no smoke or heat when you open the door, quickly make your
way out.
h) Yell for help.

Bureau of Fire Pro tection. (2009). Fire code of the Philippines. Retrieved from:
Bureau of Fire Pro tection. (n.d.) Fire Safety Tips. Retrieved from:
Singapore Civil Defence Fo rce. (2005). Emergency Handbook.Singapore: Singapore Governmen t.

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.

Source: Landslide [Image](2008). Retrieved from:
20websi te/Home.htm

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
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.

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

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

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

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
Source: Pyroclastic flows at Mayon Volcano [Image](n.d.).
crater situated at the summit of the
Retrieved from:
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
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

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.
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
Ezine Articles. (n.d.). Volcano Eruption - 15 Important Factors To Prepare. Retrieved from:
Philippine Institute of Volcanology and Seismology. (2008). Active Volcanoes. Retrieved from: http://www.phivolcs.
(n.d.). Safety During Volcanic Eruptions. Retrieved from:

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
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
destroyed properties and caused a
number of casualties in different regions
of the country as many were caught
unaware of the intensity of these
Source: Typhoon [Image](n.d). Retrieved fro m:

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

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 kilometers 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:

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

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.

CHED Memorandum Order No. 34. (2010) Commission on Higher Education (CHED). Retrieved from:
DepED Guidelines on the Suspension of Classes. (2005). Department of Education. Retrieved from:
Philippines Atmospheric, Geophysical and Astronomical Service Administration Retrieved from:
Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.
Typhoon Preparedness. (n.d.). Retrieved from:

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
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." (
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: 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 communitys adaptive capacity to these
climate risks. For one, intense typ hoons 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-nio 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
13. Provide education in disease prevention


United States Environmental Protection Agency. Retrieved from:

National Aeronautics and Space Administration. Retrieved from:
Climate Change in the Philippines (2011). Philippine Atmospheric, Geophysical and Astronomical Services

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.


This analysis was first developed as a research methodology to assess
disaster-prone communities in Oxfam Great Britains 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

PCVA also known as Participatory

Assessment is a research methodology
that is both an analysis and a learning
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

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 communitys vulnerability is affected by the following factors:

1. Physical / Material Vulnerability

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

2. Social and Organizational Vulnerability

Family and kinship structures

Lack of leadership and initiatives
Neglected by government and

administrative structures
Conflicts, cast system, ideology
community affairs
Exclusion of certain groups from

Negative attitude towards change

Passivity, fatalism, hopelessness
Lack of initiative or fighting spirit
Dependency on external support

3. Motivation and Attitudinal Vulnerability

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.

The key principle in assessing capacities is that even

the WEAKEST have some skills, resources,
strengths to help themselves and also others.

If we ignore rather than support, the capacities

and coping mechanisms might be undermined and weakened and eventually
increase vulnerability
A. Physical / Material

Asset Pentagon

Cash, land tools, food, jobs

B. Social / Organizational
Social Networks
Extended Family
Local and National welfare Institutions
C. Attitudinal / Motivational
Sense of Control





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.

Physical /Material

What productive resources,

skills and hazard exist?


What are the relations and

organizations among


How does the community
view its ability to create

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 communitys 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

Hazard Map


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


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
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
9. Demonstrate the different methods in transporting a victim in an emergency

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 victims
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. Its 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.


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.
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.


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-tomouth resuscitation; and washing your hands
thoroughly after any contact with a victim.


Basic life support is the act of sustaining lifesustaining 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 CompressionAirway-Breathing (CAB) sequence.
Compression rate should be at least 100/min rather than approximately 100/min.
Compression depth was increased from 1 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

Survey the scene

Check unresponsiveness then pulse
Call for medical assistance (activate Emergency Medical Services or EMS)
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

Survey the scene

Check unresponsiveness then pulse
Call for medical assistance (activate Emergency Medical Services or EMS)
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 wont 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
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 tilt with your hand nearest the victims head on forehead.
2. Locate the Adams apple with 2 or 3 fingers of hand nearer victims 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 victims 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
victims mouth and maintaining pressure on the victims 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 yo u can handle.


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:

Save/Prolong life
Prevent further injury
Lessen human suffering
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:

Survey the scene of the emergency

Activate the EMS system, if needed
Assess the victim
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
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.

These steps provide a quick assessment of the victims 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 victims 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 yo ur index finger.
Use one of the following methods to open the airway.
A. Obstructed airway
B. Head-tilt/Chin-lift Maneuver
C. Jaw Thrust Maneuver

Head Tilt/Chin Lift Maneuver

Jaw Thrust Maneuver


1. Facing the top of the

victims head, place
one hand on each side
of the victims head,
resting your elbows on
the surface on which B
the victim is lying.
2. Place
under the angles of the
victims lower jaw and
lift with both hands,
3. If the lips close, retract the lower lip with your thumb.

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
victims 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
Finally, check the victims 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 victims head and neck)

If you suspect the victim has any possibility of a spinal injury, establish manual
in-line spinal stabilization by bringing the victims 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

placing objects on each side of the

Stabilize against movement by

holding the head

Stabilize against movement by

placing objects on each side of the

Caution! DO NOT move the victim, even if the victim is in water. Wait for the EMS to arri ve 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 misha ndle 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.

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 victims 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.

Stabilize against movement by

holding the head

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 victims 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, 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 Control of external bleeding
by direct pressure.


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
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
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:

Spinal fractures
Fractures of the head and rib cage
Pelvic fractures
Fractures of the lower limbs
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 victims 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 refill 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.


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 victims armpit to below the heel.
Secure the entire injured
extremity. Wrap
improvised splints and
secure them with cravats.
Splint the injury in the
position you found it. If
there is no distal pulse or
attempt to return the bone
to its normal alignment by
placing one hand above
the injury and another
below. Then pull with

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
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
Splinting of a femur fracture.
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
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


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.
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
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 victims head and neck in normal anatomical position until the victim is
supine on the backboard; apply a rigid cervical collar to the victims 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
2. Kneeling at the victims 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 victims back; then pull
the backboard toward you and
place it on edge against the
victims 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 victims 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 victims side and drape the victims arm across yo ur
2. Support the victim by placing your arm around his or her waist
3. Using your body as a crutch, support the victims weight as you both
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 victims head and drag
the victim toward you; if you have to move on a stairway, keep the length
of the victims 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 victims
shirt as a handle to pull the victim (except for a T-shirt).
1. Fasten the victims hands or wrists loosely together, then link them to
the victims belt or pants to keep the arms from flopping or coming out
of the shirt.
2. Grasp the shoulders of the victims 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 victims 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 victims 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 victims chest at the nipple line.
2. Pull the ends of the sheet under the victims arms at the armpits and
behind the victims head; twist the ends of the sheet together to form a
triangular support for the head. Be careful not to pull the victims hair.
3. Grasping the loose ends of the sheet, pull the victim toward you.
Firefighters Carry
A method of lifti ng 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 victims center of mass high-usually at the rescuers
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 victims wrists.
2. Stand on the toes of both the victims 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 victims legs and grasp the victims 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 victims back.
2. Each First Aiders slips his or her other arm around the victims 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
Aiders 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
1. One First Aider kneels at the victims head; the other kneels at the
victims knees.
2. The First Aider at the victims head places one hand under each of the
victims shoulders, the second First Aider grasps the victims wrists.
3. The First Aider at the victims knees pulls the victim to a sitting position
by pulling on the victims wrists; the First Aider at the victims head
assists by pushing the victims shoulders and support his back.
4. The First Aider at the victims head slips his or her hands under the
arms, grasps the victims wrists.
5. The First Aider at the victims knees slips his or her hands beneath the
victims 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 victims
shoulders; another stands at the victims hips, and the third at the
victims knees.
2. Each First Aider kneels on the knee closest to the victims feet.
3. The First Aider at the victims shoulder works his or her hands
underneath the victims neck and shoulders; the next First Aiders
hands go underneath the victims hips and pelvis; and the final First
Aiders hands go underneath the victims 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 victims 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 CP R 3 rd Edition.1999. Jones and Bartlett)
One Rescuer Moves


Two or Three Rescuer Moves

Websites 13/latest-201103130913-japan/
http://japantsunaminow. -nuclear-reactor-japan-tsunamiearthquak e-world-photos-meltdown/ -polic y-en.pdf

Hafen, B., Karren, K., Limmer, D., Mistovich, J. An Introduction to First Aid for Colleges and Universities
Eight Edition. 2004. Pearson
US National Safet y Council. First Aid and CP R 3 Edition.1999. Jones and Bartlett
Singapore Civil Def ence Force. Emergency Handbook . 2005.