Chapter 4 DRRM PDF
Chapter 4 DRRM PDF
Chapter 4 DRRM PDF
The Sustainable Development Goals (SDG) is a successor of the Millennium Development Goals (MDG) in
addressing the global challenges faced by different nations - including but not limited to poverty, inequality,
climate, environmental degradation, prosperity, and peace and justice. 1
After more than a decade of collaborations with different nations and a ratification process, the UN General
Assembly adopted the 2030 Agenda for Sustainable Development, with 17 SDGs at its core, at the UN
Sustainable Development Summit on September 2015 in New York
This is a collection of 17 sustainable development goals and associated targets agreed upon by the United
Nations General Assembly in 2015 as targets for the year 2030. The targets are proposed to “meet[ing] the
needs of the present without compromising the ability of future generations to meet their own needs” 1
ensuring that “no one gets left behind”
That year (2015), several multilateral and international policy shaping conferences were held to address the
global concerns of different nations. One of these was the Third United Nations World Conference on
Disaster Risk Reduction, held from 14 to 18 March 2015 in Sendai, Miyagi, Japan.
1Development, World Commission on Environment and. "Our Common Future, Chapter 2: Towards Sustainable Development - A/42/427
Annex, Chapter 2 - UN Documents: Gathering a body of global agreements". www.un-documents.net.
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During the conference, the following concerns were prominent: the emphasis on the need to tackle disaster
risk reduction and climate change adaption when setting the Sustainable Development Goals, the demand
to consider the practicality of the goals, how to ensure ownership of action by all stake holders and
strengthen their accountability, and the most the significant shift to a strong emphasis on disaster risk
management as opposed to disaster management. At the end of the conference, the Sendai Framework for
Disaster Risk Reduction 2015–2030 was adopted.
Since the desired outcome for both the SDG and the Sendai Framework are a result of intricate and
interconnected social and economic processes with overlap across the two agendas, important synergies
are found thereby allowing the simultaneous and coherent monitoring and reporting on the two frameworks,
namely goals and targets of the 2030 Agenda for Sustainable Development (targets of SDGs 1, 11 and 13).2
2Sendai Framework. (2018, February 27). The Sendai framework and related SDG targets. Retrieved from
https://wateractiondecade.org/2018/01/06/the-sendai-framework-and-related-sdgs-targets/
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Lesson One
PHILIPPINES: DISASTER, HAZARDS AND RISK
Before we get our gears ready, let us first define some important terms and concepts:
HAZARD
any phenomenon, substance or situation, which has the
potential to cause disruption or damage to infrastructure
and services, people, their property and their
environment.
Hazards can be:
Natural (eg. earthquake, typhoon, etc);
Environmental (eg. loss of biodiversity, ozone
depletion, deforestation)
Anthropogenic hazards are induced entirely or
predominantly by human activities and choices
(eg. deforestation, riot, arson, cyber-crime)
RISK
The probability that negative consequences may arise
when hazards interact with vulnerable areas, people,
property and environment
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 materials and
physical resources, skills, social resources, beliefs and attitudes (e.g. ownership of land and safe
location of homes, adequate income, adequate food resources, savings etc.)
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VULNERABILITY (WEAKNESSES)
Did you know?
A concept which describes factors or
constraints of an economic, social,
“Disaster is primarily a question of vulnerability.
physical or geographic nature, which
A disaster occurs as a result of a hazard that
reduce the ability of a community to
strikes a vulnerable community or group whose
prepare for and cope with the impact
inherent capacity is not enough to withstand or
of hazards
cope with is adverse effects and impacts. “
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.
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In your Module 3: PCVA and DRRM, take note and study the DOMINANT DISASTER MANAGEMENT
POLICIES IN THE COUNTRY. Reflect on them and verify with your own experience how true and relevant
these are. Analyze the effectiveness in managing impending disaster. Do you find them 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 attitudes are
relevant principles in assessment of our vulnerability and our capacity to cope and respond.
Let us see how much you know about the current situation of our country specifically Metro Manila. It’s good
if you are familiar with the facts that will be detailed below. For those who will encounter these for the first
time, this is a moment for you to reflect on the things that might happen should a disaster happen in the
country. The important question that we need to answer is…
3 https://www.phivolcs.dost.gov.ph/
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A. Philippines: Facts and Figures
Due to rapid urbanization, there are unsatisfactory infrastructure construction, poor housing
condition, highly dense areas, and areas characterized by mixed land use and other
inappropriate conditions.
Metro Manila is also 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, the
Valley Fault System is considered to potentially cause the largest impact to the Metropolitan
Manila area should it generate a large earthquake.
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Chapter 4: Disaster Risk Reduction and Management
It 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 infrastructures. 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
Major contents of the study which are notable to the current Philippine situation are the preparation
of disaster management plan for Metropolitan Manila , and community based disaster management
activities.
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MMEIRS results
As a result of the study, there are 105 recommended action plans the Metropolitan Manila Disaster
Coordinating Council (MMDCC) members should implement within 3 to 6 years. Also, based on the
damage estimation by MMEIRS Study:
40%
There is a potential rupture of the West Valley Fault, approximately 40%
of the total number of residential buildings within Metropolitan Manila will
collapse or be affected.
This human loss, together with properties and economic losses of Metropolitan Manila will be a national
crisis.
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 this information to yourself, share it with your friends, families and neighbors. It is better to
be prepared than suffer the negative/ untoward and adverse consequences of disasters!
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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 generate VOLCANIC EARTHQUAKES. 4
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.5
4 http://www.om pongplaza.org.ph/MMEIRS/08_BOOKLET/05_MITIGATION_HANDBOOK.PDF
5 http://www.ompongplaza.org.ph/MMEIRS/02_VOL2_MAIN1/MAIN1_02.PDF
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Currently, there are 101 seismic
monitoring stations all over the
Philippines operated by PHIVOLCS,
equipped with seismometers that
detect and record earthquakes. Data
is sent to the PHIVOLCS Data
Receiving Center (DRC) to determine
earthquake parameters such as
magnitude, depth of focus and
epicenter.
Philippine Institute of
Volcanology and Seismology
Contact Information
Official mail:
[email protected]
Twitter account: @phivolcs_dost
B. Tsunami
6 https://www.phivolcs.dost.gov.ph/index.php/earthquake/introduction-to-earthquake
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Some Natural Signs of an approaching Local Tsunami:
A felt earthquake
7
What to do during tsunami?
7Earthquake 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.
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C. Storm Surge
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.
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, 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 a higher ground. Most cars can be swept away by less than two feet of moving water.
6. Make sure to 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.
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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.
8
What to do during Fire?
8Bureau 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
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E. Landslide
9
What to do during Landslide?
10
What to do 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.
10 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
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Chapter 4: Disaster Risk Reduction and Management
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.) Retrieved from http://geologycafe.com/images/landslides.jpg
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
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.
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The classification of tropical cyclones according to the strength of the associated winds as adopted
by PAGASA as of May 01, 2015 are as follows11:
1. Listen to the radio or local news for updates on the direction and strength of the typhoon.
2. Secure or move outdoor items inside like toys, grills, bicycles, furniture, plants and anything
moveable on the balcony. Move potted plants and other heavy objects away from windows 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 floor 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.
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.
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 that 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
12 Singapore Civil Defence Force. (2005). Emergency Handbook. Singapore: Singapore Government. Typhoon Preparedness.
(n.d.). Retrieved from: http://www.pdfio.com/k-430968.html#
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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/)
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.
Global mean temperature anomalies since the mid-19th century compared with the 1961-1990 average.
Retrieved from: Climate Change in the Philippines (2011). Philippine Atmospheric, Geophysical and
Astronomical Services Administration
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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.
Observed annual mean temperature anomalies (1951-2010) in the Philippines based on 1971-2000 normal values.
Retrieved from: Climate Change in the Philippines (2011). Philippine Atmospheric, Geophysical and Astronomical
Services Administration
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 are 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
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Chapter 4: Disaster Risk Reduction and Management
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?
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Lesson Two
PCVA: PARTICIPATORY CAPACITIES & VULNERABILITIES
ASSESSMENT
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.
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.
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
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A. Vulnerability Assessment
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
And other similar features
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B. Capacities Assessment
This process determines how people respond in time of crisis to reduce the damaging effects of
hazards. It also determines the coping strategies and resources of the communities.
The British DFID (Department for International Development) Asset Pentagon is an important
component in the Sustainable Livelihood Framework that visually represents people's assets. It
illustrates the importance of the interrelationship of each different assets and still considering the
aspect of 'vulnerability'.
HUMAN CAPITAL
skills, knowledge, abilities, health status
and other capabilities of the human
factor that enables them to pursue labor.
Other matrices of the human capital can
be Attitudinal / Motivational such as
sense of control, confidence, power
NATURAL CAPITAL
stocks of natural resources such as
intangible public goods from the
environment and the biodiversity of the
community (such as trees, rivers, etc.)
FINANCIAL CAPITAL
income, economic and monetary
resources, investments or any cash
equivalents
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PHYSICAL CAPITAL
infrastructures, direct public things that help in access and control of the production
SOCIAL CAPITAL
networks and connectedness, memberships in formalized groups, and other benefits that comes
through relationships between institutions and people such as local, national and international welfare
institutions.
The central point of the pentagon, where the lines intersect, means zero access to assets while the
outer perimeter represents maximum access to these assets. Below are ways on how it is utilized.
In the upper pentagon on the left the following is true: a reasonable but
declining access to physical capital; limited access to natural capital
and a falling movement to the social capital.
We can draw the following conclusion based on the given: the assets
represented live in an urban area but do not have the skills or finance
to invest in infrastructure maintenance. Forming social groups has
also been constrained based on the indicator in the social capital area
of the pentagon.
Meanwhile, the left lower pentagon shows a situation after support has
been given to financial capital assets (perhaps through micro-finance
schemes), the social capital also rose (maybe through gathering and
organizing activities that developed skills and provide training - human
capital). Together these enable the people to maintain and extend the
physical capital while the natural capital remains unchanged.
Given the two pentagon diagram, what conclusions can you draw from the two different
communities?
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If you combine the data, you gathered from the vulnerability and capacity assessment you will come up
with this matrix below.
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Community Disaster Evacuation Map
http://www.mercycorps.org/julierogers/blog/24801
©UST-NSTP 2011
Hazard Map
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Seasonal Calendar
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CONCLUSION
Our history has been a witness to the shifts and developments of disaster management in
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 involves response only, where in fact, response is 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
(e.g. mass collection for relief operation) during actual disaster to one that actually pays attention to equally
significant considerations like preparedness, mitigation, recovery and rehabilitation
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Lesson Three
BASIC FIRST AID & IMMOBILIZATION USING BACKBOARD
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 remained paralyzed for the rest of
his/her 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 the different
aspects of 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.
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The initial step in recognizing an emergency is noticing that something is wrong. But generally, you
will know when an emergency happens. You can tell by the type of injuries or by how the victim looks.
Of greatest concern to First aiders and others in emergency setting are infectious diseases
especially Hepatitis B, meningitis, tuberculosis and AIDS. You can minimize your risk of infection by
wearing protective gloves; wearing other protective gear as appropriate; using pocket mask during
mouth-to-mouth resuscitation; and
washing your hands thoroughly after
any contact with a victim
Also, in the 2010 guidelines, several steps in traditional CPR were removed while some were
improved. The summary of major changes is the following:
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Emphasis was placed on high-quality CPR (Adequate rate and depth, complete chest recoil
after each compression, 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.
Note: Ask for consent and introduce yourself after checking unresponsiveness and preparing for CPR
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GENERAL SEQUENCE OF FIRST AID RESPONSE
First aid is the immediate help provided to a sick or injured person until a 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.
Save/Prolong life
Prevent further injury and/or disability
Lessen human suffering
Lessen medical expense
to promote recovery
to provide pain relief measures
to address immediate health needs
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Typically, it is you who recognize a situation as an emergency and decide to intervene and help the victim.
After recognizing the emergency and deciding to help, you must perform the following actions quickly and
reliably:
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.
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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.
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.
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.
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CALL 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.
CARE 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).
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.
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A. Head-Tilt/Chin-Lift Maneuver
If you do not suspect cervical spine injury
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.
Click the link for video: Chin-Lift and Jaw Thrust Video
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Chapter 4: Disaster Risk Reduction and Management
Head-Tilt/Chin-Lift Maneuver vs Jaw Thrust Maneuver
While the head-tilt/chin-lift is the preferred method, it can be dangerous to use on a patient who
may have a cervical spine injury. That's where the jaw-thrust maneuver comes in: it allows you to
clear the tongue from the airway with minimal neck movement, allowing rescue breaths to be
administered. However, because it's considered relatively difficult to perform correctly, most
basic CPR courses will only cover the head-tilt/chin-lift maneuver. (Rhett, cpr-savers.com)
Breathing Assessment
A responsive person is typically breathing adequately.
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.
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.
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Checking for Pulse
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, neck,
arms, chest, abdomen, pelvis, 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).
Check for the pulse using the carotid artery by the following these steps:
1. Maintain head tilt with your hand nearest the victim’s head on forehead.
2. Locate the Adam’s apple with 2 or 3 fingers of the 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.
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Chapter 4: Disaster Risk Reduction and Management
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:
If you suspect the victim has any possibility of a spinal injury, establish manual in-line spinal
stabilization by bringing the victim’s head into a neutral in-line position. Have someone in the scene
hold the victims head so that the nose is in line with the navel (belly button) and the neck is not bent
forward or backward. Instruct the victim not to move his or her neck.
CAUTION!
DO NOT move the victim, even if the
victim is in water. Wait for the EMS to
arrive – they have the proper training and
equipment. Victims with suspected
spine injury require cervical collars and
stabilization on a spine board. It is better
to do nothing than to mishandle a victim
with a spine injury.
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Chapter 4: Disaster Risk Reduction and Management
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.
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. 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.
3. If bleeding continues, apply pressure at a pressure point, in
combination with direct pressure over the wound. The two most Control of external bleeding tourniquet.
accessible pressure points are: the brachial point in the upper
inside arm and the femoral point in the groin.
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Chapter 4: Disaster Risk Reduction and Management
4. 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.
5. The use of tourniquet to control bleeding should be a last resort only, when all other methods have
failed. It can be used only on an extremity; using it may lead to amputation of the extremity below
the tourniquet
Internal Bleeding
Internal bleeding generally results from blunt or penetrating trauma or certain fractures (such as pelvic
fracture). Though not visible, internal bleeding can be very serious – even fatal – because shock can develop
rapidly. You should suspect internal bleeding based on signs and symptoms as well as the mechanism of
injury.
The signs and symptoms of internal bleeding are similar to those of shock: restlessness and anxiety; cool
clammy skin; weak rapid pulse; rapid breathing; and ultimately, a drop in blood pressure. There may be
additional signs and symptoms depending on the source of bleeding some of which are:
Internal bleeding may not cause signs or symptoms for hours or days and it may be occurring even if there
are no signs and symptoms. For victims of internal bleeding, activate the EMS system, then:
Internal bleeding can be a serious cause of shock, and almost always requires surgical intervention
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:
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 for nerve function. There may be nerve damage if the victim cannot feel the
squeeze 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.
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
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Chapter 4: Disaster Risk Reduction and Management
B. 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.
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.
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.
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Chapter 4: Disaster Risk Reduction and Management
Cover all wounds, including open fractures, with sterile dressing before applying a splint, then
gently bandage. Avoid excessive pressure on the wound.
If there is a severe deformity or the distal extremity is cyanotic or lacks pulse, align the injured
limb with gentle traction before splinting, following the guidelines above.
b. Improvised Splints
You may have access to commercial splint, but it is more likely that you will improvise at the scene.
A splint can be improvised from a cardboard box, cane, ironing board, rolled -up magazine, umbrella,
broom handle or any other similar object.
You can also use a self-splint (also called an anatomical splint) by tying or tapping an injured part to
an adjacent uninjured part. For example, splint a finger to a finger, a toe to a toe, a leg to the other
leg, or an arm to the chest. An effective improvised splint must be
Compress the nerves, tissues and blood vessels under the splint, aggravating the existing
injury and causing new injury
Cause or aggravate damage to the tissues, nerves, blood vessels, or muscles as a result of
excessive bone or joint movement
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Chapter 4: Disaster Risk Reduction and Management
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 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.
A. 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 is in
danger of toppling off an embankment)
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)
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Chapter 4: Disaster Risk Reduction and Management
a. Moving Victims Using the Spine board
If there is a suspected spine injury, you need to
immobilize the spine. Manually support the victim’s
head and neck in normal anatomical position until
the victim is supine on the backboard; apply a rigid
cervical collar to the victim’s neck. But before you
move the victim into the backboard, stabilize
airway, breathing, circulation, and hemorrhage;
correct any life threatening problems, then provide
other care as needed. Bandage all wounds, splint all
fractures, and give psychological support. To get
the victim onto a backboard, follow these steps:
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Chapter 4: Disaster Risk Reduction and Management
b. One Rescuer Techniques
Illustrations (From US National Safety Council. “First Aid and CPR 3rd Edition”.1999. Jones and Bartlett)
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. 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.
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Chapter 4: Disaster Risk Reduction and Management
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 pair 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.
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Chapter 4: Disaster Risk Reduction and Management
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.
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 until the victim rests on the bends of their elbows.
5. Moving in unison, all three rise to a standing position and walk with the victim to a place
of safety or to the stretcher. To place the victim on the stretcher, simply reverse the
procedure.
This may also be done by four rescuers positioned at the victim’s head, chest, hips and knees.
Support is then given to the head, chest, hips, pelvis, knees and ankles.
Alternative: Flat life and Carry for two-rescuers, Make sure that the tallest
rescuer is at the head area, and one hand is under the head.
(Image from Wikipedia.org)
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Chapter 4: Disaster Risk Reduction and Management
Illustrations for the lifts and carries
From US National Safety Council. “First Aid and CPR 3rd Edition”.1999. Jones and Bartlett
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Chapter 4: Disaster Risk Reduction and Management
SOURCES
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 3rd Edition”.1999. Jones and
Bartlett Singapore Civil Defence Force. “Emergency Handbook”. 2005.
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