Welcome to Chapter 4!

In the previous chapter, you have learned much about the different issues and problems that concern us, citizens and our country as a whole. You are now aware of the Millennium Development Goals (MDG) as it calls us to do our part whether big or small action to respond to the 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 Philippines.

LESSON 1:
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 fieldwork Let us see how much you know about the current situation of our country specifically to Metro Manila. If your familiar with the facts that will be detailed below, 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

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

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generators. The Philippines has approximately 400 volcanoes, of which 23 are known to be currently active. A. Philippines: Facts and Figures The Philippines is situated at the junction of two large converging tectonic plates - the Pacific plate and the Eurasian plate. It has experienced the most destructive earthquake in July 1990 with a death toll of approximately 1,666 and 12.2 billion pesos in damages.
Geological Disasters in the Philippines: The July 1990 Earthquake and the June 1991 Eruption of Mount Pinatubo

It lies in the path of turbulent typhoons, with an average of 20 typhoons crossing the Philippine area of responsibility. The archipelagic nature of the Philippine coastal areas increases susceptibility to storm surges, tsunamis and sea level changes. The country experiences floods and landslides which are common due to rains brought by typhoons and monsoon. Located in the western part of the Pacific Ocean, the country is also vulnerable to the El 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 11.5 million and it is now one of the most densely populated areas in Southeast Asia.
(2007 Census of Population, http://www.census.gov.ph/data/census2007/index.html)

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.

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 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 Marikina 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 how the study went.

The Metropolitan Manila Earthquake Impact Reduction Study (MMEIRS)

In August 2002 to March 2004, the Government of Japan through the Japan International Cooperation Agency (JICA) granted an aid to the Philippines to study for Metropolitan Manila Earthquake Impact Reduction Study (MMEIRS). It focuses on how to manage potential earthquakes in Metro Manila.

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The objectives of this study are: (1) to formulate a master plan for earthquake impact reduction in Metro Manila; and, (2) to carry out technology transfer to Metro Manila Development Authority (MMDA) and Philippine Institute of Volcanology and Seismology (PHIVOCS) in the course of the study. Major contents of the study which are notable to the current Philippine situation is the preparation of disaster management plan for Metropolitan Manila, and community based disaster management activities.

MMEIRS results
As a result of the study, there were 105 recommended action plans which the Metropolitan Manila Disaster Coordinating Council (MMDCC) members should implement within 3 to 6 years. Also, based on the damage estimation by MMEIRS Study: There is a potential rupture of West Valley Fault, approximately 40% of the total number of residential buildings within Metropolitan Manila will collapse or be affected. This building collapse directly affects large numbers of people, since it is estimated to cause 34,000 deaths and 1,144,000 injuries. Moreover, additional 18,000 deaths are anticipated by the fire spreading after the earthquake event. This human loss, together with properties and economy losses of Metropolitan Manila will be a national crisis. To know more about this study, follow this link http://www.phivolcs.dost.gov.ph/index.php?option=com_content&view=article&id=41 9%3Ammeirs&catid=66&Itemid=300083.

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Now that you are updated with the current disaster situation of our country, it is time to ask ourselves, how prepared are we? How does our country respond and manage these threats?

Take note and study the DOMINANT DISASTER MANAGEMENT POLICIES IN THE COUNTRY. Reflect on it and verify with your own experience how true and relevant this is. Try to analyze its effectiveness in managing impending disaster. Do you find it useful and effective? All attention of disaster response is focused on the hazard and the disaster event itself Reactive, response-oriented Disaster preparedness is inadequately integrated into the overall development planning process Non-participatory It follows a top-down, control of policies It is also interesting to note how an ordinary Filipino views disaster. These prevailing views and attitude is a relevant principle in our assessment of our vulnerability and our capacity to cope and respond. Disasters are unforeseen events People affected are helpless victims and passive recipients Donors decide what victims need Responses are on individual families and on restoring infrastructure Key players are government, aid agencies, scientist, experts and disaster managers Top-down approach

What are your thoughts about this? Too passive? Is this also how your family or community views disaster?
These common notions about how we view disaster are not flattering at all. In fact one expert in disaster management cited that disasters in developing countries were caused by 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 (Berbilidin:1990)

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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:

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

Before we get our gears ready, let us first define some important terms and concepts: Hazards any phenomenon, substance or situation, which has the potential to cause disruption or damage to infrastructure and services, people, their property and their environment. Can be: NATURAL (i.e. earthquakes, droughts) HUMAN INDUCED ( i.e. industrial accidents, armed conflicts) ENVIRONMENTAL (i.e. loss of biodiversity, ozone depletion, deforestation) http://www.onsafelines.com/new-international-coshh-symbols.html

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Risk

The probability that negative consequences may arise when hazards interact with vulnerable areas, people, property and environment The probability of harmful consequence or expected losses resulting from the interactions between hazards and vulnerable conditions To understand better, check out this diagram:

RISK =

HAZARD

X Vulnerability CAPACITY

Vulnerability (weaknesses) A concept which describes factors or constraints of an economic, social, physical or geographic nature, which reduce the ability of a community to prepare for and cope with the impact of hazards Capacities (strengths) The resources and skills people possess, can develop, mobilize and access which allow them to have more control over shaping their own future and coping with disaster risks The existing strengths in individuals and social groups related to 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:

(Anderson:1989)

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Disaster The serious disruption of the functioning of society, causing widespread human, material or environmental losses, which exceed the ability of the affected communities to cope using their own resources. Disasters occur when the negative effects of the hazards are not well managed. Risk Reduction Measures These are various activities, projects and programs that the communities may identify after assessing and analyzing the risks that they face. These measures are specifically intended to reduce the current and prevent future risks in the community.
DISASTER RESTORATION LONG-TERM RECOVERY

PRE-DISASTER

RESILIENT COMMUNITY

NON RESILIENT COMMUNITY

TAKE NOTE: A disaster resilient community (individual) has the capacity or ability to anticipate, prepare for, respond to and recover quickly from the impacts of disaster. Now let us move on to the natural disasters that commonly hit the Philippines. As the 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.
(http://www.ompongplaza.org.ph/MMEIRS/08_BOOKLET/05_MITIGATION_HANDBOOK.PDF)

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The destructive effects of earthquakes are due mainly to intense ground shaking or vibration. Because of severe ground shaking, low and tall buildings may tilt, split, topple or collapse, foundation of roads, railroad tracks and even bridges may break, electric posts may tilt or topple, water pipes and other utility installations may get dislocated, dams and similar structures may break and cause flooding, landslides and other forms of mass movement may occur in hilly and mountainous areas and tsunamis may be generated. These destructive effects of earthquake may cause many casualties and short to long term socio-economic disruptions. The following figures show the historical distribution of earthquakes recorded in some parts of the country for the past decades.

Distribution of Historical earthquakes from 1608 to 1895

Distribution of Instrumentally recorded Earthquakes from 1907 to 2002

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

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.

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Sources: 1. California Governors Office of Emergency Services.(2003). Earthquake Preparedness Tips. Retrieved from: www.oes.ca.gov/CEPM2003.nsf/htmlmedia/dch.../dch_drill.pdf 2. Earthquake and Tsunami.(1990). Department of Science and Technology- Philippine Institute of Volcanology and Seismology. Quezon City: DOST-PHILVOLCS. 3. National Disaster Risk Reduction and Management Council. (2005). Philippine Disaster Management Framework. Retrieved from: http://www.ndcc.gov.ph/ 4. Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.

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[Image](n.d.). Retrieved from: http://www.cartoonaday.com/tag/japan-tsunamicartoon/

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Some Natural Signs of an approaching Local Tsunami: 1. A felt earthquake

2. Unusual sea level change: sudden sea water retreat or rise

3. Rumbling sound of approaching waves

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.
Sources:
Earthquake and Tsunami.(1990). Department of Science and Technology- Philippine Institute of CHAPTER 4: DISASTER RISK REDUCTION MANAGEMENT IN Volcanology and Seismology. Quezon City: DOST-PHILVOLCS. THE PHILIPPINES Page 12 of 46 PAGASA Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.

C. 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 exit. 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 th e door, quickly make your way out. h) Yell for help.
Sources:
Bureau of Fire Protection. (2009). Fire code of the Philippines. Retrieved from: http://www.bfpresponse.gov.ph/RA9514%20IRR%20Signed%20by%20SILG.pdf Bureau of Fire Protection. (n.d.) Fire Safety Tips. Retrieved from: http://www.bfpresponse.gov.ph/downloads.html CHAPTER 4: DISASTER RISK REDUCTION MANAGEMENT IN Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.

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D. 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: http://www.uwec.edu/jolhm/EH3/Group3/New% 20website/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 belongings. 5. Be especially alert if you are driving. Embankments along roadsides are particularly susceptible to landslides. Watch the road for collapsed pavement, mud, fallen rocks, and other indications of possible debris flows. 6. Whenever you are in the path of a landslide or debris flow, move away as quickly as possible. If escape is not possible, curl into a tight ball and protect your head with your hands or a helmet. 7. Landslides are extremely dangerous, so it is far better to evacuate immediately if you suspect imminent danger than to ponder the potential.
Sources: Federal Emergency Management Agency. (2010). Landslide. Retrieved from http://www.fema.gov/hazard/landslide/ls_before.shtm Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government. United States Search and Rescue Task Force. (n.d.)What are Landslides?. Retrieved from: http://www.ussartf.org/landslides.htm

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E. Volcanic Eruption
A volcano can be simply defined as a rupture or an opening on the crust of a planet like earth. This opening allows hot ash, molten rock and gases to blow off from the underground spaces. Volcanoes generally acquire shape of a mountain. Volcanoes are usually found at places where tectonic plates get converged or diverged. The common features of volcanic eruptions are lava and release of poisonous gases from the crater situated at the Source: Pyroclastic flows at Mayon Volcano [Image](n.d.). summit of the volcanoes. If a volcano erupts Retrieved from: http://es.wikipedia.org/ where you live follow the evacuation order wiki/Archivo:Pyroclastic_flows_at_Mayon_Volcano.jpg issued by authorities and evacuate immediately from the volcano area to avoid flying debris, hot gases, lateral blast, and lava flow. What to do to during volcanic eruptions:
1. Avoid the declared permanent danger zones in your locality. Also, rivers where hazardous volcanic substances can flow should be avoided. 2. Leave the area immediately. If you are warned to evacuate because an eruption is imminent, evacuate. 3. Be aware of mudflows. The danger from a mudflow increases near stream channels and with prolonged heavy rains. Mudflows can move faster than you can walk or run. Look upstream before crossing a bridge, and do not cross the bridge if a mudflow is approaching. 4. Avoid river valleys and low-lying areas. 5. If you are along the path of potential lahar flows, move to higher ground or to a designated evacuation site. 6. Remember to help your neighbors who may require special assistance infants, elderly people, and people with disabilities. 7. If you have a respiratory ailment, avoid contact with any amount of ash. 8. Food should always be covered to prevent contamination. 9. Wear long-sleeved shirts and long pants. 10. Use goggles and wear eyeglasses instead of contact lenses. 11. Use a dust mask or hold a damp cloth over your face to help with breathing. 12. Stay indoors until the ash has settled unless there is a danger of the roof collapsing. 13. Close doors, windows, and all ventilation in the house (air conditioners, fans, and other vents.) 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.

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Sources for the Guidelines on Volcanic Eruptions: Centers for Disease Control and Prevention. (n.d.). Key Facts About Protecting Yourself During a Volcanic Eruption. Retrieved from: http://www.bt.cdc.gov/disasters/volcanoes/during.asp Ezine Articles. (n.d.). Volcano Eruption - 15 Important Factors To Prepare. Retrieved from: http://EzineArticles.com/1662110 Philippine Institute of Volcanology and Seismology. (2008). Active Volcanoes. Retrieved from: http://www.phivolcs. dost.gov.ph/index.php?option=com_content&view=article&id=57:active-volcanoes&catid=55&Itemid=114___________. (n.d.). Safety During Volcanic Eruptions. Retrieved from: http://www.healthypinoy.com/health/articles/disaster-preparednessvolcanic-eruption.html

G. Typhoon
The Philippines geographical location and physical environment make it vulnerable to natural hazards such as tropical cyclones, floods, extreme rainfall, thunderstorm (TSTM), storm surges, strong winds, tornado and others. Every year, these hazards bring havoc to life and property, seriously disrupt our agriculture-based economy and disturb the lives of millions of Filipino families. In 2009, a series of typhoons hit the country over a five-week period. Typhoons Ondoy, Pepeng, Ramil and Santi brought extensive flooding, destroyed properties and caused a number of casualties in different regions of the country as many were caught unaware of the intensity of these typhoons. Source: Typhoon [Image](n.d). Retrieved from:
http://ecohope.blogspot.com/2009/09/typhoon-ondoy-in-manila-philippines.html

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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Philippine Storm Warning Signals: Signal Number 1 2 3 4 Wind Speed 30-60 Kph 60 -100 Kph 100-185 Kph >185 Kph Time of Occurence At least 36 hours At least 24 hours At least 18 hours At least 12 hours

Source: Philippine Institute of Volcanology and Seismology (PHILVOLCS). (n.d.). The Philippine Storm Warning Signals. Retrieved from: http://kidlat.pagasa.dost.gov.ph/genmet/psws.html

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.
Sources: CHED Memorandum Order No. 34. (2010) Commission on Higher Education (CHED). Retrieved from: http://202.57.63.198/chedwww/index.php/eng/Information/CHED-Memorandum-Orders/2010-CHED-Memorandum-Orders DepED Guidelines on the Suspension of Classes. (2005). Department of Education. Retrieved from: http://www.deped.gov.ph/e_posts.asp?id=475 Philippine Institute of Volcanology and Seismology (PHILVOLCS). (n.d.). The Philippine Storm Warning Signals. Retrieved from: http://kidlat.pagasa.dost.gov.ph/genmet/psws.html DISASTER RISK REDUCTION MANAGEMENT Singapore Civil Defence Force. (2005). Emergency Handbook.Singapore: Singapore Government.

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IN

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

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Dealing with an impending disaster is a responsibility that is dealt NOT solely by a single family or the community leaders or the government. Managing disaster is encompassing to all sectors of the society. In managing disaster a careful analysis of the community must be done. The key is PARTICIPATORY! This analysis was first developed as a research methodology to assess disaster-prone communities in Oxfam Great 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 na tural calamities and armed conflicts in Maguindanao and North Cotobato.

PCVA also known as Participatory Capacities and Vulnerabilities Assessment is a research methodology that is both an analysis and a learning tool. This method provides an opportunity for the people in the community to express its own perceptions and understanding of disasters and its impact. PCVA will help us: Understand the existing capacity and vulnerability of the communities http://krishanagyanwali.blogspot.com/ Identify long and short term needs of the communities Identify possible options to address the needs and aid in formulating an efficient disaster risk reduction management program

Earlier in this chapter you have learned that a community that has high vulnerabilities when hazard is experienced, a DISASTER is very likely to happen.

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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

Location Hazard prone location Design and construction materials Lack of basic services Violence (domestic and conflict) Lack of access and control over means of production Environmental degradation etc
http://article.wn.com/view/2009/10/09/Fresh_floods_swamp_Philippines/

2. Social and Organizational Vulnerability

Family and kinship structures Lack of leadership and initiatives Neglected by government and
http://anakbayannynj.wordpress.com/2012/06/02/anakbayan-usatribute-to-ernesto-ka-erning-gulfo/

administrative structures Conflicts, cast system, ideology Unequal participation of community affairs Exclusion of certain groups from decision-making Isolation

3. Motivation and Attitudinal Vulnerability

Negative attitude towards change Passivity, fatalism, hopelessness Lack of initiative or fighting spirit Dependency on external support

http://pinoyexpat.net/%E2%80%9860-of-ofw-families-arepoor%E2%80%99/

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

A. Physical / Material
Cash, land tools, food, jobs B. Social / Organizational Social Networks Extended Family Local and National welfare Institutions C. Attitudinal / Motivational Sense of Control Power Confidence Skills

Asset Pentagon
HUMAN SOCIAL NATURAL

PHYSICAL

FINANCIAL L

If you combine the data you gathered from the vulnerability and capacity assessment you will come up with this matrix below. This is the most usable tool in PCVA.
Vulnerabilities Physical /Material
What productive resources, skills and hazard exist?

Capacities

Social/Organizational
What are the relations and organizations among people?

Motivational/Attitudinal
How does the community view its ability to create change?

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Participatory Capacities and Vulnerabilities Assessment as the name of the method implies invokes the participation of every single member of the community, even the children. All of them has the right to be heard in planning for their community. Depending on the need and extent of the research for the 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

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

UST-NSTP 2011

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Hazard Map

Seasonal Calendar

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

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Conclusion Our history has been a witness to the shifts and developments of disaster management of the country. The most notable has been the shifts of focus from disaster response to the recognition and strengthening of mitigation measures. These points to the commonly held misconception that disaster management involved only with response, whereas, in fact, response constitutes only one phase of the whole disaster management continuum (Rosales, 2001). Now, formal structures, offices and organizations are in place to manage disaster that comes our way.

Rather than being on the reactive gear, you should start working the anticipatory measures and strategies that will further facilitate the Philippines shift from a culture that concentrate on response (eg. mass collection for relief operation) during actual disaster to one that actually pays attention to equally significant considerations like preparedness, mitigation, recovery and rehabilitation

Continue reading to Lesson 2.

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LESSON 2: BASIC FIRST AID AND IMMOBILIZATION USING BACKBOARD

At the end of the lesson, you are expected to: 1. Discuss the importance of first aid, its definition and aims, and the need for properly prepared first aiders. 2. Explain how to recognize a medical emergency and demonstrate the sequence of first aid response upon recognition of the emergency. 3. Describe and conduct: a. Scene survey of an emergency. b. Primary survey or initial assessment of a victim in an emergency using the ABCD approach. 4. Exercise good-decision making in prioritizing the needs of a victim in an emergency. 5. Demonstrate ways to establish and maintain an open airway 6. Use the look, listen, feel assessment method of determining breathlessness. 7. Demonstrate skills in recognizing and managing internal and external bleeding 8. Demonstrate skills in recognizing and managing fractures including the use of splints 9. Demonstrate the different methods in transporting a victim in an emergency setting. I. INTRODUCTION Imagine a 10-wheeler truck crashes into an automobile and pushes it over an embankment. Bystanders rush to the rescue. They remove the driver of the car, stop a passing car, lift him to his feet, and send him in a sitting position to a nearby hospital. The driver lived but he remained paralyzed for the rest of his life. The permanent disability could have been prevented by knowledge of what to do in an emergency. The unskilled and improper handling of the victim has caused the 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

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emergency before medical help arrives often determines how well a victim recovers. In extreme cases, it can spell the difference between life and death. II. DEFINING FIRST AID First aid is the temporary and immediate care given to a person who is injured or who suddenly becomes ill. It can also involve home care if medical assistance is delayed or not available. First aid includes recognizing life-threatening conditions and taking effective action to keep the injured or ill person alive and in the best possible condition until medical treatment can be obtained or until the chance for recovery without medical care is assured. First aid does not replace the physician, nurse, or paramedic. In fact, one of the primary principles of first aid is to obtain medical assistance in all cases of serious injury. III. RECOGNIZING A MEDICAL EMERGENCY Everyone should be able to perform first aid since most people will eventually find themselves in a situation requiring it, either for another person or for themselves. Since you might be the person to respond first at the scene of an emergency, you need to know how to recognize emergencies and how to respond in a way that best protects and aids the victim. In general, laypersons have a great deal of difficulty deciding when an emergency exists. This difficulty can lead to delays in providing the necessary first aid and contacting the Emergency Medical Service (EMS). The initial step in recognizing an emergency is noticing that something is wrong. But generally, you will know when an emergency happens. You can tell by the type of injuries or by how the victim looks. IV. PREVENTING TRANSMISSION OF INFECTIOUS DISEASES Of greatest concern to First aiders and others in emergency setting are infectious diseases especially Hepatitis B, meningitis, tuberculosis and AIDS. You can minimize your risk of infection by wearing protective gloves; wearing other protective gear as appropriate; using pocket mask during mouth-to-mouth resuscitation; and washing your hands thoroughly after any contact with a victim. V. GENERAL SEQUENCE OF FIRST AID RESPONSE 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

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the following actions quickly and reliably: 1. 2. 3. 4. Survey the scene of the emergency Activate the EMS system, if needed Assess the victim Provide first aid

You are a vital link between the EMS system and the victim. Delaying these actions presents significant dangers to the victim. 1. Conducting a Scene Size-Up 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

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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. 2. Activating the EMS system During the first minutes of an emergency, it is essential that the EMS system be activated. Calling anyone else first only wastes time. If the situation is not an emergency, call your doctor. However, if you are in any doubt as to whether the situation is an emergency, activate the EMS system. As a general rule, activate EMS whenever a situation is more than you can handle. If you are in at UST here are the important numbers that you can contact in case of emergencies: 3. Conducting the Primary Survey (Initial Assessment) Assessing the victim is one of the most important and critical parts of first aid. The assessment is conducted to identify and care for immediate life threats to the airway, breathing and circulation. Some injuries are obvious; others are hidden. A conscious victim may be able to guide you to the problem but an unconscious victim will be of no help at all. The respiratory, circulatory and nervous systems include the most important organs in the body: the heart, lungs, brain and spinal cord. A serious problem in any of those three body systems generally produces a serious threat to life. And if any one of those systems stops functioning, death occurs within minutes. The goal of the primary survey is to quickly assess the three most important body systems to determine any life-threatening condition so that it can be corrected immediately. Unless you find a life threatening situation that needs to be treated immediately, you should be able to complete the primary survey in approximately 60 seconds. The effectiveness of your first aid will depend on effective assessment you need to find what is wrong before you can treat it. Start with the following steps: 1. Determine unresponsiveness by tapping the victim on both shoulders and ask loudly, Are you okay? You are not looking for an answer as much as you are any kind of response fluttering eyelids, muscle movement, turning to the sound, and so on. If there is no response, the victim is unresponsive.

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2. If the victim is conscious, 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 your index finger. Use one of the following methods to open the airway. 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.

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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. 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 the victim is lying. 2. Place your fingers under the angles of the victims lower jaw and lift with both hands, displacing the jaw forward. 3. If the lips close, retract the lower lip with your thumb.
A A. Obstructed airway B. Head-tilt/Chin-lift Maneuver C. Jaw Thrust Maneuver B

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
Look for chest rise and fall Listen for sounds of air movement coming from the victim by placing your ear next to the victims mouth and nose
Feel for air passing in and out by placing your cheek

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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 Follow these steps in checking for the victims pulse: 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). Carotid artery is used because it lies close to the heart and is accessible. If the victim has no pulse, not breathing and unresponsive, begin cardiopulmonary resuscitation or CPR (Basic Life Support training needed) 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

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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 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 inline 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.

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Stabilize against movement by holding onto shoulders and gently squeeze head between arms

Stabilize against movement by holding the head

Stabilize against movement by placing objects on each side of the head.

Caution! DO NOT move the victim, even if the victim is in water. Wait for the EMS to arrive they have the proper training and equipment. Victims with suspected spine injury require cervical collars and stabilization on a spine board. It is better to do nothing than to mishandle a victim with a spine injury.

VI. FIRST AID FOR BLEEDING The life processes depend on an adequate and uninterrupted supply of blood. The loss of 2 pints in an adult is usually serious; the loss of 3 pints of blood can be fatal if it occurs over the course of a few hours. Bleeding in certain parts of the body such as from the large blood vessels in the neck can prove fatal within just a few minutes. 1. External Bleeding

Severity of bleeding depends on how fast the blood is flowing, whether it is flowing from an artery or vein, where the bleeding originated and whether the blood is flowing freely externally or into a body cavity. Bleeding from an artery is always more serious than bleeding from a vein or capillary. Arterial blood is bright red and spurts or pulsates out. But regardless of the type, in controlling external bleeding, the first aid is the same. Whenever you help a victim who is bleeding or losing other body fluids, take the following precautions to protect yourself against transmission of infectious disease: Place a barrier between you and the victims blood. If you can, wear protective gloves; if not, use plastic wrap, aluminium foil, extra gauze bandages, or a clean, thick, folded cloth. As a last resort, use the victims own hand. Avoid touching your mouth, nose, or eyes or handling food while providing first aid care. As soon as you finish treating the victim, wash your hands thoroughly with soap and hot water or an antiseptic cleanser, even if you wore gloves. Use a fingernail

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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 tourniquet.

Control of external bleeding by direct pressure.

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2.

Internal Bleeding

Internal bleeding generally results from blunt or penetrating trauma or certain fractures (such as pelvic fracture). Though not visible, internal bleeding can be very serious even fatal because shock can develop rapidly. You should suspect internal bleeding based on signs and symptoms as well as the mechanism of injury. The signs and symptoms of internal bleeding are similar to those of shock: restlessness and anxiety; cool clammy skin; weak rapid pulse; rapid breathing; and ultimately, a drop in blood pressure. There may be additional signs and symptoms depending on the source of bleeding some of which are: Bruises or contusions of the skin Painful, tender, rigid, bruised abdomen Fractured ribs or bruise on the chest Vomiting or coughing up blood Stools that are black or contain bright red blood

Internal bleeding may not cause signs or symptoms for hours or days and it may be occurring even if there are no signs and symptoms. For victims of internal bleeding, activate the EMS system, then: 1. Secure and maintain an open airway, and monitor the ABCDs. 2. Check for fractures; splint if appropriate. 3. Keep the victim quiet. Position and treat the victim for shock by elevating the feet 8 to 12 inches and covering him or her to maintain body heat. (Do not elevate the feet if you suspect leg or spine injuries.) If the victim starts to vomit, position his or her side with face pointing downward to allow for drainage. 4. Monitor vital signs every 5 minutes until emergency personnel arrive. Internal bleeding can be a serious cause of shock, and almost always requires surgical intervention.

VII. 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

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and symptoms of bone and joint injury: 1. 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

First aid care

It is difficult to tell whether a bone is broken, so when in doubt, always treat the injury as a fracture. Fractures should be treated in priority order: 1. 2. 3. 4. 5. 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 jewelery 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

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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. 2. Splinting

Splints are used to support and immobilize suspected fractures, dislocations, or severe sprains; to help control bleeding; to help control pain; and to prevent further damage to tissues from the movement of bone ends. Any victim with suspected fracture, dislocation, or severe sprain should be splinted before being moved. a. General Rules of Splinting Regardless of where you apply the splint, follow these general rules: Do not splint if it will cause more pain for the victim. Both before and after you apply the splint, assess the pulse and sensation below the injury. You should evaluate these signs every 15 minutes after applying the splint to make sure the splint is not impairing circulation, Measure the splint to make sure it is the right size. The splint should be long enough to immobilize the entire bone plus the joints above and below the fractured site. For example, in immobilizing the leg, ideally, the outside splint should be long enough to reach from the victims armpit to below the heel. Secure the entire injured extremity. Wrap roller bandages around improvised splints and secure them with cravats. Splint the injury in the Splinting of a femur fracture. position you found it. If there is no distal pulse or movement, you may attempt to return the bone to its normal alignment by placing one hand above the injury and another below.

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Then pull with gentle traction while moving the injury back toward the correct anatomical position. In splinting the hand or foot, immobilize in the normal position of function. Make sure you can still see and feel the hand or foot so you can assess pulse or sensation. Remove or cut away all clothing around the injury site to prevent accidentally moving the fractured bone ends and complicate the injury. Remove all jewelry around the fractured site. Cover all wounds, including open fractures, with sterile dressing before applying a splint, the gently bandage. Avoid excessive pressure on the wound. If there is a severe deformity or the distal extremity is cyanotic or lacks pulses, align the injured limb with gentle traction before splinting, following the guidelines above. Never intentionally replace protruding bone ends. Pad the splint to prevent pressure and discomfort to the victim. Apply the splint before trying to move the victim When in doubt, splint the injury. If the victim shows signs of shock, align the victim in the normal anatomical position and arrange for immediate transport without taking the time to apply a splint.

b. Improvised Splints You may have access to commercial splint, but it is much more likely that you will need to improvise at the scene. A splint can be improvised from a cardboard box, cane, ironing board, rolled-up magazine, umbrella, broom handle or any other similar object. You can also use a self-splint (also called an anatomical splint) by tying or tapping an injured part to an adjacent uninjured part. For example, splint a finger to a finger, a toe to a toe, a leg to the other leg, or an arm to the chest. An effective improvised splint must be Light in weight, but firm and rigid Long enough to extend past the joints and prevent movement on either side of the fracture As wide as the thickest side of the fractured limb Padded well so the inner surfaces are not in contact with the skin

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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

VIII. TRANSPORTING VICTIMS IN AN EMERGENCY Although speed is important in cases where a victim is exposed to hazards, it is always more important to accomplish the handling and moving of a victim in a way that will not further injure the victim. As a basic rule of thumb, you should not move a victim until you absolutely have to or until you are completely ready to-and, if you can avoid it, you should not try to move a victim by yourself if you can wait and get help. Guidelines 1. If you find a victim in a facedown position, move the person to an assessment position after the ABCD assessment and checking for possible neck and spinal injury. 2. Generally, you should not move a victim if moving the person will make the injuries worse. 3. Provide all necessary emergency care; splint all fractures, especially those of the neck and back. 4. Move the victim only if there is immediate danger. Only when there is a threat to life should a victim be moved before the ABCD are completed. 5. If it is necessary to move the victim, your speed will depend on the reason for the move. For example, a victim who needs to be moved away from a fire should be moved as quickly as possible; a victim who needs to be moved so you have access to others victims should be moved with due considerations to his or her injuries before and after the move. Emergency Move Under life threatening conditions, you may have to risk injury to the victim in order to save his or her life. You should make an emergency move only when no other options are

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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 reach. 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.

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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 your shoulder. 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 walk.

Blanket Drag A method of moving an injured victim in which a rescuer places the victim on a blanket and drags the victim to safety. 1. Spread a blanket alongside the victim; gather half the blanket into lengthwise pleats. 2. Roll the victim away from you, then tuck the pleated part of the blanket as far beneath the victim as you can. 3. Roll the victim back onto the center of the blanket on his or her back; wrap the blanket securely around the victim. 4. Grab the part of the blanket that is beneath the 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

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support both sides of the head. 3. Using the shirt as a handle, pull the victim toward you; the pulling power should engage the 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 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 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.

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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 injuries. 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.

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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 CPR 3 rd Edition.1999. Jones and Bartlett) One Rescuer Moves

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Drags

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Two or Three Rescuer Moves

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References Websites http://www.mmda.gov.ph/ http://www.phivolcs.dost.gov.ph/ http://www.jica.go.jp/english/index.html http://www.euronews.net/nocomment/2011/03/13/latest-201103130913-japan/ http://www.imageblogs.org/huge-disaster-japan-tsunami-part1 http://www.imageblogs.org/huge-disaster-japan-tsunami-part2 http://japantsunaminow.wordpress.com/2011/03/20/38/ http://news.nationalgeographic.com/news/2011/03/pictures/110315-nuclear-reactor-japan-tsunamiearthquake-world-photos-meltdown/ http://pubs.usgs.gov/gip/dynamic/fire.html http://www.ompongplaza.org.ph/mmeirs.php http://www.phivolcs.dost.gov.ph/images/IEC/tsunami_poster_english.pdf Text Hafen, B., Karren, K., Limmer, D., Mistovich, J. An Introduction to First Aid for Colleges and Universities Eight Edition. 2004. Pearson rd US National Safety Council. First Aid and CPR 3 Edition.1999. Jones and Bartlett Singapore Civil Defence Force. Emergency Handbook. 2005.

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