UST_NSTP_e-READ_Chapter4

CHAPTER 4: DISASTER PREPAREDNESS AND MANAGEMENT

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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. Let us

all hope that with the little and big things that we can do, we may be able to fulfill the

objectives of the Millennium Development Goals (MDG).

In this chapter, you will encounter two lessons regarding disaster preparedness and

management which basically prepares you on how to deal with disasters and encourages

to always be prepared.

LESSON 1: DISASTER PREPAREDNESS

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

1. Identify ways in making a household/neighborhood a hazard-free environment.

2. Analyze a particular disaster and immediately devise a good exit plan to be able to

save lives and property.

3. Influence other people (family, relatives and/or friends) to be more involved in

preparing for a potential disaster.

Let us see how much you know about the current situation of our country

and more specifically to the Metro Manila. When you found out that you

already know the facts enumerated below, then, that’s a good job. For

those who encounter these for the first time, this is a moment for you to

reflect on the things that might happen to our people if a disaster will

occur in the country.

I. The Philippine situation

According to the Office of Civil Defense, the

Philippines because of its geographical location, is

considered one of the most disaster- prone

countries in the world. It lies along the western

segment of the Pacific Ring of Fire, a most active

part of the Earth characterized by an ocean

encircling belt of active volcanoes and earthquake

generators. The Philippines has approximately 400

volcanoes, of which 23 are known to be

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


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Here are some facts and figures about our country:

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

1,666 and 12.2 billion pesos in damages.

It lies in the path of turbulent typhoons, with

about 20 crossing the Philippine area of responsibility, of which an average of 9 makes

a landfall. The archipelagic nature of the Philippine coastal areas increases

susceptibility to storm surges, tsunamis and sea level changes.

The country undergoes floods and landslides which are common due to rains brought

by typhoons and the monsoon. Located in the western part of the Pacific Ocean, the

country is also vulnerable to the El Niño Southern Oscillation (ENSO). The El Niño of

1997-98 induced drought and delayed the onset of monsoon, which resulted to a

scarcity in drinking water in urban areas and shortfalls in hydro-electricity generation

because of reduced water levels in major dams.

II. Metro Manila: At a glance

Metropolitan Manila

is geographically located at Luzon Island.

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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Distribution of Faults and Trenches around Metropolitan Manila

Did you know? Recent studies show that the West Valley Fault has moved at 4 times and generated strong earthquakes within the last 1400 years. The approximate return period of these earthquakes is less than 500 years and no event along the West Valley Fault is known after 17th century, it means that the active phases of the Valley Faults is approaching. Many research studies indicate that active phases of the Valley Faults are approaching and the estimated magnitude will be around 7 or more.

is located in and around numerous earthquake generators, such as the Valley Fault System (VFS), Philippine Fault, Lubang Fault, Manila Trench, and Casiguran Fault. Among these faults, the Valley Fault System is considered to potentially cause the largest impact to the Metropolitan Manila area should it generate a large earthquake.

is topographically composed of coastal lowlands, a central plateau where the central district including Makati is located, as well as alluvial lowlands along the Marikina River and the Laguna Lake. In case of an earthquake, liquefaction in these lowland areas may cause damage to 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’ve discovered how much our country is prone to a lot of disasters! In an effort to prepare for such disasters, the Philippines and Japan government worked together to come up with a comprehensive study called Metropolitan Manila Earthquake Impact Reduction Study (MMEIRS). Isn’t this exciting! Let us see how the study went.

The

Metropolitan

Manila

Earthquake

Impact

Reduction

Study

(MMEIRS)

In August 2002 to March 2004, the Government of Japan through the

Japan International Cooperation Agency (JICA) granted an aid to the


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Philippines to study for Metropolitan Manila Earthquake Impact Reduction Study

(MMEIRS). It focuses on how to manage potential earthquakes in Metro Manila.

The objectives of this study are: (1) to formulate a master

plan for earthquake impact reduction in Metro Manila; and,

(2) to carry out technology transfer to Metro Manila

Development Authority (MMDA) and Philippine Institute of

Volcanology and Seismology (PHIVOCS) in the course of the

study.

Major contents of the Study are:

1) existing data collection and evaluation, 2) geological survey, 3) social condition survey, 4) building and infrastructure survey, 5) important public facilities survey and dangerous

material treatment facilities survey, 6) GIS database development, 7) production of 1:5,000 scale digital topographic maps, 8) analysis of earthquake ground motion and hazards, 9) earthquake damage estimation, 10) preparation of disaster management plan for Metropolitan Manila, and 11) 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


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earthquake event. This human loss, together with properties and economy losses of Metropolitan Manila will be a national crisis.

To know more about this study, follow this link http://www.phivolcs.dost.gov.ph/index.php?option=com_content&view=article&id=419%3Ammeirs&catid=66&Itemid=300083.

With that study, 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.

How prepared are you?

In order to manage a potential earthquake disaster in Manila, it is necessary to prepare an earthquake disaster mitigation plan, and to start actions as soon as possible. The disaster management plan will focus on raising awareness of concerned organizations, employ a comprehensive disaster management approach, and strengthen vertical synergetic networks from the central government to local governments, and communities.

Prevention and preparedness need to be the cornerstone of any emergency plan. Anticipating the level of damage supported by geographical information systems, early warning devices etc. are also critical elements of a good disaster preparedness and mitigation plan. This has to be integrated with a post-disaster assessment, which can be used to draw lessons for preparedness and mitigation.

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

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


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Now, let us define some important terms:

Disaster happens when there are progressive or sudden events brought

about by natural or human-induced hazards that cause losses and sufferings,

the consequence of which results to people and communities undertaking

extra-ordinary measures to cope with their impacts.

Hazards are natural or man-induced phenomena or activities of which poses

a threat to people’s lives, limbs, properties and socio-economic condition.

Risks refer to the degree or chance and frequency that such hazards will

affect or impact people and communities.

Disaster Preparedness refers to pre-disaster actions and measures being

undertaken to avert or minimize loss of lives and properties, such as, but not

limited to, community organizing, training, planning, equipping, stockpiling,

hazard mapping and public information and education initiatives.

Disaster Management is the efficient and effective utilization of resources

and the application of measure that will mitigate the impact or unfortunate

events and facilitate return to normalcy and redevelopment.

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


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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 generates VOLCANIC

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

.PDF)

The destructive effects of earthquakes are due mainly to intense ground

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

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

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

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

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

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

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

following figures show the historical distribution of earthquakes recorded in some

parts of the country for the past decades.

Distribution of Historical earthquakes from 1608 to 1895

Distribution of Instrumentally recorded Earthquakes from 1907 to 2002

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


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PHILVOLCS Earthquake Intensity Scale (PEIS)

The Philippine Institute of Volcanology and Seismology (PHIVOLCS) is a service

institute of the Department of Science and Technology (DOST) that is principally

mandated to mitigate disasters that may arise from volcanic eruptions, earthquakes,

tsunami and other related geotectonic phenomena.

The following scale is a measure of how an earthquake was felt in a certain locality

or area. It is based on relative effect to people, structures, and objects in the

surroundings. It is represented by Roman Numerals with intensity “I” being the

weakest and intensity “X” the strongest. It is being used since 1996. (http://www.phivolcs.dost.gov.ph/images/IEC/peis_new.pdf)

I. Scarcely Perceptible

- Perceptible to people only under favourable circumstances

- Delicately-balance objects are slightly

disturbed.

- Still water in containers oscillates

slightly.

II. Slightly Felt

- Felt by few individuals at rest indoors.

- Hanging objects slightly swing.

- Still water in containers oscillates noticeably


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III. Weak - Felt by many people indoors specially in

upper floors of buildings. Vibration is felt like the passing of a light truck.

- Dizziness and nausea are experienced by some people.

- Hanging objects swing moderately.

- Still water in containers oscillates moderately.

IV. Moderately Strong - Felt generally by people indoors and

some people outdoors. Light sleepers are awakened. Vibration is felt like the passing of a heavy truck.

- Hanging objects swing considerably. Dinner plates, glasses, windows and doors rattle. Floors and walls of wood-framed buildings creak. Standing motor cars may slightly rock.

- Water in containers oscillates strongly.

- Rumbling sounds may sometimes be heard.

V. Strong - Generally felt by most people indoors

and outdoors. Many sleeping people awakened. Some are frightened; some run outdoors. Strong shaking and rocking are felt throughout the building.

- Hanging objects swing violently. Dining utensils clatter and clink; some are broken. Small, light and unstable objects may fall or overturn. Liquids spill from filled open containers. Standing vehicles rock noticeably.

- Shaking of leaves and twigs of trees is noticeable.


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VI. Very Strong - -Many people are frightened; many run

outdoors. Some people lose their balance. Motorists feel like driving with flat tires.

- Heavy objects and furniture move or may be shifted. Small church bells may ring. Wall plaster may crack. Very old or poorly built houses and man-made structures are slightly damaged, though well-built structures are not affected.

- Limited rockfalls and rolling boulders occur in hilly to mountainous areas and escarpments. Trees are noticeably shaken.

VII. Destructive - Most people are frightened and run

outdoors. People find it difficult to stand in upper floors.

- Heavy objects and furniture overturn or topple. Big church bells may ring. Old or poorly built structures suffer considerable damage. Some well-built structures are slightly damaged. Some cracks may appear on dikes, fish ponds, road surfaces, or concrete hollow block walls.

- Limited liquefaction, lateral spreading

and landslides are observed. Trees are shaken strongly.

(Liquefaction is a process by which loose saturated sand loses strength during an earthquake, and

behaves like liquid.)


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VIII. Very Destructive

- People are panicky. They find it difficult to stand even outdoors.

- Many well-built buildings are considerably damaged. Concrete dikes and foundations of bridges are destroyed by ground settling or toppling. Railway tracks are bent or broken.

- Tombstones may be displaced, twisted or overturned. Utility posts, towers and monuments may tilt or topple. Water and sewer pipes may be bent, twisted or broken.

- Liquefaction and lateral spreading cause man-made structures to sink, tilt or topple. Numerous landslides and rockfalls occur in mountainous and hilly areas. Boulders are thrown out from their positions particularly near the epicenter. Fissures and fault rupture may be observed. Trees are violently shaken. Water splashes or slops over dikes or banks of rivers.

IX. Devastating

- People are forcibly thrown to the ground. Many cry and shake with fear.

- Most buildings are totally damaged. Bridges and elevated concrete structures are toppled or destroyed.

- Numerous utility posts, towers and monuments are titled, toppled or broken. Water and sewer pipes are bent, twisted or broken.

- Landslides and liquefaction with lateral spreading and sandboils are widespread. The ground is distorted into undulations. Trees are shaken very violently with some toppled or broken. Boulders are commonly thrown out.

River water splashes violently or slops over dikes

and banks.


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3. If you take cover under a sturdy piece of

furniture, HOLD on to it and be prepared

to move with it. Hold the position until

the ground stops shaking and it is safe to

move. Sources:

California Governor’s Office of Emergency Services.(2003). Earthquake Preparedness Tips. Retrieved from: www.oes.ca.gov/CEPM2003.nsf/htmlmedia/dch.../dch_drill.pdf

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

What to do during earthquakes?

Duck, Cover and Hold

X. Completely Devastating

- Practically all man-made structures are destroyed.

- Massive landslides and liquefaction, large scale subsidence and uplifting of landforms, and many ground fissures are observed.

- Changes in river courses and destructive seiches in lake occur. Many trees are toppled, broken or uprooted.

2. Take COVER under a sturdy desk, table or

other furniture. If that is not possible,

seek cover against an interior wall and

protect your head and neck with your

arms. Avoid danger spots near windows,

hanging objects, mirrors or tall furniture.

1. DUCK or DROP down to the floor.

http://www.oes.ca.gov/CEPM2003.nsf/htmlmedia/dch.../dch_drill.pdf


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1. Stay-put and protect your head and face from shattered glass or falling objects.

2. Move away from hazardous areas or unstable objects. If possible put on a pair of shoes to protect

your feet from broken glass.

3. If you are OUTDOORS, stay away from buildings and overhead electrical cables.

4. When on a SIDEWALK NEAR BUILDINGS, duck into a doorway to protect yourself from falling

bricks, glass, plaster and other debris.

5. When in a HIGH-RISE BUILDING, move against an interior wall if you are not near a desk or

table. Protect your head and neck with your arms.

6. Brace yourself against walls without glass windows or mounted shelves. Crawl under a sturdy

table, desk or bed as they will provide you with air space and protection against falling objects.

7. When in a CROWDED STORE OR OTHER PUBLIC PLACE, move away from display shelves

containing objects that could fall. Do not rush for the exit.

8. When driving a vehicle during the earthquake, pull to the side of the road and stop. Park away

from bridges, flyovers, overpass, overhead wires, posts and similar infrastructures. Do not attempt

to cross bridges or flyovers as they may have been damaged by the earthquake.

9. If you are in a safe area, stay there. Do not attempt to use the stairs or elevators as there dangers

like falling debris, damaged stairways or exits and power outages in elevators and stairwells.

10. Use a flashlight to attract attention. Do not turn on light switches, matches and gas stoves unless

you are sure that there is no danger of gas leak.

11. If you are pinned down by debris, periodically move your fingers and toes to ensure blood

circulation and prevent blood clots.

12. Keep calm, be alert and respond to rescuers’ calls. Do not shout unnecessarily as you may

weaken yourself by losing energy.

13. Consume food and water from the refrigerator if it is near you. Moderate your consumption to

enable the food to last longer.

Here are the GENERAL GUIDELINES to follow when an earthquake occurs:

Sources:

1. California Governor’s Office of Emergency Services.(2003). Earthquake Preparedness Tips. Retrieved from: www.oes.ca.gov/CEPM2003.nsf/htmlmedia/dch.../dch_drill.pdf

2. Earthquake and Tsunami.(1990). Department of Science and Technology- Philippine Institute of Volcanology and Seismology. Quezon City: DOST-PHILVOLCS.

3. National Disaster Risk Reduction and Management Council. (2005). Philippine Disaster Management Framework. Retrieved from: http://www.ndcc.gov.ph/

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

http://www.oes.ca.gov/CEPM2003.nsf/htmlmedia/dch.../dch_drill.pdf

http://www.ndcc.gov.ph/


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

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

cartoon/

B. Tsunami

Tsunamis are giant sea waves

generated by the under-the-sea earthquakes

and volcanic eruptions. Not all underwater

earthquakes and volcanic eruptions,

however, can cause the occurrence of

tsunamis. Tsunamis can only occur when the

earthquake is shallow-seated and strong

enough to displace parts of the seabed and

disturb the mass of water over it. Although

tsunamis may be triggered in various ways,

their effects on coastal areas are similar.

Types of Tsunamis

1. Locally generated tsunamis

The coastal areas in the Philippines especially those facing the Pacific Ocean, South

China Sea, Sulu Sea and Celebes Sea can be affected by tsunamis that may be

generated by local earthquakes.


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On 17 August 1976, a M7.9 earthquake in Moro Gulf

produced tsunamis which devastated the southwest

coast of Mindanao and left more than 3,000 people

dead, with at least 1,000 people missing. More than

8,000 people were injured and approximately 12,000

families were rendered homeless by more than 5-meter

high waves.

The 15 November 1994 Mindoro Earthquake also generated tsunamis that left 78

casualties.

These tsunamis occurred within a very short time, with a first wave reaching the

shoreline nearest the epicenter, 2 to 5 minutes after the main earthquake. These

tsunamis were both locally generated. There will not be enough time for warning in

case of locally generated tsunamis.

(http://www.phivolcs.dost.gov.ph/images/IEC/tsunami_poster_english.pdf)

2. Far field Tsunamis

Tsunamis may also be generated from distant locations, such as those coming from

other countries bordering the Pacific Ocean like Chile, Alaska in the USA and Japan.

The tsunami of 2 May 1960 that was generated by a strong earthquake from Chile killed

61 in Hilo, Hawaii while 20 people were reportedly killed in the Philippines. Travel times

for tsunamis generated in distant locations are no longer (1 to 24 hours) and will

generally give enough time for warning from the Pacific Tsunami Warning Center

(PTWC) and Northwest Pacific Tsunami Advisory Center (NWPTAC).

Some Natural Signs of an approaching Local Tsunami:

1. A felt earthquake


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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 do wn 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.


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

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

had passed.

C. 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.

Things to do to prevent fire:

1. Avoid electrical overloading and unplug all

electrical appliances after every use.

2. Check all electrical installations regularly for.

3. Check gas stoves and LPG tanks for leaks. Turn

off all cooking appliances and unplug them when

not in use.

4. Keep children away from flammable liquids,

lighters and matches.

5. Ensure you have a pre-fire plan at your residence

or office.

6. Do not leave lighted mosquito coils unattended.

7. Always take extra precautions while cooking.

8. Never leave lighted candles unattended.

9. Do not throw lighted cigar or cigarette butts on dried leaves and garbage.

10. Strictly obey the no smoking signs.

11. Maintain proper housekeeping to eliminate fire hazards.

12. Check fire protection gadgets or devices of appliances and equipment regularly.

13. Be fire-safety conscious. Actively participate during fire drills in your locality.

14. If possible, install smoke detectors and fire extinguishers.

Sources:

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

Volcanology and Seismology. Quezon City: DOST-PHILVOLCS.

PAGASA



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What to do to during fire:

1. When you’re in a building (such as offices, malls etc.), make sure to know where the

“FIRE EXIT” is located.

2. Use a fire extinguisher to put out small fires. You can also use water if the fire is not

electrical or chemical. Do NOT try to

put out a fire that you can’t control.

3. If there’s a fire that is too big to put

out, leave the place immediately.

4. If you can see smoke in the house,

stay low to the ground as you make

your way to the exit.

5. Do not run, if your clothes catches

fire but “Stop Drop and Roll”

instead.

6. When you’re trap in a room, do the

following:

a) Check to see if there’s

heat or smoke coming in

the cracks around the

door.

b) Don’t open the door when you the smoke coming under the door.

c) Touch the door if you don’t see the smoke. If it’s hot or very warm then

don’t open it.

d) If you don’t see smoke and the door isn’t hot, then slightly use your fingers

to lightly touch the doorknob. If it’s hot, don’t open it.

e) If the doorknob feels cool and you don’t see any smoke around, only then

you can open the door slowly and carefully.

f) When you open the door and you feel a burst of heat or see smoke pours

into the room, quickly close the door and make sure it is really closed.

g) If there’s no smoke or heat when you open the door, quickly make your

way out.

h) Yell for help.

Sources:

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



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Sources:

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

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


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

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

D. Landslide

Landslides are rock, earth, or debris flows

on slopes due to gravity. They can occur on any

terrain given the right conditions of soil, moisture,

and the angle of slope. Integral to the natural

process of the earth's surface geology,

landslides serve to redistribute soil and

sediments in a process that can be in abrupt

collapses or in slow gradual slides. Such is the

nature of the earth's surface dynamics.

What to do to during landslide:

1. If there has been a period of heavy rainfall and you are in a landslide prone area, you may

be at risk of a landslide.

2. If you remain or are caught suddenly at home, move to a second story if possible. Staying

out of the path of a landslide or debris flow saves lives.

3. Listen for any unusual sounds that might indicate moving debris, such as trees cracking or

boulders knocking together. A trickle of flowing or falling mud or debris may precede larger

landslides. Moving debris can flow quickly and sometimes without warning.

4. If you are near a stream or channel, be alert for any sudden increase or decrease in water

flow and for a change from clear to muddy water. Such changes may indicate landslide

activity upstream, so be prepared to move quickly. Don't delay! Save yourself, not your

belongings.

5. Be especially alert if you are driving. Embankments along roadsides are particularly

susceptible to landslides. Watch the road for collapsed pavement, mud, fallen rocks, and

other indications of possible debris flows.

6. Whenever you are in the path of a landslide or debris flow, move away as quickly as

possible. If escape is not possible, curl into a tight ball and protect your head with your

hands or a helmet.

7. Landslides are extremely dangerous, so it is far better to evacuate immediately if you

suspect imminent danger than to ponder the potential.

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

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

20website/Home.htm


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

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

wiki/Archivo:Pyroclastic_flows_at_Mayon_Volcano.jpg

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

summit of the volcanoes. If a volcano erupts

where you live follow the evacuation order

issued by authorities and evacuate

immediately from the volcano area to avoid flying debris, hot gases, lateral blast, and

lava flow.

Classification of Volcanoes

1) Active volcanoes: erupted within historical times (within the last 600 years), accounts of these eruptions were documented by man; erupted within the last 10,000 years based on analyses of datable materials.

2) Potentially active volcanoes: morphologically young-looking but with no historical records of eruption.

3) Inactive volcanoes: no record of eruptions; physical form is being changed by agents of weathering and erosion via formation of deep and long gullies.

http://es.wikipedia.org/


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List of Active Volcanoes in the Philippines:

Precursors of an Impending Volcanic Eruption The following are commonly observed signs that a volcano is about to erupt. These precursors may vary from volcano to volcano.

1. Increase in the frequency of volcanic quakes with rumbling sounds; occurrence of volcanic tremors.

2. Increased steaming activity; change in color of steam emission from white to gray due to entrained ash.

3. Crater glow due to presence of magma at or near the crater. 4. Ground swells (or inflation), ground tilt and ground fissuring due to magma

intrusion. 5. Localized landslides, rockfalls and landslides from the summit area not

attributable to heavy rains. 6. Noticeable increase in the extent of drying up of vegetation around the

volcano's upper slopes.


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7. Increase in the temperature of hot springs, wells (e.g. Bulusan and Canlaon) and crater lake (e.g. Taal) near the volcano.

8. Noticeable variation in the chemical content of springs, crater lakes within the vicinity of the volcano.

9. Drying up of springs/wells around the volcano. 10. Development of new thermal areas and/or reactivation of old ones’ appearance

of solfataras (A volcanic area that gives off sulfurous gases and steam).

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.

Avoid driving in heavy ash fall unless absolutely required. If you have to drive, keep

speed down to 35 MPH or slower.


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Source: UST Flood [Image](2009). Retrieved from:

http://www.flickr.com/photos/lordzagato/385440

9501/

F. Flood

Floods are among the most frequent and

costly natural disasters. Conditions that cause

floods include heavy or steady rain for several hours

or days that saturate the ground. Flash floods occur

suddenly due to rapidly rising water along a stream

or low-lying area.

What to do to during flood:

1. If a flood is likely in your area, you should be

aware of streams, drainage channels, canyons,

and other areas known to flood suddenly. Flash

floods can occur in these areas with or without

such typical warnings as rain clouds or heavy

rain.

2. If you must evacuate, you should secure your

home. If you have time, bring in outdoor

furniture. Move essential items to an upper

floor.

3. Turn off utilities at the main switches or valves if instructed to do so. Disconnect

electrical appliances. Do not touch electrical equipment if you are wet or standing in

water.

4. Do not walk through moving water. Six inches of moving water can make you fall. If you

have to walk in water, walk where the water is not moving. Use a stick to check the

firmness of the ground in front of you.

5. Do not drive into flooded areas. If floodwaters rise around your car, abandon the car and

move to higher ground safely. You and the vehicle can be quickly swept away.

Sources for the Guidelines on Volcanic Eruptions:

Centers for Disease Control and Prevention. (n.d.). Key Facts About Protecting Yourself During a

Volcanic Eruption. Retrieved from: http://www.bt.cdc.gov/disasters/volcanoes/during.asp

Ezine Articles. (n.d.). Volcano Eruption - 15 Important Factors To Prepare. Retrieved from:

http://EzineArticles.com/1662110

Philippine Institute of Volcanology and Seismology. (2008). Active Volcanoes. Retrieved from:

http://www.phivolcs. dost.gov.ph/index.php?option=com_content&view=article&id=57:active-

volcanoes&catid=55&Itemid=114___________. (n.d.). Safety During Volcanic Eruptions. Retrieved

from: http://www.healthypinoy.com/health/articles/disaster-preparedness-volcanic-eruption.html


Page 25 of 53

6. If you come upon a flooded road while driving, turn around and go another way. If you

are caught on a flooded road and waters are rising rapidly around you, get out of the car

quickly and move to higher ground. Most cars can be swept away by less than two feet

of moving water.

7. Listen for news reports to learn whether the community’s water supply is safe to drink.

Avoid floodwaters. Water may also be electrically charged from underground or downed

power lines.

8. Stay away from downed power lines, and report them to the power company.

9. After the flood, return home only when authorities indicate it is safe. Use extreme caution

when entering buildings; there may be hidden damage, particularly in foundations.

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.

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

Source:


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

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


Page 26 of 53

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.

Philippine Storm Warning Signals:

Signal Number

Wind Speed Time of Occurence

1 30-60 Kph At least 36 hours

2 60 -100 Kph At least 24 hours

3 100-185 Kph At least 18 hours

4 >185 Kph 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

The Department of Education (DepED) and the Commission on Higher Education (CHED)

has created a memorandum regarding the suspension of classes for primary and tertiary

levels respectedly and these are as follows.

For Pre-School, Kinder, Elementary and High School Students:

The Department of Education set the rules on the suspension of classes to keep

parents aware and students danger-free in cases of typhoons and other calamities.

1. Classes in pre-school level in all public and private schools will be automatically

suspended with storm number 1.

2. Classes in pre-school, elementary and high school in all public and private schools will

be automatically suspended with storm signal number 2.

3. Classes in all levels are automatically suspended with storm signal number 3.

4. All travel and outdoor activities are cancelled with storm signal number 4.

5. In the absence of typhoon signal warnings from PAGASA, localized suspension or

cancellation of classes in both public and private elementary and secondary schools

may be implemented by the school principal.

6. Likewise, the schools division superintendent shall decide on the suspension of classes

if such covers the entire division. Parents wishing to ascertain whether or not to send

their children to school should check for media advisories coming from PAGASA,

DepED, Calamity, Disaster and Fire Control (CDFC) groups, Local Disaster Coordinating

Council (LDCC) and the Local Governments Units (LGUs).


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7. In the absence of official storm warnings, parents have the ultimate responsibility for

determining whether their children should go to school.

8. The required number of school days for the school year shall be considered especially in

holding make-up classes to offset the days when classes are suspended. Make-up

classes shall be held on Saturdays or on weekdays beyond the originally-set school

calendar in both public and private schools. (DepED, 2005)

For College and Graduate School Students:

In line with the guidelines of the National Disaster Reduction Management Council

(NDRRMC), the following are the guidelines for the suspension of classes in higher

education institutions:

1. Classes at the collegiate level, including graduate school, are automatically suspended if the proper authorities have declared storm signal no. 3 or higher.

2. Classes at the collegiate level, including graduate school, may be suspended at the discretion of heads of HEIs if special circumstances in their area such as flooding, road damage, etc warrant it.

3. HEI heads or their duly authorized representatives shall make the announcement for the suspension of classes not later than 5’ o clock in the morning of the day when it shall take effect, using all means of communication.

4. Even without the suspension of classes, students who are unable to report to class or participate in scheduled activities such as exams, due to inclement weather, shall be given consideration and be allowed to make up for the missed class or activity. (CHED, 2010)

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.


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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


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

http://202.57.63.198/chedwww/index.php/eng/Information/CHED-Memorandum-Orders/2010-CHED-Memorandum-Orders

http://202.57.63.198/chedwww/index.php/eng/Information/CHED-Memorandum-Orders/2010-CHED-Memorandum-Orders

http://kidlat.pagasa.dost.gov.ph/genmet/psws.html

http://www.pdfio.com/k-430968.html


Page 29 of 53

LESSON 2: BASIC FIRST AID AND IMMOBILIZATION USING

BACKBOARD

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

1. Discuss the importance of first aid, its definition and aims, and the need for

properly prepared first aiders.

2. Explain how to recognize a medical emergency and demonstrate the sequence

of first aid response upon recognition of the emergency.

3. Describe and conduct:

a. Scene survey of an emergency.

b. Primary survey or initial assessment of a victim in an emergency using the

ABCD approach.

4. Exercise good-decision making in prioritizing the needs of a victim in an

emergency.

5. Demonstrate ways to establish and maintain an open airway

6. Use the “look, listen, feel” assessment method of determining breathlessness.

7. Demonstrate skills in recognizing and managing internal and external bleeding

8. Demonstrate skills in recognizing and managing fractures including the use of

splints

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

setting.

I. INTRODUCTION

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

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

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

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

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

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

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

lifetime paralysis.

This illustration clearly demonstrates the need for first aid training. It’s better to know it

and not need it than to need it and not know it. How people respond to an

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

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


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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.


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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

the following actions quickly and reliably:

1. Survey the scene of the emergency

2. Activate the EMS system, if needed

3. Assess the victim

4. Provide first aid

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 won’t be able to help someone else if you

become victim yourself.

The scene can also provide clues to whether the victim is injured or ill. For example,

if you note a ladder next to a person lying on the ground, you would assume the

victim is injured from a fall. This is referred to as the mechanism of injury. If a person

is found sitting in a chair in a restaurant, you would assume the victim is ill.


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Knowing the mechanism of the injury will allow you to give useful information to the

EMS personnel who will later attend to the victim. This will enable the physician to

fully recognize the extent of injuries.

Also determine the number of injured people. Once you have determined the

number of victims, you can then have a bystander contact the necessary resources.

You may request more than one ambulance if you find several people who are

injured or ill. And also, if there is more than one victim, you will have to prioritize

which one you should give attention first.

To begin, establish rapport with the victim by introducing yourself and explaining that

you are there to help. It would be very helpful to demonstrate competence,

confidence and compassion. Obtain consent to treat before assessing the victim.

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.


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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.

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 victim’s overall condition. The rest of the

primary survey consists of evaluating the ABCDs- airway, breathing, circulation (pulse and

bleeding), and disability (nervous system disability or altered responsiveness).

a. Establish Airway

Determine whether the airway is open. If the victim is conscious or talking, the

airway is open. If the airway is not open, use either the head-tilt/chin lift maneuver or

the modified jaw thrust maneuver to open it (see later discussions). Use only the

modified jaw thrust maneuver if a spine injury is suspected.

If the victim is unconscious, the tongue can relax, fall back, and block the airway; the

epiglottis can also relax and block the throat. Sometimes, the victim’s efforts to

breathe can create negative pressure that draws the tongue or the epiglottis, or both

into the airway. In these cases, opening the airway may be all that is needed to

restore breathing.

If you see liquids (such as vomitus) in the mouth, wrap your index and middle fingers

in cloth and sweep the liquid out. If you can see solid foreign objects (such as

broken teeth), quickly hook them out with your index finger.

Use one of the following methods to open the airway.


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A. Obstructed airway

B. Head-tilt/Chin-lift Maneuver

C. Jaw Thrust Maneuver

Head-Tilt/Chin-Lift Maneuver

If you do not suspect cervical spine injury

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

pressure to tilt the head back.

2. Place the index and middle finger of the other hand under the bony part of the

lower jaw near the chin; be careful not to compress the soft tissues underneath

the chin.

3. Lift the jaw to bring the chin forward while avoiding complete closure of the

victim’s mouth and maintaining pressure on the victim’s forehead to keep the

head tilted backward. Leave dentures in place if they are secure in the mouth.

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

If the head-tilt/chin-lift position is unsuccessful or if you suspect a spine injury, first try to

open the airway by lifting the chin without tilting the head back. If the airway remains

blocked, perform the jaw thrust maneuver.

Jaw Thrust Maneuver

1. Facing the top of the victim’s head, place one hand on each side of the victim’s

head, resting your elbows on the surface on which the victim is lying.

2. Place your fingers under the angles of the victim’s lower jaw and lift with both

hands, displacing the jaw forward.

3. If the lips close, retract the lower lip with your thumb.

A

B C


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Look for chest rise and fall

Listen for sounds of air movement coming from the

victim by placing your ear next to the victim’s mouth

and nose

Feel for air passing in and out by placing your cheek

next to the victim’s mouth and nose

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

tilting it backward or moving it side to side.

b. Breathing Assessment

A responsive person is typically breathing adequately.

To determine whether a victim with an altered mental

status is breathing

This process should take only three to five seconds. If the victim is breathing,

maintain an open airway and place the victim in recovery position. This position

helps both conscious and unconscious victims maintain an open airway. If you

suspect trauma or cervical spine injury, do not move the victim.

To place the victim in the recovery position, roll her or him onto one side, moving

head, shoulders, and torso simultaneously without twisting. Then flex one leg at the

knee. Place the bottom arm behind the back. Flex the top arm, placing the hand

under the cheek. Continue with your primary survey.

If the victim is not breathing spontaneously or not breathing adequately, begin

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

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

personnel.


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c. Circulation and Bleeding Assessment

Follow these steps in checking for the victim’s pulse:

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

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).

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 victim’s entire body for blood

(blood-soaked clothing or blood pooling on the floor or the ground) and by

thoroughly and quickly, but gently, running your gloved hands over and under the

head and neck, arms, chest and abdomen, pelvis and buttocks, and legs. Check

your gloves often for blood.

If you find major bleeding – blood that is spurting or flowing freely – control it by

direct pressure, use of pressure points, or elevation. Spurting or steady flow

bleeding is the only kind of bleeding that should be treated during the primary

survey.

Finally, check the victim’s skin condition. Skin color, especially in light-skinned

people, reflects the circulation under the skin as well as oxygen status. In darkly

pigmented people, changes may not be readily apparent but can be assessed by the

appearance of nail beds, the inside of the mouth and the inner eyelids. If there is

decreased circulation or slow pulse, the skin becomes cool and pale or cyanotic

(blue-gray color).


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Stabilize against movement by

holding onto shoulders and gently

squeeze head between arms


holding the head

Caution! DO NOT move the victim, even if the victim is in water. Wait for the EMS to arrive – they have the

proper training and equipment. Victims with suspected spine injury require cervical collars and stabilization on a

spine board. It is better to do nothing than to mishandle a victim with a spine injury.


placing objects on each side of the

head.

d. Disability (Spine Injuries) Check

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

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

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

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

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

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

Head injuries serve as a clue since the head may have been snapped suddenly in

one or more directions, endangering the spine. Other signs and symptoms include

the following:

- Painful movement of the arms and legs

- Numbness, tingling, weakness, or burning sensation in the arms or legs

- Loss of bowel or bladder control

- Paralysis of the arms or legs

- Deformity (odd-looking angle of the victim’s head and neck)

If you suspect the victim has any possibility of a spinal injury, establish manual in-

line spinal stabilization by bringing the victim’s head into a neutral in-line position.

Have someone in the scene hold the victims head so that the nose is in line with the

navel (belly button) and the neck is not bent forward or backward. Instruct the victim

not to move his or her neck.


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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 victim’s blood. If you can, wear protective

gloves; if not, use plastic wrap, aluminium foil, extra gauze bandages, or a clean,

thick, folded cloth. As a last resort, use the victims own hand.

Avoid touching your mouth, nose, or eyes or handling food while providing first

aid care.

As soon as you finish treating the victim, wash your hands thoroughly with soap

and hot water or an antiseptic cleanser, even if you wore gloves. Use a fingernail

brush to clean thoroughly under your fingernails.

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

water. Rinse well.

After taking infection-control precautions, follow these steps in controlling the bleeding.

1. Expose the wound by removing or cutting the clothing to see where the blood is

coming from.

2. Place a sterile gauze pad or a clean cloth (such as handkerchief, sanitary napkin

or towel) over the entire wound and apply direct pressure with your fingers or the

palm of your hand. The gauze or cloth allows you to apply even pressure. Be

sure the pressure remains constant. Do not remove blood-soaked dressings;

simply apply new dressings over the old ones.

3. If bleeding does not stop in 10 minutes, the pressure may be too light or in the

wrong location. Press harder over a wider area for another 10 minutes. If the

bleeding is from an arm or leg, while still applying pressure, elevate the injured

area above heart level to reduce blood flow. Elevation allows gravity to make it


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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.

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

Control of external bleeding by direct pressure.


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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

and symptoms of bone and joint injury:

Deformity, shortening or angulation

Pain and tenderness on the site of injury

Increased temperature on the injury site

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

broken fragments of bone grind against each other

Rapid swelling

Discoloration or redness followed by bruising 2 or 3 days later

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

Joint locked into position

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

and avoids moving it)

Possible loss of function


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1. First aid care

It is difficult to tell whether a bone is broken, so when in doubt, always treat the injury as

a fracture. Fractures should be treated in priority order:

1. Spinal fractures

2. Fractures of the head and rib cage

3. Pelvic fractures

4. Fractures of the lower limbs

5. Fractures of the upper limbs

The most important first aid care is immobilization of any suspected fracture or

extensive soft-tissue injury. You should immobilize before you apply ice or elevate the

injured part. Treat fracture as follows:

1. Support the injured part; gently remove clothing and 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 victim’s fingers or toes to assess for nerve function. There may be nerve

damage if the victim cannot feel the squeeze.

4. Immobilize joints above and below the fracture. Wrap from the distal end of

the splint to the proximal end. Splint firmly enough to immobilize but not tightly

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

in the next section.

5. Check distal pulses and capillary 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.


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Splinting of a femur fracture.

a. General Rules of Splinting

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

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

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

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

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

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

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

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

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

Secure the entire injured extremity. Wrap roller bandages around improvised

splints and secure them with cravats.

Splint the injury in the position you found it. If there is no distal pulse or

movement, you may attempt to return the bone to its normal alignment by

placing one hand above the injury and another below. Then pull with gentle

traction while 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.


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

Apply the splint before trying to move the victim

When in doubt, splint the injury.

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

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

a splint.

b. Improvised Splints

You may have access to commercial splint, but it is much more likely that you will

need to improvise at the scene. A splint can be improvised from a cardboard box,

cane, ironing board, rolled-up magazine, umbrella, broom handle or any other similar

object.

You can also use a self-splint (also called an anatomical splint) by tying or tapping

an injured part to an adjacent uninjured part. For example, splint a finger to a finger,

a toe to a toe, a leg to the other leg, or an arm to the chest. An effective improvised

splint must be

Light in weight, but firm and rigid

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

side of the fracture

As wide as the thickest side of the fractured limb

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

c. Hazards of improper splinting

Improper splinting can

Compress the nerves, tissues and blood vessels under the splint,

aggravating the existing injury and causing new injury

Delay the transport of a victim who has a life-threatening injury

Reduce distal circulation, threatening the extremity

Aggravate the bone or joint injury by allowing movement of the bone

fragments or bone ends or by forcing bone ends beneath the skin surface

Cause or aggravate damage to the tissues, nerves, blood vessels, or

muscles as a result of excessive bone or joint movement


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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

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)


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a. Moving Victims Using The Backboard

If there is a suspected spine injury, you need to immobilize the spine. Manually

support the victim’s head and neck in normal anatomical position until the victim is

supine on the backboard; apply a rigid cervical collar to the victim’s neck. But before

you move the victim into the backboard, stabilize airway, breathing, circulation, and

hemorrhage; correct any life threatening problems, then provide other care as

needed. Bandage all wounds, splint all fractures, and give psychological support. To

get the victim onto a backboard, follow these steps:

1. Bring a long board to within arm’s

reach.

2. Kneeling at the victim’s side,

reach across the victim and grab

his or her shoulder and hip. With

another first aider stabilizing the

head and neck, log roll the victim

toward you.

3. With the victim on his or her side,

examine the victim’s back; then pull

the backboard toward you and

place it on edge against the

victim’s back. Roll the victim onto

the board.

4. Make sure that the victim is at the center of the backboard. Use the push

and pull technique in moving the victim; lifting should be avoided.

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

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

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

transported to a medical facility.

b. One Rescuer Techniques

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

collapse, or other life threatening situations.

Walking Assist

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

in assisting the injured victim to walk


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1. Stand at the victim’s side and drape the victim’s arm across your shoulder.

2. Support the victim by placing your arm around his or her waist

3. Using your body as a crutch, support the victim’s weight as you both walk.

Blanket Drag

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

a blanket and drags the victim to safety.

1. Spread a blanket alongside the victim; gather half the blanket into lengthwise

pleats.

2. Roll the victim away from you, then tuck the pleated part of the blanket as far

beneath the victim as you can.

3. Roll the victim back onto the center of the blanket on his or her back; wrap the

blanket securely around the victim.

4. Grab the part of the blanket that is beneath the victim’s head and drag the

victim toward you; if you have to move on a stairway, keep the length of the

victim’s body in contact with several stairs at once to prevent the victim from

bouncing on the steps.

Shirt Drag

A method of moving a victim in which a single rescuer uses the victim’s shirt

as a handle to pull the victim (except for a T-shirt).

1. Fasten the victim’s hands or wrists loosely together, then link them to the

victim’s belt or pants to keep the arms from flopping or coming out of the shirt.

2. Grasp the shoulders of the victim’s shirt under the head; use your forearm to

support both sides of the head.

3. Using the shirt as a handle, pull the victim toward you; the pulling power

should engage the victim’s armpits, not the neck.

Sheet Drag

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

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

victim.

1. Fold a sheet several times lengthwise to form a narrow, long “harness”; lay the

folded sheet centered across the victim’s chest at the nipple line.

2. Pull the ends of the sheet under the victim’s arms at the armpits and behind


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the victim’s head; twist the ends of the sheet together to form a triangular

support for the head. Be careful not to pull the victim’s hair.

3. Grasping the loose ends of the sheet, pull the victim toward you.

Firefighter’s Carry

A method of lifting and carrying a victim in which one rescuer carries the

victim over his or her shoulder, is not as safe as most ground level moves because it

places the victim’s center of mass high-usually at the rescuer’s shoulder level- and

because it requires a fair amount of strength. It is, however, preferred if a rescuer

will move a victim over irregular terrain. Unless there is life threatening situations, do

not attempt this move especially if neck or spinal injuries are suspected.

1. Position the victim on his or her back with both knees bent and raised; grasp

the back side of the victim’s wrists.

2. Stand on the toes of both the victim’s feet; lean backward and pull the victim

up toward you. As the victim nears a standing position, crouch slightly and

pull the victim over your shoulder, then stand upright.

3. Pass your arm between the victim’s legs and grasp the victim’s arm that is

nearest your body.

c. Two and Three-Rescuer Techniques

Seat Carry

A method of lifting and moving a victim in which two rescuers form a “seat”

with their arms.

1. Raise the victim to a sitting position; each First Aider steadies the victim by

positioning an arm around the victim’s back.

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

clasps the wrist of the other First Aider. One pair of arms should make a seat,

the other pa a backrest.

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

the First Aiders make a seat with all four hands; the victim then supports him

or herself by placing his or her arms around the First Aider’s shoulders.


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Extremity Lift

A method of lifting and carrying a victim in which two rescuers carry the victim

by the extremities. Do not use this method if the victim has back injuries.

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

knees.

2. The First Aider at the victim’s head places one hand under each of the

victim’s shoulders, the second First Aider grasps the victim’s wrists.

3. The First Aider at the victim’s knees pulls the victim to a sitting position by

pulling on the victim’s wrists; the First Aider at the victim’s head assists by

pushing the victim’s shoulders and support his back.

4. The First Aider at the victim’s head slips his or her hands under the arms,

grasps the victim’s wrists.

5. The First Aider at the victim’s knees slips his or her hands beneath the

victim’s knees.

6. Both First Aider crouch on their feet and then simultaneously stand in one

fluid motion.

Chair Lifter Carry (Two Rescuers)

If the victim does not have contraindicating injuries and if a chair is available,

you can use the chair lifter carry. Sit the victim in the chair. One First Aider then

carries the back of the chair while the other carries the legs; the chair itself is used

as a litter. Be sure the chair is sturdy enough to support the weight of the victim.

Flat Lift and Carry (Three Rescuers)

This method has the advantage of permitting you to move the victim through

narrow passages and down stairs. Use this method only if the victim does not have

spinal injuries.

1. Three First Aiders line up on the least injured side of the victim; if one First

Aider is noticeably taller, that person stands at the victim’s shoulders; another

stands at the victim’s hips, and the third at the victim’s knees.

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

3. The First Aider at the victim’s shoulder works his or her hands underneath the

victim’s neck and shoulders; the next First Aider’s hands go underneath the

victim’s hips and pelvis; and the final First Aider’s hands go underneath the

victim’s knees.


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4. Moving in unison, the First Aiders raise the victim to knee level and slowly

turn the victim towards themselves until the victim rests on the bends of their

elbows.

5. Moving in unison, all three rise to a standing position and walk with the victim

to a place of safety or to the stretcher. To place the victim on the stretcher,

simply reverse the procedure.

This may also be done by four rescuers positioned at the victim’s head, chest,

hips and knees. Support is then given to the head, chest, hips, pelvis, knees and

ankles.

Illustrations (From US National Safety Council. “First Aid and CPR 3rd Edition”.1999.

Jones and Bartlett)

One Rescuer Moves


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Drags


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Two or Three Rescuer Moves


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Page 53 of 53

References

Websites

http://www.mmda.gov.ph/

http://www.phivolcs.dost.gov.ph/

http://www.jica.go.jp/english/index.html

http://www.euronews.net/nocomment/2011/03/13/latest-201103130913-japan/

http://www.imageblogs.org/huge-disaster-japan-tsunami-part1

http://www.imageblogs.org/huge-disaster-japan-tsunami-part2

http://japantsunaminow.wordpress.com/2011/03/20/38/

http://news.nationalgeographic.com/news/2011/03/pictures/110315-nuclear-reactor-japan-

tsunami-earthquake-world-photos-meltdown/

http://pubs.usgs.gov/gip/dynamic/fire.html

http://www.ompongplaza.org.ph/mmeirs.php

http://www.phivolcs.dost.gov.ph/images/IEC/tsunami_poster_english.pdf

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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