CHAPTER III

EMERGENCY RESCUE TRANSFER

"Our role is to develop techniques that allow us to provide emergency life-saving
procedures to injured patients in an extreme, remote environment without the presence
of a physician."
Chris Hadfield.

There's a sense of heroism and nobility whenever a person has been given a chance to
help people whenever chances occur. Emergencies are inevitable yet its impact and
magnitude can be mitigated. That's why it is important that aspiring young professional
should be capacitated in rendering first aid. However, it is ironic that whenever we learn
first aid technique, we opted not to use it to anyone at any circumstances for we do not
hope for any person or entity to get ill or injured. In this chapter, we are going to discuss
the different techniques in transferring and carrying the victim from one place to another
and the responsibilities a rescuer holds.
_________________________________________________________________

Learning Objectives
At the end of this chapter, the students should be able to comply with the following:
1. Define the different concepts in emergency rescue transfer.
2. Demonstrate the different techniques in rescue transfer depending on what the
situation requires.
3. Familiarize to the protocols in the conduct of emergency transfer according to the
situation.
4. Identify the responsibilities that are set to emergency rescuers.

Teaching Methodology
1. Lecture
2. Discussion and Oral Recitation
3. Quizzes and Summative Evaluation
4. Case Analysis and Workshops
5. Summary and Feedbacks
Concept of First Responder

First Responder are individuals either from the Emergency Medical Team (EMT), Law
Enforcement, Fire, or Disaster groups that are responsible in reacting to emergencies,
whether man-made or natural, involving contacts with blood-borne pathogens,
chemicals, or either disaster.

These responders are tasked to make decisions that may be unpopular to the public,
but is actually a decision for their safety and well-being. It is essential, then, that
responders make their judgments using a clear and concise procedure.
Introduction
The optimum goal of rescue is to save the greatest number of lives and properties
in the fastest time possible. To begin with, search is defined as the careful process of
looking for victims in order to find someone missing or lost. With search comes the word
rescue, it means an act of freeing a trapped victim or casualty from containment or
under the rubble safely. These two are the essentials of successful life-saving
operation.
The safety of the rescuer or first aider is just as important as the safety of the
victim. Before tackling down the scene, it is imperative that the rescuer or first aider
assess the surroundings and the hazards that might become a hindrance along the
way. Moreover, it should be taken into consideration the safety of the area where the
first aid shall be rendered or else it will cause further harm to the victim and the rescuer.

Basic Concepts
According to New Zealand Civil Defense Management, people tend to react
differently to danger, but the most general responses are anxiety and fear, perhaps the
most powerful of all emotions. It must be remembered that is not just the victim who
faces the danger; in order to rescue the victim, the rescuer must first enter the site of
the dangerous situation and face the same danger. Even if the main danger has struck
and passed, additional dangers are still often present.
The difference between the victim and the rescuer is that the rescuer is better
able to cope with, or handle, the situation. This is because the rescuer has the
knowledge and the resources to minimize risk and remedy the situation. It is normal to
be anxious and feel fear in the face of danger. These are emotional reactions common
to both victim and rescuer. Many other emotional responses may become manifest
during a rescue situation - pity, disgust, contempt, pride, concern, and many more.
These are often exaggerated beyond all reason by the urgency and pressures of the
situation, thus lowering the efficiency of the overall operation. The rescuer must be
aware of the psychological needs of the victims, not just their physical needs, and be
prepared to meet these psychological needs.

Emergency Rescue Transfer Techniques

Meanwhile, in order to rescue a victim or casualty transfer techniques are
important to know and understand. Transfer is the process or movement of the victim
from an unsafe place to a place where is safe to administer first aid or stay for recovery.
These are the techniques for lifting and carrying as illustrated and described by the Boy
Scouts of America:

Lift and Carries

Table 2. The One Man Carry
ANKLE PULL The ankle pull is the fastest method for moving a victim a
short distance over a smooth surface. This is not a preferred
method of patient movement.

1. Grasp the victim by either ankles or pant cuffs.

2. Pull with your legs, not your back.

3. Keep your back as straight as possible.

4. Try to keep the pull as straight and in-line as possible.

5. Keep aware that the head is unsupported and may

bounce over bumps and surface imperfections.
SHOULDER PULL The shoulder pull is preferred to the ankle pull. It supports the
head of the victim. The negative is that it requires the rescuer
to bend over at the waist while pulling.

1. Grasp the victim by the clothing under the shoulders.

2. Keep your arms on both sides of the head.

3. Support the head.

4. Try to keep the pull as straight and in-line as possible.

BLANKET PULL This is the preferred method for dragging a victim.
 1. Place the victim on the blanket by using the "logroll" or
the three-person lift.

2. he victim is placed with the head approx. 2 ft. from one

corner of the blanket.

3. Wrap the blanket corners around the victim.

4. Keep your back as straight as possible.

5. Use your legs, not your back.

6. Try to keep the pull as straight and in-line as possible.

ONE- PERSON LIFT This only works with a child or a very light person.

1. Place your arms under the victim's knees and around

their back.

FIREFIGHTER CARRY This technique is for carrying a victim longer distances. It is

very difficult to get the person up to this position from the
ground. Getting the victim into position requires a very strong
rescuer or an assistant.

1. The victim is carried over one shoulder.

2. The rescuer's arm, on the side that the victim is being

carried, is wrapped across the victim's legs and grasps
the victim's opposite arm.
PIGGY BACK CARRY When injuries make the firefighter carry unsafe, this method is
better for longer distances than the one-person lift.

1. Place both the victim's arms over your shoulders.

2. Cross the victim's arms,

3. grasping the victim's opposite wrist.

4. Pull the arms close to your chest.

5. Squat slightly and drive your hips into the victim while
bending slightly at the waist.

6. Balance the load on your hips and support the victim

with your legs.

Table 3. The Two Man Carry

HUMAN CRUTCH/ For the conscious victim, this carry allows the victim to swing
TWO- PERSON their leg using the rescuers as a pair of crutches. For the
DRAG unconscious victim, it is a quick and easy way to move a victim
out of immediate danger.

1. Start with the victim on the ground.

2. Both rescuers stand on either side of the victim's chest.

3. The rescuer's hand nearest the feet grabs the victim's wrist
on their side of the victim.

4. The rescuer’s other hand grasps the clothing of the

shoulder nearest them.

5. Pulling and lifting the victim's arms, the rescuers bring the
victim into a sitting position.

6. The conscious victim will then stand with rescuer

assistance.

7. The rescuers place their hands around the victim's waist.

 8. For the unconscious victim, the rescuers will grasp the belt
or waistband of the victim's clothing.

9. The rescuers will then squat down.

10. Place the victim's arms over their shoulders so that they
end up facing the same direction as the victim.

11. Then, using their legs, they stand with the victim.

12. The rescuers then move out, dragging the victim's legs
behind.

FOUR- HANDED This technique is for carrying conscious and alert victims' moderate
distances. The victim must be able to stand unsupported and hold
themselves upright during transport.

1. Position the hands as indicted in the graphic.

2. Lower the seat and allow the victim to sit.

3. Lower the seat using your legs, not your back.

4. When the victim is in place, stand using your legs, keeping

your back straight.
TWO- HANDED SEAT This technique is for carrying a victim longer distances. This
technique can support an unconscious victim.

1. Pick up the victim by having both rescuers squat down on

either side if the victim.

2. Reach under the victim's shoulders and under their knees.

3. Grasp the other rescuer's wrists.

4. From the squat, with good lifting technique, stand.

5. Walk in the direction that the victim is facing.

CHAIR CARRY This is a good method for carrying victims up and down stairs or
through narrow or uneven areas.

NOTE: The chair used should be a sturdy one. Don't use

aluminum beach chairs, resin patio chairs, swivel chairs, or
lightweight folding chairs.

REMEMBER: Chairs with wheels can be used to roll the victim,

but should not be used for a carry.

1. Pick the victim up and place them or have them sit in a

chair.

2. The rescuer at the head grasps the chair from the sides of
the back, palms in.

3. The rescuer at the head then tilts the chair back onto its
rear legs.

4. For short distances or stairwells, the second rescuer should

face in and grasp the chair legs.

5. For longer distances, the second rescuer should separate

the victim's legs, back into the chair and, on the command
of the rescuer at the head, both rescuers stand using their
legs.

IMPROVISED This technique requires two poles / pipes

STRETCHER
strong enough to support the victim's weight and at least two shirts.

REMEMBER: Rescuers should not give up clothing if, for any

reason, this might affect their health, welfare, or reduce their
effectiveness.
 1. While the first rescuer is grasping the litter poles, the
second rescuer pulls the shirt off the head of rescuer one.

2. All buttons should be buttoned with the possible exception

of the collar and cuffs.

3. The rescuers then reverse the procedure and switch sides.

BLANKET This technique requires two poles and a blanket.

1. Place the blanket down on the ground.

2. Place one pole approx. 1 foot from the middle of the

blanket.

3. Fold the short end of the blanket over the first pole.

4. Place the second pole approx. 2 feet from the first (this
distance may vary with victim or blanket size).

5. Fold both halves of the blanket over the second pole.

Table 4. The Three or More Carry

HAMMOCK CARRY Three or more rescuers get on both sides of the victim. The
strongest member is on the side with the fewest rescuers.

1. Reach under the victim and grasp one wrist on the

opposite rescuer.

2. The rescuers on the ends will only be able to grasp

one wrist on the opposite rescuer.

3. The rescuers with only one wrist grasped will use

their free hands to support the victim's head and
feet/legs.

4. The rescuers will then squat and lift the victim on the
command of the person nearest the head,
remembering to use proper lifting techniques.
THREE OR STRETCHER This technique is for lifting patients onto a bed or stretcher,
or for transporting them in short distances.

1. Each person kneels on the knee nearest the victim's

feet.

2. On the command of the person at the head, the

rescuers lift the victim up and rest the victim on their
knees.

If the patient is being placed on a low stretcher or litter

basket:

On the command of the person at the head, the patient is

placed down on the litter/ stretcher.

If the victim is to be placed on a high gurney/bed or to

be carried:

At this point, the rescuers will rotate the victim so that the
victim is facing the rescuers, resting against the rescuers'
chests.

1. On the command of the person at the head, all the

rescuers will stand.

2. To walk, all rescuers will start out on the same foot,

walking in a line abreast.

BLANKET CARRY This is an effective method for loading or moving a casualty

in a confined space.

1. Make a stretcher ready using one blanket.

 2. Roll a blanket lengthways for half of its width and lay
the rolled section along the side of the casualty
(casualty flat on back).

3. The leader then directs two (or three) rescuers to

kneel down on each side of the casualty.

4. The rescuers on one side ease the casualty over on

one side and the rolled section of the blanket is
pushed well underneath the casualty.

5. With the rolled-up section of the blanket now under

the center of the casualty, the casualty is eased over
in the opposite direction and the blanket is unrolled.
The casualty should now be lying flat on their back.

6. The sides of the blanket are rolled up close to the

casualty's body to provide handgrips for the bearers.

7. On the order from the leader, the casualty is lifted

waist high, and carried to the stretcher,

8. On the order from the leader, the casualty is lowered

onto the stretcher.

9. The blanketing is then completed with one blanket,

leaving the lifting blanket in position.

10. This 'blanket carry' can also be used as an

improvised stretcher for carries over moderate
distances.

The Use of Commercial Stretcher

This kind of stretcher serves a number of advantages to the different rescue
environment, it includes but not limited to:
 1. Providing protection for the patient
from underneath.
2. A number of handholds.
3. Relatively inexpensive.
4. This stretcher is suitable for patient
transport and some rescue
techniques.
5. A footplate is usually used to
prevent the patient sliding
downwards if the stretcher is tilted
towards the vertical position

The patient should be lashed to the Board Rescue Stretcher whenever it is

going to be lowered. This may also be necessary if carrying the patient in rough or
difficult terrain (e.g.: rubble, confined spaces, and the stretcher does not come with
webbing or nylon straps)

The process is as follows:

1. Begin with a Rethreaded Figure 8
through the top most handhold or
hole (depending on the design of
the stretcher this may be on the
top or bottom edge, or along the
sides).

2. Pass the line down the side of the

board.

3. Take a complete turn under the

board and back across the
casualty's chest.
Moving a stretcher

A stretcher should, wherever possible, be

carried in the horizontal position or
slightly 'head high'. When moving over
debris or uneven ground, this may prove
to be difficult, but risks to both casualty
and rescuers can be reduced to a
minimum by adopting the following
procedures:

1. The leader should position three

on each side of the stretcher.

2. On the order: Prepare to Lift, the

rescuers stoop and grasp the
stretcher. When all is in readiness,
the leader gives the order: Lift and
the stretcher is raised to waist
height.

3. The next order will be: Prepare to

Pass. Any member of the team
who for any reason is not ready
should inform the leader.

4. Good footing on debris is hard to

find, and care should be taken in
this regard.

5. On the command: Pass, the

stretcher is passed until such time
as it is supported by four rescuers,
leaving two spares.

6. These two then climb carefully

around the stretcher and take up
positions at the other end of the
stretcher.

7. The process is then repeated until

the stretcher arrives on clear, solid
ground.

8. It is stressed that this operation

calls for a high degree of teamwork
 and that the leader must retain
control throughout.

9. The leader must ensure that while

the stretcher moving is being
passed, no member of the team is
on the debris.

The Use of Improvised Stretcher

One of the characteristics a first aider must have is a sense of resourcefulness -
making the best out of what is available. In case of emergency, there are unfortunate
times that the first aider does not have the necessary equipment. Here are some of
useful techniques in creative improvise stretcher which will be helpful in transporting
victims.

Tarp Stretcher
1. Spread out a tarp and lay a pole down at a position about 2/3 of the distance
between the edges.
2. Fold the short side of the tarp back over the pole, then lay the other pole down on
the top of the previous fold, at the edge.
3. Fold the remaining section of tarp over the second pole. Don't worry about
securing final fold, the weight of your victim on the stretcher will hold it in place.

Jacket Stretcher
1. Invert the sleeves of 2-3 jackets (depending on the size of your victim and what's
available) so that they run along the inside of the jacket.
2. Thread your poles through the jacket sleeves.
3. Use diagonal lashings to attach cross members at the end of the stretcher to
keep the jacket taut add stability.
The Emergency Rescue Van
Logistics operation in an emergency is essential, most especially the transport of
the rescuers, first aiders, and victims. It is not limited to people but essential equipment
as well, ropes, ladders, and cutting machines. However, it is not as easy as we thought
it could be when they will be transporting heavy equipment and a few numbers of
people at a time, not mention the terrain of the place. The terrain can be a smooth
travelling road or rough-road; they can never know or predict until they arrive in the
area.
With this, emergency rescue vans or vehicles have been made for these reasons.
Moreover, these were made for rapid transport and efficient use If equipment,
sophisticated loading concepts and individual solutions. Regardless of fires, disasters,
or technical operations these vehicles provide the best possible mobility and support on
any terrain.

The Ambulance
Basic life support (BLS) is a level of medical care administered to victims of
non-life-threatening illnesses or injuries until they can be given full medical care at a
hospital. This is provided by trained medical personnel, including emergency medical
technicians, paramedics, and by qualified bystanders. ABLS ambulance is primarily for
those patients that require medical transportation and it contains essentials like a
patient bed, a pulse oxyimeter and oxygen delivery devices. Auto-loading stretchers,
wheel chair, are also provided for efficient patient management. This emergency service
is ideal for patients who have undergone any kind of surgery or art ailing and weak, but
do not require advanced support or cardiac monitoring. For that, read on about the
next type of ambulance.
 Advanced Life support (ALS) ambulance also known as the Cardiac Care
Ambulance is equipped with a ventilator, defibrillator, oxygen cylinder, an
electrocardiogram (ECG) machine and a monitoring device. These ambulances are
mainly used to address life-threatening emergencies including sudden cardiac arrests
and the emergencies which require providing oxygen and respiratory support to critically
ill-patients. Equipped with these advanced features, ALS ambulance services are better
equipped to handle life-threatening situations that involve cardiac arrests, lung related
Issues and rescue operations, to name a few
A Patient Transport Vehicle (PTV)
transports patients to and fro from the medical
centers and cater to non-urgent care, for
example a visit to the hospital or a dialysis
center. For such instances of none emergency
treatment, vans, buses or other vehicles may
be converted into ambulances. Equipped with
the PTV a patient allows bed for patients &
other to basic make life-support the journey
device, in a hygienic environment.
Some other lesser known and sparsely used ambulances are the train
ambulance and Air Ambulances. As their names suggest, a patient is transported via
train or Airplane respectively. This especially is useful when a patient needs to be
moved from one city to another, or from a remote area of the country into a metropolitan
space. In fact, air ambulances are most used in case of medical tourism -when a patient
needs to be moved to another country for medical aid. India recognizes the need of air
ambulances, and is working on improving the Medical Air Ambulance Transport system,
with a focus on easy and swift access to remote areas. There are still many parts of the
country which do not have access to basic medical facilities. Developing the Air
Ambulance system will not only ensure that medicines and other medical services are
made available to even the rural areas, but also help save many lives.

Protocols in the conduct of Emergency Transfer

Steps for rescuer's safety
1. Survey the scene (i.e. prevent further injuries by identifying potential
environmental or other risks to the rescuer, victim or bystanders).
2. Determine first aid needs.
3. Plan your course of action.
4. Build the rescue system.

Components of Search & Rescue operation

1. Rescuers - these are persons who are capable and trained in search and rescue
operations such as uniformed personnel, volunteers, etc.
2. Tools - these are equipment, materials, or things needed in times of emergency.
Some circumstances require specific tools. For example, in an aftermath of
earthquake, rescuers may need tools used for lifting debris or cutting metal in
case of victims being trapped in the building.
3. Time - rescuers must save as many victims in the fastest time possible. The first
24 hours are the crucial hours when it comes to rescue, since the victims might
have the highest survival rate.

Search and rescue functions are broken into two aspects:

1. Search - to carefully look for victims in or order to find missing someone missing
or lost
2. Rescue - to free a trapped victim casualty from confinement or from under a
rube includes trained personnel and volunteers depend on their availability and
the needs of the situation.

For example, storm or earthquake damage may require tools for lifting debris
whereas flood damage may require boats and ropes. May be very limited for some
Victims. The first 24 hours after a disaster are called the "Golden hours “where injured
or trapped victims has an 80 percent chance of survival, if rescued

Emergency Hotlines
 National Disaster Risk Reduction and Management Council

Trunk lines (02) 8911-5061 to 65 local 100

(02) 8911-1406
Operations Center (02) 8912- 2665
(02) 8912- 5668
(02) 8911- 1873

Red Cross
Hotline 143
Trunk line (02) 8790-2300
Emergency Response Unit (02) 8790-2300 local 604

The Use of Emergency Hotlines

Everyone, not only first aider, must safe a list of emergency hotlines. These digits
are more than just numbers but an avenue for saving lives. As stated in Executive
Order 56, all calls made to the new 911 hotlines will be free of charge. This will be
ensured by the 911 Emergency Commission created under the EO to replace the Patrol
117 Commission. The National Telecommunications Commission, said EO 56,
managed to assign the "911" number as the national hotline number through a
memorandum issued in July 2016. EO 56 states that "there is a need to conform to
international standards on emergency numbers for public telecommunications
networks." Primary responders to 911 calls will be the Philippine National Police and the
Bureau of Fire Protection.

In basic life support (as stated in Chapter 2)' there are three key steps in
conducting CPR: check, call' and care. First aiders cannot replace actual medical
professionals or doctors, that's why it is important to immediately call for help after
assessing the situation.

The Emergency Rescuer

More than the skills and knowledge of the rescuers acquired from their training.
There are certain characteristics that a rescuer must possess that separates them as a
good one. Ideally, the rescuer will have the following qualities:

1. Interest - a genuine interest in rescue work, not just because of peer pressure,
trying to impress, etc.
 2. Training- the will to continually undergo training to maintain a professional
standard.

3. Cooperation - rescue work is usually a team effort, hence cooperation with

others is vital.

4. Dependability - the lives of victims, and team members rely on you.

5. Initiative - the nature of rescue operations is such that it is often impossible to

closely supervise each team member. Each must be able to see what needs
doing, set priorities, and do the tasks at hand

6. Versatility - each situation is unique. An individual must be able to apply a wide

range of skills and knowledge to new situations.

7. Physical Fitness - rescue work of any kind is physically demanding and often
continues for long periods. Any physical limitations must be recognized and
taken into consideration.

8. Leadership Qualities - required by all rescuers at various times and to varying

degrees. Through the capable leadership personnel of trained rescuers, many of
maybe utilized.

Principles of the Search and Rescue

Basic Principles to be followed during the Search and Rescue Operation These
steps are:

1. Search and Locate Victim

2. Gain Access to the Victim
3. Stabilize the Victim TIJDDE 2191
4. Extricate the Victim

How to approach the damaged buildings?

1. Damaged buildings and facilities should only be approached from the least
dangerous side

2. While surveying indoor space in buildings, do not use open fire (torches,
kerosene lamps) for lighting
 3. When searching for casualties DO NOT walk or stay near badly damaged and
collapse-prone buildings

4. Do not allow many people to gather in one spot, in shafts, or floors

5. Do not go near collapse-prone walls or other constructions

6. Move very carefully over building ruins (only if it is absolutely necessary) as they
are unstable heaps of fragments

7. When removing rubble from ruins, do not permit abrupt jerks, shaking, or strong
blows at the site

The Responsibilities of an Emergency Rescuer

Safety is the principal consideration in any rescue activity and it is the responsibility of
each rescuer to ensure that safety procedures and Occupational Health and Safety
requirements are followed, instructions observed, and operations carried out with a
minimum of risk. There are a number of guidelines, codes of practice, regulations, and
procedures that relate to safety, and to operational aspects such as critical incident
stress, and risk management. These are constantly being amended and updated - it is
the responsibility of organizations to keep current.

Additionally, individual services have procedures for the management of these

factors, and for laying out individual and organizational responsibilities. All of these
factors must be taken into account in the management of rescue activities. This section
covers the key points of safety in training and operations as they affect the rescuer, the
casualty, or the bystander. Specific safety points will be covered with each rescue
technique, as they affect the conduct of that rescue technique.

Basic precautions should be appointed for any rescue activity. Team Leaders
and Safety Officers are responsible for safety at all times. The orders given by these
officers are to be obeyed without question or delay, as they are vital to safety.
Equipment must be regularly and carefully checked both before and after use. Ropes
can wear and rot, batteries can corrode equipment, and machinery can break down.
Faulty equipment can cost lives. Any faulty or suspect equipment must be labelled
immediately and removed for repair or replacement (e.g., the rope that a rescuer used,
but did not check, and was damaged; may kill someone next time it is used). Personnel
at risk' by working at heights or depths must be protected by properly established and
monitored safety lines and systems.
 Wherever possible, rescuers should adhere to standard techniques and
practices. In any rescue technique, safety limits and margins have been built in for
casualty and rescuer protection. These must never be ignored or exceeded. Protective
clothing and helmets are issued to each rescuer. Each has an obvious safety
application, and they must be properly used. Helmets, in particular, must be worn at all
times of risk, whether great or small. They are designed to protect the wearer from a
single impact, then be replaced. They must never be mistreated by dropping, throwing,
or being sat on. They should never be exposed to the effects of UV for prolonged
periods (e.g., by being left on the back window ledge of cars, or any other place). All
safety equipment must be maintained and replaced in accordance with the
manufacturer's recommendations. For training and operations, other items such as
protective clothing foul weather gear, debris gloves, safety goggles, ear protection, and
safety harnesses maybe issued. These are all for specific purposes, and must be
treated and issued with utmost care.

CHAPTER IV
BASIC PROCEDURE FOR
FIRST RESPONDERS

Learning Objectives
At the end of this chapter, the students should be able to comply with the following:

1. Describe the importance of medical aspects in crime investigation.

2. Identify the different stages of post mortem body occurrences as it aids to qualify
certain act into a particular crime.

3. Describe the significance of medico-legal aspects of investigation on death,

physical injuries, rape, strangulation, asphyxia and toxicologic cases.

4. Apply the procedures in the identification, collection and preservation of medical

evidence.

5. Internalize the importance of medical principles in personal identification.

Teaching Methodology

1. Lecture
2. Discussion and Oral Recitation
3. Quizzes and Summative Evaluation
4. Case Analysis and Workshops
5. Summary and Feedbacks

Concept of First Responder

First Responder are individuals either from the Emergency Medical Team (EMT),
Law Enforcement, Fire, or Disaster groups that are responsible in reacting to
emergencies, whether man-made or natural, involving contacts with blood-borne
pathogens, chemicals, or either disaster.

These responders are tasked to make decisions that may be unpopular to the
public, but is actually a decision for their safety and well-being. It is essential, then, that
responders make their judgments using a clear and concise procedure.

The Crucial and Risky Role

A First Responder plays a crucial role. That is because First Responders carry so
many responsibilities on their shoulders. They are first on the scene helping the injured,
maintaining the integrity of the scene for potential suspects. Every minute counts, and
every small item must be deemed potentially important to the case at hand.

That is why training in various aspects of handling different types of emergencies is

very important for these front liners. First and foremost, injured personnel must be
provided with basic first aid. First Responders must know to call for help and assistance,
and how to direct the movement of people and vehicles, on top of that, the First
Responder usually has to deal with media and provide the information in what is going
on within the area. This means that their data gathering has to be accurate and precise

These tasks expose the First Responder to external risks such as exposure to
blood-borne pathogens, and danger coming from unruly bystanders.

The Importance of Protective Equipment and Communication

On March 20, 1995, a deadly nerve gas called SARIN was released by the
Japanese cult Aum Shinrikyo (Currently known as Aleph), in the subway system of
Tokyo, Japan, twelve commuters were killed, and 54 were injured. Among the
casualties were the medical and police first responders.

How did this happen? The first responders on the scene were not prepared with
the correct equipment to protect then against the deadly gas. Could this happen here in
the Philippines? Definitely. Imagine this incident happening during rush hour in our MRT
and LRT. Are we prepared to respond to such incidents?

The good news is that slowly but surely, the government is acquiring chemical and
biological equipment for our law enforcement officers. As of this time, the Special
Response unit (SRU) of the Fire Protection Bureau has been given several equipment
for such events and their crew has also been trained to respond accordingly. The
question is: Are the equipment adequate in number and proportionately issued to law
enforcement and medical EMTs (Emergency Medical Teams) across the nation? This
we have to ponder on and correct as soon as possible.

Lack of communication can also bring havoc to the scene. Each disaster
preparedness center should have a standard way of communicating while protecting the
information from criminal elements from being scanned over the airwaves and
monitored. Criminal and terrorist elements may use the information exchange between
authorities gleaned from the airwaves to their advantage. Law enforcers and medical
teams should practice using the proper Ten Codes. These codes could mean life and
death to our first Responders.

Ten Codes
Ten Codes, properly known as ten signals, are code words used to represent
common phrases in voice communication, particularly by law enforcement and in
Citizen's Band (CB) radio transmissions. The codes, developed in 1937 and expanded
in 1974 by the Association of Public-Safety Communication Officials-International
(APCO), allow for brevity and standardization of message traffic.

The APCO Ten Codes

APCO TEN SIGNALS

10-0 Use caution 10-19 go to station

10-1 signal weak 10-20 advise to location
10-2 signal good 10-21 phone
10-3 stop transmitting 10-22 disregard
10-4 message received 10-23 arrived at scene
10-5 relay 10-24 assignment complete
10-6 station is busy 10-25 report to
10-7 out of service
10-8 in service
10-9 repeat
10-10 fight in progress
10-11 animal problem
10-12 stand by
10-13 report conditions
10-14 prowler report
10-15 civil disturbance
10-16 domestic problem
10-17 meet complainant
10-18 urgent
10-38 stop suspicious vehicle
10-39 respond with siren and
flashers
10-40 do not use siren and flashers
10-41 beginning shift
10-42 end shift
10-43 information
10-44 permission to leave
10-45 dead animal
10-46 assist motorist
10-47 emergency road repair
10-48 traffic control
10-49 traffic signal out
10-50 traffic accident
10-51 request tow truck
10-52 request ambulance
10-53 roadway blocked
10-54 livestock on roadway
10-55 intoxicated driver
10-56 intoxicated pedestrian
10-57 hit and run accident
10-58 direct traffic
10-81 breathalyzer report
10-82 reserved lodgings
10-83 school crossing
10-84 estimated time of arrival
10-85 arrival delayed
10-86 operator on duty
10-87 pick up
10-88 advise telephone number
10-89 bomb threat
10-90 bank alarm
10-26 detaining suspect
10-27 driver's license
10-28 vehicle registration
10-29 check record for want or stolen
10-30 unauthorized use of radio
10-31 crime in progress
10-32 person with gun
10-33 emergency - all units
10-34 riot
10-35 major crime alert
10-36 correct time
10-37 suspicious vehicle
10-59 escort
10-60 squad in vicinity
10-61 personnel in vicinity
10-62 reply to message
10-63 prepare to copy
10-64 local message
10-65 net message
10-66 cancel message
10-67 clear for net message
10-68 dispatch information
10-69 message received
10-70 fire alarm
10-71 advise nature of alarm
10-72 report progress of alarm
10-73 smoke progress
10-74 negative
10-75 in contact with
10-76 en route to
10-77 estimated time of information arrival
10-78 request assistance information
10-79 notify coroner
10-80 pursuit in progress radio
10-91 pick up subject
10-92 illegally parked vehicle
10-93 blockage
10-94 drag racing 10-95 subject in
custody
10-96 detain subject
10-97 test signal
10-98 prisoner escaped
10-99 wanted or stolen

Ethical Responsibilities of a First responder

1. Make the physical and emotional needs of the patient a priority.

2. Practice your skills to the point of mastery.
3. Attend continuing education/ refresher programs.
4. Review performances, seeking ways to improve response time, patient outcome,
communication.
5. Honesty in reporting.
Duties of the First Responder in Crime Incident (PNP)
a. Proceed to the crime scene to validate the information received.

b. Record the exact time of arrival and all pertinent data regarding the incident in his
issued pocket notebook and notify the TOC.

c. Cordon off the area and secure the crime scene with a police line or whatever
available material like ropes, straws or human as barricade to its integrity

d. Check whether the situation still poses imminent danger and call for back up if
necessary.

e. Identify possible witnesses and conduct preliminary interview and ensure their
availability for the incoming investigator-on-case.

f. Arrest the suspect/s if around or in instances wherein the suspect/ s is fleeing,

make appropriate notification for dragnet operations.

g. Prepare to take the "Dying Declaration" of severely injured persons with the
following requisites:

1. That death is imminent and the declarant is conscious of that fact.

 2. That the declaration refers to the cause and surrounding circumstances of such
death.
3. That the declaration relates to facts which the victim is competent to testify to.
4. That the declaration is offered in a case wherein the declarant's death is the
subject of the inquiry. (Section 37, Rule 130 of the Rules of Court).

h. Evacuate the wounded to the nearest hospital using emergency services.

i. Account for the killed, wounded and arrested persons for proper disposition.

j. Conduct initial investigation.

k. Brief the investigator-on-case upon arrival and turn over the crime scene.

l. Conduct inventory on the evidence taken at the crime scene; the Inventory by the
first responder, SOCO and the investigator

CRIME SCENE RESPONDER'S SPECIFIC FUNCTIONS,

RESPONSIBILITIES AND PROCEDURES
FIRST RESPONDER (FR)
 The first police officers to arrive at the crime scene are the FRs who are
dispatched by the local police stations concerned after receipt of incident report.

 Immediately, the FR shall conduct preliminary evaluation of the crime scene. This
evaluation should include the scope of the incident, emergency services
required, scene safety concerns, administration of life saving measures and
establishment of security and control of the scene.

 The FR is mandated to save and preserve life by giving the necessary first aid
measures to injured and medical evacuations as necessary. The FR shall
likewise secure and preserve the crime scene by cordoning the area to prevent
unauthorized entry of persons.

 The FR shall take dying declaration of severely injured persons if any.

  The FR, upon arrival of the IOC shall turn-over the crime scene. The FR shall
prepare and submit CSI Form "First Responders Report" to the IOC.

INVESTIGATOR-ON-CASE/DUTY INVESTIGATOR
 Upon arrival at the crime scene, the OIC shall request for a briefing from the FR
and make quick assessment of crime.

 At this stage, the IOC shall assume full responsibility over the crime scene and
shall conduct a thorough assessment of the scene and inquiry into incident. If
necessary, the IOC may conduct crime scene search outside the area where the
incident happened employing any of the various search methods.

 Based on the assessment, if the IOC determines that a SOCO team is required,
he shall report the matter to his COP and request for a SOCO, otherwise the IOC
shall proceed with the CSI without the SOCO team and shall utilize CSI Form 4
"SOCO Report Forms in the conduct of CSI.

 The IOC may by himself if the situation so demand, conduct CSI if, there is no
Provincial Crime Laboratory Office in the province. The IOC must, however,
ensure that the correct procedures in the collection of evidence are observed to
ensure the admissibility of the evidence.

 The police station operation center, upon directive of the COP, shall make the
request for the SOCO team through the Provincial/City Operation Center.

 It shall be the responsibility of the Provincial/ City Operations Center.

 Upon the arrival of the SOCO team, the IOC shall accomplish the CSI Form 2
"Request for the conduct of SOCO" and submit the same to the SOCO team
leader. The SOCO team shall not enter the crime scene unless the IOC makes
the official written request wherein, he assures the SOCO team of his presence
and support.

 The IOC shall brief the SOCO team upon their arrival at the crime scene and
shall jointly conduct the preliminary crime scene survey.

SOCO TEAM

 The SOCO Team shall not join any operation conducted by the local police or
accompany FRs or the IOC in going to the crime scene. They will only respond
upon request through the Operations Center and after the IOC has already made
proper assessment of the crime scene.
 Upon request of the SOCO, the SOCO team shall then conduct the scene of the
crime operations which include among other narrative description of the crime
scene.

 In case the SOCO team needs to temporarily suspend the processing, the Chief
of Police shall be primarily responsible and accountable for securing the crime
scene and ensuring its integrity until the return of SOCO team.

 After the termination of the SOCO, the SOCO team shall brief the IOC on the
initial result and thereafter conduct the final crime scene survey together with the
IOC.

 The SOCO team shall accomplish the CSI Form 4 "SOCO Report Forms" and
furnish the IOC of copies of the same before leaving the crime scene.