Chapter 4 - Disaster Risk Reduction and Management

Chapter 4: Disaster Risk Reduction and Management | 1
ARE YOU READY? LEARNING OBJECTIVES

The Philippines is considered 9th most
vulnerable country to disaster (World Risk
Report 2020). Every year we are faced with
different natural, human-induced, and In this chapter, you will be able to:
environmental hazards due to our physical
and geographical location and socio- Identify the key concepts of disaster risk
economic and political situation. This leads to reduction and management through the
the loss of lives and livelihood and worth analysis of the current disaster situation of
millions of damages in infrastructure and our country.
agriculture.
Explore the different risk drivers of the
In a disaster, marginalized sectors in the country’s vulnerability to disaster.
community are the most vulnerable because of
their dire situation. Their socio-economic Identify the framework, principles and the
condition inhibits their ability to cope and programs of disaster risk reduction and
recover from hazards. management in the Philippines.
With this, the UST NSTP CWTS/LTS advocates

Equip yourselves with basic knowledge,
to its students and partner communities the
practical skills and attitude required to
Community Based Disaster Risk Reduction and
perform appropriate basic first aid care
Management which aims to substantially response to those in need of emergency
reduce risk by addressing the roots of people’s care.
vulnerability and strengthening their capacities.
This is done through their inclusion and active
participation in the aspects of disaster
mitigation, preparedness, response, recovery
and rehabilitation. Why do we need to study Disaster Risk Reduction and
Management in the context of service-learning?
With the knowledge and skills gained from the
key concepts of disaster risk reduction and Because:
management to first aid on different 1. We become agents with the capacity to BUILD
emergencies, NSTP students are then called to a culture of disaster resilience in our families
be partners in building a culture of disaster and communities.
resilience through service-learning in our 2. We are called to EDUCATE on the different
partner communities. approaches, knowledge, skills, and attitude
required in managing disaster risk and
CHAPTER OVERVIEW emergency situations.
3. We will INSPIRE fellow Filipinos with best
Lesson One: DRRM practices and collective actions in building safe
Lesson Two: CBDRRM and self-reliant communities.
Lesson Three: BLS and Basic First Aid 4. We will be able to EMPOWER the communities
by recognizing their strength and building up
their potential and capabilities through our
service-learning engagement with them.
Chapter 4: Disaster Risk Reduction and Management

Lesson Two: Community-Based Disaster Risk Reduction and Management (CBDRRM)
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GLOBAL AND LOCAL FRAMEWORKS IN DISASTER RISK
REDUCTION AND MANAGEMENT
In the previous chapter, we have learned about the different social issues and problems that concern us.
To address the different societal issues, we experience, the members of United Nations (UN) came up with
the 2030 Agenda for Sustainable Development.
Figure 1. 17 Sustainable Development Goals - United Nations
The Sustainable Development Goals are the blueprint to achieve a better and more sustainable future
which aim to mobilize efforts to end all forms of poverty, fight inequalities, tackle climate change, promote
justice and peace, while ensuring that no one is left behind (UN, 2015).1
On March 2015, world leaders affirmed that disaster risk reduction needs to be at the core of sustainable
development. They adopted the Sendai Framework for Disaster Risk Reduction 2015-2030, which aims
to promote a “substantial reduction of disaster risk losses in lives, livelihoods while strengthening and
investing to disaster governance to manage disaster risk”. 2
The Sendai Framework includes the Building Back Better approach to post-disaster recovery &
reconstruction which focus on “building a disaster-resilient community better than before by the
implementation of well-balanced disaster risk reduction measures, including physical restoration of
infrastructure, revitalization of livelihood and economy/industry, and the restoration of local culture and
environment”. (Figure 2)
1
Sustainable Development Goals: https://www.youtube.com/watch?v=4bN9yimMXro
2
Sendai Framework for Disaster Risk Reduction: https://www.youtube.com/watch?v=izpDdnaSxN0&t=22s
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Pope Francis’ encyclical letter
Laudato Si’ captures the
interconnectedness of social,
economic, and environmental
justice in building and caring for
our common home. It highlights
the ‘intimate relationship
between the poor and the
fragility of the planet’. Protecting
the planet requires an integrated
approach to combating poverty,
restoring dignity to the excluded,
and at the same time protecting
nature.3
In the Philippines, Republic

Act 10121 or the Philippine
Disaster Risk Reduction and
Management Act of 2010
was enacted to reform and
transform disaster governance
from mere response to risk
reduction, prevention, mitigation,
rehabilitation, and recovery. It
brought a comprehensive, multi-
hazard, multi-stakeholder, and
interagency and community-
based approach to disaster risk
reduction which:
Figure 2. Sendai Framework for Disaster Risk Reduction 2015-2030
1. Prioritizes community-level DRRM, focusing on the most vulnerable sectors (i.e., the poor, the sick,
persons with disabilities, the elderly, women and children)
2. Recognizes the important role and strengthens capacities of local communities
3. Ensures broad-based and greater participation from civil society such as NGOs, academic
institutions, and churches
4. Address the root causes of disaster risk such as inequality, poverty, and people’s inaccessibility to
resources.
3
Laudato Si: https://www.youtube.com/watch?v=o3Lz7dmn1eM
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Lesson One
DISASTER RISK REDUCTION & MANAGEMENT IN THE
PHILIPPINES
Before we get our gears ready, using this mnemonic device, let us first define some important terms and
concepts in Disaster Risk Reduction and Management and see how they interact with each other. 4
HAZARD
A process, phenomenon or human activity that may cause loss of life, injury or other health
impacts, property damage, social and economic disruption or environmental degradation
(UNDRR, 2020).
Hazards can be classified into:
1. Natural hazards are associated to natural 2. Anthropogenic hazards, or human-induced
processes and phenomena. hazards, are induced entirely or predominantly
a. Geological or geophysical hazards by human activities and choices.
originate from internal earth a. Technological hazards originate
processes (e.g. earthquakes, volcanic from technological or industrial
activity and emissions, tsunami, conditions, dangerous procedures,
landslides, surface collapses and infrastructure failures or specific
debris or mud flows) human activities. (e.g. industrial
b. Hydrometeorological hazards pollution, nuclear radiation, toxic
originate from atmospheric, wastes, dam failures, transport
hydrological, or oceanographic accidents, factory explosions, fires
occurrences (e.g. typhoons, flash and chemical spills)
floods, heatwaves, drought, and b. Societal hazards originate from the
coastal storm surges) inability of society to address inequality
c. Biological hazards originate and injustices which is driven by
organically or conveyed by biological political, cultural and economic
vectors such as pathogenic systems (e.g. war, human rights
microorganisms, toxins, and violations, militarization, terrorism,
bioactive substances (e.g. bacteria, criminality, gender violence, racial
viruses or parasites, as well as discrimination and class exclusion)
venomous wildlife and insects,
poisonous plants and mosquitoes 3. Socionatural hazards are a combination of
carrying disease-causing agents) natural and anthropogenic factors (e.g.
environmental degradation, climate change,
physical or chemical pollution in the air, water
and soil, ozone depletion).
4
LISTEN TO: HANDA AWIT LINDOL
Handa... Awit... Lindol! (Ready... Sing... Earthquake!) is a collection of songs for preparedness for earthquakes and
related calamities, that can be used to educate listeners about earthquakes and preparing for them.
https://soundcloud.com/up-diliman-ovcrd/sets/handa-awit-lindol

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Reflective Question VULNERABILITY (WEAKNESSES)
This is the economic, physical,
What are the most common hazards environmental, material, social and
that you experience in your community? cultural characteristics and circumstances
Where does it originate? of a person and community that makes
them susceptible to the damaging
impact of hazards (Wisner, Gaillard
and Kelman, 2012); (ACCORD et. al,
2012) and (CDP, 2010).
Vulnerability Factors
1. Economic / Personal
 Lack of biodiversity resources

 Lack of control or access over assets
such as farmlands, animals and
tools
 Limited skills and formal education
 Low income
 Poor public and mental health
 Poverty & inequality
Editorial Cartoon by Arlene Pasaje in Edge Davao November

18, 2016
2. Physical/ Environmental
 The decline of risk regulating

ecosystem services
 Overconsumption of natural
resources
 Physically living in an unsafe location
 Poor environmental management
 Unprotected buildings and
infrastructure
Editorial Cartoon by Eugene Bacasmas in Philippine Star
Jan. 25, 2020

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3. Social and Organizational
 Conflicts between individual and
groups
 Government policies and priorities
that do not effectively address
poverty and vulnerability, or that
create and exacerbate poverty and
vulnerability
 Lack of awareness and activities in
disaster preparedness
 Marginalization and discrimination
From a petition started by Ayen De Sagun “Rice Tariffication by gender, social status, disability,
Law: A Government Trap” in
https://www.change.org/p/rodrigo-duterte-rice-tariffication- age, ethnicity
law-a-government-trap 5  Political divisions
 Poor and lack of delivery of basic
social services
Wisner, Gaillard and Kelman (2012, p. 18-34); ACCORD et.al (2012, p. 48-55); CDP (2011)
Reflective Question
Vulnerability may also refer to the pre-existing
conditions of a community that can be further
In your household and community who intensified and worsened during and after the
are the most vulnerable? What do you hazard. 6
think are the factors that make them
vulnerable?
CAPACITY (STRENGTH)
Capacity is the combination of all the strengths, attributes and resources available within a family,
community, society or organization that can be used to lessen the adverse impacts of a disaster,
prepare for emergencies and recover from it. (ACCORD et.al, 2012, p. 14).
5
https://www.change.org/p/rodrigo-duterte-rice-tariffication-law-a-government-trap
6
Poverty and Inequality as Vulnerability | Watch the three-part series of Kwentong Kwarantine: Ano ang Inequality?
by Prof. Devralin Lagos
https://www.facebook.com/kwentongkwarantin/videos/1120475028302984
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Capacity Factors
1. Economic / Human Resources
 Access to essential social services

such as hospitals & schools
 Adequate income and savings
 Healthy population and ecosystem
 Literacy and numeracy programs
 Presence of micro-finance and local
market
 Utilization of local knowledge
Editorial Cartoon of Kyth B. Pallogan in Baguio Herald
Express Online (Jan. 21, 2018)
2. Natural/Physical Resources
 Biodiversity resources
 Food sustainability
 Hazard resistant crops
 Safe houses and infrastructure
 Traditional architecture
 Traditional water resources
UST Main Building as first earthquake-resistant building

in the Philippines by Carlo Angelo in
https://www.deviantart.com/carlangelo25
3. Political/Social Resources
 There is broad participation in

decision making, where the poor and
disadvantaged groups have a voice
on matters that affect their lives
 Inclusive leadership and political will
 Presence of community organization
 Presence of solidarity and social
networks
 Good kinship ties
SOLIDARITY WITH HEALTH WORKERS by Dee Ayroso in
www.bulatlat.com
Wisner, Gaillard and Kelman (2012, p. 18-34); ACCORD et. al (2012, p. 48-55); CDP (2011)

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Reflective Question
Did you know?
Increasing and strengthening the What are the capacities and the
capacity of the community is KEY resources of your community? Are these
in reducing the level of disaster resources available and accessible to the
risk.7 8 vulnerable sectors?
EXPOSURE
The situation of people, infrastructure, housing, production capacities and other tangible human
assets located in hazard-prone areas. (UNDRR, 2017).
DISASTER RISK
The probability that negative consequences may arise when hazards interact with vulnerable
people, property and localities.
Therefore, using this mnemonic device, we can say that disasters are the result of the interaction
between vulnerable people/community with limited capacity, exposed to natural, anthropogenic,
or socionatural hazards.
Disaster Risk (DR) is HIGH if:

1. The probability of a hazard occurring is high (H)
2. The vulnerability of the community is high (V)
3. The exposure of the community to hazard is high (E)
4. The capacity of the community is low (C)
7
Watch: What is Capacity Building? https://www.youtube.com/watch?v=oNr9_riy5XU
8
Participatory Guarantee System: Importance of Organic Farming for Small Scale Farmers
https://www.youtube.com/watch?v=Ie84qCREqes

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DISASTER
A serious disruption of the functioning of a community or a society at any scale due to hazardous
events interacting with conditions of exposure, vulnerability and capacity, leading to one or more
of the following: human, material, economic and environmental losses. (UNDRR, 2017).
It is important to clarify that “natural” disaster10 11 is a misnomer because:

 the word “natural” triggers the idea that no matter the
decisions taken by humans, the event would occur anyway
and there is nothing we can do about it.
 the word portrays disasters as “extra-ordinary”,
“uncontrollable”, “incredible”, “unpredictable”, “unexpected”
phenomena where it strips disaster stories of its political,
social, environmental and economic context - one where
social injustice is pervasive.
 the attribution of blame for disaster losses to nature, or as
an ‘act of God’, absolves powerful decision-makers of the
A father carries the lifeless body of his daughter on the responsibility for allowing people to live in vulnerable
way to the morgue after super typhoon Haiyan hit
Tacloban City in Leyte province 9 conditions.
 Such view will shape the disaster policies, strategies and
investment focusing only to the preventive measures to
natural hazards but not in addressing the root causes of
the vulnerability and strengthening the people’s capacity.
(Gaillard, 2015; Blanchard, 2018)
It is also important to note that not all hazards result in disasters. A hazard becomes a disaster only if:
 A community or a significant number of people are affected.
 The hazard hits a vulnerable community and disrupts the regular activities and livelihood of the
community.
 The community does not have enough capacity to cope with the damages using its own
resources and external aid is needed.
9
Photo Credit Reuters at https://www.dailymail.co.uk/news/article-2501471/Philippines-Typhoon-Haiyan-Bodies-
piled-streets-makeshift-mortuaries-overrun.html
10
Watch: Eskinita Episode 4: Bagyong Yolanda, Bagyong Gobyerno : https://www.youtube.com/watch?v=G-443MiqmtQ
11
Watch: Galit ba ang Diyos?: Pag-unawa sa Pandemya bilang Kalamidad: https://www.facebook.com/watch/?v=3201239109896771;
READ: 5 Most Common (and Most Dangerous) Disaster Myths: https://disasterdoc.org/5-common-dangerous-disaster-
myths/ ; WATCH: The Science of Disasters Series with Ilan Kelman:
https://www.youtube.com/watch?v=BlVyY1UAOnU&list=PLCuu5t_nsFKC5IbjnahIEoKHK8o2vegaZ&index=2

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UNDRR. (2019). Disaster Risk Reduction in the Philippines. United Nations Office for Disaster Risk Reduction (UNDRR),
Regional Office for Asia and the Pacific, 32.
Why is the Philippines VULNERABLE to disaster??
A. Geographical and physical location

 Located in the western section of Pacific Ring
of Fire, where majority of earthquakes and
volcanic eruptions occur (CDRC, 2014).
 Located between the Eurasian and Pacific
tectonic plates creating the seismic activity in
the region which predicted to have the
capacity to generate major earthquakes in
the near future (CDRC, 2014).
 Located on the Western North Pacific Basin
where 50% of worlds typhoon formed.
 On the average, 20-22 typhoons enter the
Philippines each year (ESCAP/WMO, 2009;
Bankoff, 2003).

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 Coastal areas increase susceptibility to storm surges, tsunamis and sea level changes predicted to
affect more than 40% of the coastal population living in informal settlements (CFE-DM, 2018).
 Located in the western part of the Pacific Ocean, the country is also vulnerable to the impact El
Niño Southern Oscillation (ENSO) or drought.
B. Climate Change
 The Philippines is already experiencing the impacts of climate change including sea level rise,
increased frequency of extreme weather events, rising temperatures and extreme rainfall due to
greenhouse gas emission from human activities driven by industries and transportation (Oxfam,
2010).
Did you know?

It is projected that in year 2050:
 the country’s temperature will increase 1.8°–2.2°C;

 reduced rain falls from March–May, making the dry season drier
 Increased heavy and extreme rainfall in Luzon and Visayas during the southwest monsoon,
making the wet season wetter, but decreasing rainfall trends for most of Mindanao.
 Increased frequency of extreme weather events, including days exceeding 35°C, days with
less than 2.5mm of rain, and days exceeding 300mm of rain
 Rising sea levels of 0.48–0.65 meters by year 2100.
IMPACT OF CLIMATE CHANGE IN THE PHILIPPINES12

WATER RESOURCE & COASTAL
AGRICULTURE HUMAN HEALTH
ECOSYSTEM
 Increased pest infestation  Water shortages and disrupted  Increased risk of
 Increased frequency of crop provision of water supplies waterborne disease such
and/or productivity loss  Increased incidence of floods as malaria, dengue, and
from floods and droughts and landslides, degrading diarrhea
 Loss of arable land and watershed  Increased risk of food
irrigation water to salinity  Temperature-induced shifts in insecurity and malnutrition
 Failure of rain fed crops and adult fish distributions and and reduced maternal and
increased need for irrigation reproduction cycles; decreased child health
 Higher food prices and fish stocks  Forced migration and
increased demand for  Loss of livelihood for the fisher relocation to high-risk
imports folks areas
C. Poverty, Marginalization & Inequality
12
WATCH | Effect of Climate Change in the Philippines Stand for Truth: Paano naapektuhan ng climate change ang
Pilipinas? by GMA News and Public Affairs: https://www.youtube.com/watch?v=z_DBYApc9m0

Page | 12
 Poverty, hunger, inadequate income,
unemployment, and illiteracy are the key
factors why Filipinos are vulnerable to
disasters. When a hazard strikes, the impact
will exacerbate poor people’s situation,
making them unable to recover and drives
them into further poverty. (CDRC, 2014;
ACCORD et. al, 2012; CDP, 2011; Wisner,
Gaillard and Kelman, 2012).
 17.7 million Filipino people are living in
extreme poverty (PSA, 2018). They are most
likely situated in the hazard prone areas, with
houses made of light materials. Their income
is insufficient to meet their basic needs and
they have lack of access to assets such as
agricultural land and farm tools.
 Poor Filipino people have the lack of access to
social insurance and basic social facilities
such as hospitals and schools. 6 out of 10
Filipinos die without seeing a doctor while only
1 out of 10 Filipino youth are able to graduate
in college (CDRC, 2014).
 Moreover, poor people experience social
discrimination and marginalization because
they have been denied access to their human
rights, the lack of opportunity to participate in
decision-making process and often neglected
by those in power (Cadag & Gaillard, 2009). 13
 This system is built on structural inequality
which is perpetrated and maintained by the
class interest of the powerful elite to
accumulate more wealth and maintain power
for themselves. Thus, there is unequal distribution of wealth and resources in society. This is not
conducive to achieving disaster resilience for communities as the essential elements of good
governance, accountability, sustainable environment, food security, respect for human rights and
democracy is missing (ACCORD et. al, 2012; IBON, 2020). 14 15
D. Development Aggression and Environmental Degradation
13
Watch: GMA Digital Specials: BAKIT MAHIRAP ANG MAGING MAHIRAP SA LUZON LOCKDOWN?
https://www.youtube.com/watch?v=ihO6MfhgED0
14
LISTEN: The UrbanisMO Podcast S3 Episode 2: Economic Repercussions, Social Relations, and #COVID19PH
https://soundcloud.com/user-641630314/the-urbanismo-podcast-s3-ep2
15
Watch: Power and poverty in disaster-prone urban contexts - The Philippines:
https://www.youtube.com/watch?v=s7j4O_V3oNA

Page | 13
 Development aggression refers to systematic accumulation and exploitation of indigenous
people’s collective rights to land and their resources in the guise of “development projects” resulting
to environmental degradation, human rights violations, and displacement of community.
 Development aggression increases the vulnerability of communities to disasters. For instance,
large scale mining causes contamination of water and rivers which are the primary source of food
and income for fisher folks. Construction of dams will displace the inhabitants leading to loss of
community’s land, livelihood and even culture.
Case Study
PAYATAS TRASHSLIDE 2000

On July 10, 2000, a 50-foot-high mountain of packed
trash collapsed after a week of heavy rains caused
by Typhoons “Ditang” and “Edeng”. As a result of the
trashslide, 218 residents, many of whom were
women and children, died and thousands of houses
were buried.
Despite being a garbage dumpsite, around 3000

urban poor lived in Payatas and scavenged the trash
as a means of living.
Photo from:
https://www.bworldonline.com/payatas-landfill- After the disaster, survivors were relocated by the
closure-causes-stir/ government to a socialized housing project in
Kasiglahan Village, Rodriguez, Rizal.
However, this did not make them less vulnerable to disasters.

Most of them had difficulty looking for jobs or earned less as
the area is far from the city center. Since the village is near
Wawa Dam, they experience flash floods every rainy season.
The substandard quality of houses also makes them
vulnerable to the effects of an earthquake as it is located within
a 500-meter radius of the West Valley Fault line.
For the victims of the July 2000

Payatas disaster, poverty and political
neglect acted as a vicious worsening
cycle which ranged from vulnerability
to poor recovery, from marginality to
further marginalization, from danger
zone to death zone. (Gaillard & Cadag,
2009; Ellao, 2013).
Photo from:
https://trashingitout.wordpress.com/

Page | 14
Case Study
The Tragedy of Mining in Rapu-rapu Island Ecosystem, Albay Province
By Emelina Regis, Ph.D.
In April 2005, Lafayette, an Australian mining
firm started mining gold, silver, copper and
zinc on Rapu Rapu island, Albay. Within
barely six months of operation, Lafayette
however caused cyanide spill and fish kills in
October 11 and 31, 2005 after heavy rains.
For months, it paralyzed the livelihood of
predominantly poor fishing communities in
Rapu-Rapu and Sorsogon due to chemical
contamination of the water system.
Lafayette denied the fish-kill. Mines

Geosciences Bureau of DENR supported it
with a report that only 2-15 kilos of dead fish
were collected at the outfall of the
river/creeks, further exonerating Lafayette
from the blame. The report of the Pollution Adjudication Board in 2005 however showed cyanide
levels in water of the affected creeks and siltation ponds, exceeding the standard of 0.05 parts per
million (ppm) up to 36,000 times.
The problem of Lafayette mining can never be blamed on the weather because this company and
concerned government agencies were forewarned since year 2000 by the research conducted by
Institute for Environmental Conservation and Research (INECAR) of Ateneo de Naga University.
The study recommended that if mining will pursue it will have a negative impact to geophysico-
chemical nature, economy and public health of the communities in Rapu-Rapu.
It is sad that during unsolved problems of mining in Rapu-Rapu, the government continues to invite
foreign mining companies to mine many areas in the Philippines. What is further heartbreaking is
the fact that these foreign companies, such as Lafayette Mining Ltd. of Australia , come from rich
countries, yet their own government would tolerate their mining, causing destruction of large areas
of productive land and sea in a poor country and results to further destruction and poverty.
Mining is not only a political issue in the Philippines

because it causes the destruction of the major economic
base of a poor country. People depend on agriculture and
fisheries that are sustainable and could sustain
generations of people from all walks of life despite
typhoons, earthquakes. In the end, the issue is moral,
which is greed. Its perpetuation is ultimately an issue on
justice for peace loving people living in separate islands
but linked with a simple trust to a loving God.
Excerpt from:
Regis, E. G. (2007, August 23). The Tragedy of Mining in Rapu-rapu Island Ecosystem, Albay Province.
Retrieved September 1, 2020, from http://www.minesandcommunities.org/article.php?a=2309

Page | 15
DISASTER RISK REDUCTION, MANAGEMENT & SUSTAINABLE
DEVELOPMENT
Since disasters are indicator of failed practice of governance and unsustainable economic, environment
and social processes, reducing disaster risk requires to resolve and address the structural causes of
vulnerability (poverty, marginalization, inequality, climate change, environmental degradation &
development aggression) while strengthening the capacity (increasing the resources, fostering dialogue
and people’s solidarity) to achieve sustainable development for all.
Therefore, using the mnemonic device earlier, Disaster Resilience can only be achieved by reducing and
managing disaster risk at the community level.
16
16
Responsibility to reduce the disaster risk does not lie with disaster risk managers alone. It is rather a
concern for everyone.
Reflective Question
As an NSTP student, how can you help

address, resolve, and decrease the
vulnerabilities of people and strengthen
the capacities of communities to build a
disaster resilient country?
16
READ Information, Education and Communication Materials for Disaster & COVID-19 Prevention and
Management ; http://www.ocd.gov.ph/index.php/iec;
https://sites.google.com/phivolcs.dost.gov.ph/infographics/home;
https://www1.pagasa.dost.gov.ph/index.php/18-publication/2714-information-education-and-communication-
materials; https://doh.gov.ph/2019-nCoV
Page | 16
Lesson Two
COMMUNITY-BASED DISASTER RISK REDUCTION AND
MANAGEMENT
While dealing with disasters is the main responsibility of the government as they have the human capacity
and resources to address it, we can still do our part as individuals and members of a community.
The Community-Based Disaster Risk Reduction and

Management (CBDRRM) is an approach that
emphasizes the practice of reducing disaster risks by
decreasing the vulnerability of people and increasing
their capacities. This is done through the community’s
active and organized participation in collectively
analyzing the causes of their vulnerabilities, wise
management and use of their resources and planning
for adverse events.
Rights-Based Approach can be used as a

complementary tool of CBDRRM. Rights-Based Filipino youth discuss on how they can play a substantial role
Approach (RBA) means that in order for people in mitigating disasters and promoting resilient community.
(World Vision: https://www.worldvision.org.ph/news/youths-
affected by disasters to claim/reclaim the rights that voice-on-disaster-risk-reduction/)
were violated, it is the obligation of the state as the
primary duty-bearer to secure the basic needs of the
affected families such as shelter, clothing and food.
Learning Activity
Whatever you have listed down, those
Imagine yourself in the situation of a poor person exposed to things are considered your human
different hazards: rights, whether they be food, shelter,
freedom, health, education etc.
As a human being:
The Universal Declaration of Human
 What are the 3 things that you consider to be most Rights recognizes that all humans as
important to you? being "born free and equal in dignity
 In reality, are you able to achieve those things? and rights" regardless of "nationality,
 What do you think should be done to the things or place of residence, gender, national or
people that you value? ethnic origin, colour, religion,
language, or any other status".
CLICK THE LINK TO SEE THE UNIVERSAL DECLARATION OF HUMAN RIGHTS

https://www.zenpencils.com/comic/134-the-universal-declaration-of-human-rights/

Page | 17
However, in reality, as discussed in Lesson 1, poverty is a consequence of an unjust society which means
that many of the poor people’s rights are neglected and violated. When a disaster happens, the poor people
are the most affected.
Therefore, your answers to the third question are exactly what should be done to your Human Rights: it
should be recognized, upheld, defended and protected especially more during disasters so that you as a
survivor can be able to live a life with dignity (ACCORD, 2012 p. 6). 17
Government as duty-bearers are accountable to give quality service to the most affected while the rights-
holders have the responsibility to be pro-active in the assertion of their human rights and in building their
own community-based organizations to help mitigate and address disasters as opposed to passively
waiting for relief and aid.
CBDRRM and RBA focuses on:
1. Capacity Building18
Builds upon and strengthens existing coping
strategies and capacities such as solidarity,
cooperation, local knowledge, and resources.
Usually, the poor and highly vulnerable communities
have very low literacy rates and providing basic
Filipino Older Persons participated in an Emergency Training
Artemio Andaya
17
WATCH: Rights based approach in practice: introduction European Youth Forum
https://www.youtube.com/watch?v=dMxHYFDh4K4
18
WATCH: Building Capacity for Disaster Risk Management https://www.youtube.com/watch?v=Mxp6R1D2Kng
Page | 18
knowledge on hazards, its effects, and
preparedness measures linked with their practices
gives them the confidence to deal with emergency
situations.
2. Inclusivity and Responsiveness

No person will be left behind. It creates space for
the vulnerable to share their voice, commitment,
and abilities. It is responsive to the communities’
PWD are included in Disaster Preparedness Planning and
urgent needs such as accessibility and Implementation | Photo: Philippine Coordinating Center for
prioritization of needed services during a disaster Inclusive Development
situation.
Eg. Early warning systems, community shelters or

search and rescue services are accessible to the
needs of persons with disabilities in the event of a
disaster.
3. Participatory and Empowering19

Community members are at the heart of decision-
making and implementation of their own DRRM
activities. It gives people the power to create their
own disaster risk assessment, project planning,
implementation, and evaluation.
4. Gender Sensitive 20
Women are subjected to the additional burden of
their gender as they are confined to housekeeping
or child-rearing roles depriving them of
opportunities for financial independence. They
are also subjected to gender-related violence
especially during disaster. CBDRRM and RBA
recognizes that the needs of women should be
addressed in all aspects of DRRM.
5. Proactive and Comprehensive

The emphasis is on preventive and mitigating Single Mothers of Kasiglahan Village, Rodriguez, Rizal
measures in preparation for disasters, instead of illustrate the dangerous areas for the children and women in
their community using hazard and resource mapping.
merely reacting after a hazard strikes. It
strengthens the non-structural (health, literacy,
public awareness, training, and community organizing) and structural (disaster resilient infrastructure)
capacities of the whole community and addresses every aspect of decreasing their vulnerabilities.
19
WATCH: Community members work together for disaster risk reduction:
https://www.youtube.com/watch?v=QyH6htOsSMk
20
WATCH: Six steps to mainstream gender equality in Disaster Risk Reduction:
https://www.youtube.com/watch?v=h-XhihCAtLM
Page | 19
Local government units are encouraged to invest in DRRM
and emergency equipments
6. Collective
Mobilizes all persons in a community to develop
their own organization. The organization is a
testament to their capacity, enabling them to
achieve their own plans and projects. The
process by which their capacities are
strengthened to form and run their own
organizations is in fact a part of the process of
claiming their rights.
7. Collaborative
Encourages collaboration with other people’s
organizations, academic institutions, and non-
government organizations. These partnerships
are avenues for learning as they share their
scientific and local experiences to disasters
which will be the basis for their unity and solidarity
The School Watching Application (DepEd SWApp) is a
mobile and web app developed by DepEd, in partnership with towards change.
Save the Children Philippines (SCP) and Prudence
Foundation, that specifically engaged students in disaster CLICK the links if you want to see: Video of the app:
preparedness
https://www.youtube.com/watch?v=iyQCKlznBOQ

Page | 20
Activities of Community Based Disaster Risk Reduction and Management
This section will celebrate the highlights and gains of CBDRRM as showcased by the good practices of
different people’s organization and their partners.
NSTP students are encourage to share, replicate and develop these activities in service-learning with the
vulnerable sectors. Learning and journeying with them contributes to promotion of human rights, justice
and resilience. We hope that this will become an inspiration for you to collaborate with the community in
building a disaster resilient nation.
Community Disaster Risk Assessment
It is a participatory activity and a process which involves the community members so
that they will be able to collectively:
a. Identify and analyze the hazards that might affect their community,
b. Identify and analyze their vulnerabilities and capacities that largely determine
the degree by which a hazard can affect them, and therefore help them
understand the causes of disasters (ACCORD, 2012, p. 1).
The UST NSTP students facilitated community disaster risk assessment together with the various at-risk sectors in the partner
communities. The process lets the community understand their situation increased their awareness and knowledge regarding their
exposure to hazards and helps them to formulate disaster risk reduction plan in their community.
Did you know? Tips in Facilitating Community Risk Assessment 21

Community Risk Assessment is
the first step in community  Listen and learn from the people. Spend enough time
disaster risk planning where the with them. Have the confidence that poor people can
voice, experience, and the needs of analyze, teach, and plan. Treat them with respect and as
every member of the community partners in community development.
especially the vulnerable sectors  Use different methodologies and strategies such as
are collectively heard and visualization techniques, ice breakers, group dynamics
recognized. The process enables and interactive games that allows poor people to express
them to work together and to themselves.
strengthen their strategies to  Be flexible with people's priorities and schedule. We
address their vulnerabilities. should be the one adjusting to their priorities, not them to
our schedule.
21
Chambers, 1994; Geilfus, 2008; Manalili, 2012
Page | 21
MORE ON THE
TOPIC To know more about Community Risk Assessment
Watch: ABC of VCA
https://www.youtube.com/watch?v=wS719VN-HfU
Watch: Community members work together for disaster risk reduction
https://www.youtube.com/watch?v=QyH6htOsSMk
Participatory Capacities and Vulnerabilities Assessment: Finding the link between disasters and development
https://oxfamilibrary.openrepository.com/bitstream/handle/10546/112522/participatory-capacities-vulnerabilities-
assessment-010602-en.pdf;jsessionid=AE67F8232ED121934B1425E5E036CC6D?sequence=1
Community Awareness, Education & Advocacy

It is an activity that provides community members an opportunity to learn and discuss the strategies on
disaster mitigation, prevention, response, and rehabilitation. It also aims to gain public recognition of their
situation through information campaign, community dialogue and participatory learning.
Its goal is to share their local knowledge to create specific action that can help reduce disaster risk in their
community.
Below are some examples of Community Awareness, Education & Advocacy:
DRRM Seminar of UST NSTP CWTS/LTS

Since 2010, 100,000 NSTP CWTS/LTS students learned Community Based Disaster Risk Reduction
and Management, Cardiopulmonary Resuscitation, Basic First Aid and Basic Emergency Response
using a mixed method of UST cloud campus e-learning and classroom-based learning. It is done
thru the partnership of UST NSTP with UST Red Cross Youth Council, Rescue 177, MMDA &
Philippine Heart Association.
Click the link to see is a peek on DRRM Seminar 2019. https://bit.ly/346IpNN

Page | 22
NSTP CWTS | LTS Resilience Schools (Community First Aid and Disaster Preparedness Seminar) 22
22
As part of their Fieldwork, NSTP CWTS/LTS students trained approximately

5, 000 participants from several partner communities and institutions, with
the proper skills in conducting First Aid Care on different emergencies.
Lumad Bakwit School in UST

UST students immersed and gave solidarity with the “Lumad
Bakwit”(indigenous peoples from the Mindanao who are
internally displaced due to human rights violations and threats to
destroyed their schools and communities by state forces and
paramilitary groups brought by the development aggression
TUKLAS Innovation Labs

TUKLAS Innovation Labs is a community-centered innovation fair that seeks to find homegrown
solutions on disaster risk reduction and management.
One of the featured inventions was the ANIA Disaster

Preparedness Simulator which uses virtual reality as a novel tool
for communities to experience and learn from authentic disaster
scenarios and improve preparedness.
SolveX38 is an intelligent flood warning and monitoring system
providing real-time information to communities at risk from
flooding.
To know more about Tuklas Innovation Labs, click the link: TUKLAS VIDEO
22
READ the Fieldwork Report of NSTP students:
https://drive.google.com/drive/folders/1ZVWfn1MX9GejviWWhWP2zWnmTG8Nxk9j?usp=sharing
Page | 23
Reflective Question
Being a student of your course, how can

you use your expertise in advocating for
Community Based Disaster Risk
Reduction and Management in your
community and in the country?
Community Early Warning and Risk Communication

System
It is a system that disseminates timely and
meaningful warning information to enable
communities threatened by a hazard to prepare and
to act appropriately to reduce the possibility of harm
or loss.
It is based on the local knowledge of the community
on what will be effective for them. It is developed,
established, and managed by the community for the
safety of its residents.
Photo Credit: Dave Martinez
Characteristics of an effective community-based early

warning system23 24
 Hazard-specific, Target group-specific & Location-
specific
 Brief and clear (KISS Rule: “Keep It Short and Simple”)
 Updated so the people are informed and would not
panic
 There are specially assigned persons in the
community to disseminate the warning
 Regular monitoring of the hazard
 Organized and clear dissemination of the warning
23
Elements of End-to-End, People-Centered Early Warning: https://www.youtube.com/watch?v=b_rfyZ0G4QE
24
Early Warning Systems Save Lives in Disaster-prone Communities: https://www.youtube.com/watch?v=Cb8-
18F14Hk
Page | 24
Formation of Community-Based Disaster Organization
It is a process of the community members to create their own organization focused on reducing
their vulnerabilities and increasing their capacities with the goal of being disaster resilient. The
organization will have their own set of officers, committees, and by-laws that they themselves
create and agree upon. This also ensures the sustainability of the organization as the community
members themselves run it.
Case Study
KADAMAY: Community-Led Kusinang

Bayan of Sitio San Roque
Sitio San Roque is comprised of approximately
6,000 urban poor families based in Barangay
Bagong Pag-asa, Quezon City. Since 2010, they are
continuously threatened with demolition to make
way for the Quezon City Central Business District
project of the local and national government. Like
most urban poor communities, the residents were
mostly landless farmers who came from the
provinces and started to live in Sitio San Roque
hoping for better livelihood opportunities for their
families.
Amidst living in poor conditions, they were able to

find ways on how they can improve their situation
by creating their own community-based
organization. They were able to increase their skills
and capacities because of learning with and from
each other.
Through this, they were able to reach out and seek support from other
individuals and Roque was created by supporters and advocates for
their calls for a decent, affordable, pro-people and inclusive urban
development.
When the Enhanced Community Quarantine was implemented in Metro

Manila from March to May 2020, they were able to cope through the
creation of their own Kusinang Bayan. The COVID-19 restrictions led to
the loss of livelihood of the residents and the lack of means of getting
food was a pressing concern.
While waiting for government aid to reach them, the organization was
able to set-up at least 20 community kitchens distributed in the area.
Through the donations they received, they were able to provide warm
meals to at least 2000 families in their community every day.

Page | 25
The Kusinang Bayan is manned by the members and they share the
tasks of food preparation, cooking, and distribution.
They also have volunteer community health workers that constantly

checks the physical health and well-being of the members.
25
Sitio San Roque’s Kusinang Bayan counters the portrayal of urban
poor in mass and social media as “pasaway”, “walang disiplina” and
“tamad”. The government has consistently put them in bad light, with
the numerous attempts of demolishing their community kitchens and
arrest of their members, with the police saying that they have defied
quarantine protocols.
In the midst of the pandemic and other disasters, the stories of the
vulnerable sectors who have limited capacities but found ways on how
to collectively help themselves and their communities should be
celebrated and emulated.
25
ALAY BAYAN LUSON

In 2018, Alay-Bayan Luson, Inc., together with the community of Bagulin, La Union, ran a project where one
barangay transferred their knowledge and skills about disasters to another barangay. For eight months,
members of the Disaster Preparedness Organization of Brgy. Alibangsay became community instructors
and helped create the organization of nearby Brgy. Cardiz. They gave trainings on CBDRRM, basic
leadership skills as well as basic health skills.
To view their experience: https://www.youtube.com/watch?v=Q2B52kTkkFU
25 To know more about Save San Roque Alliance: Watch Kusinang Bayan:
https://www.facebook.com/watch/?v=315484130146618

Page | 26
SYNTHESIS AND CHALLENGE
We have discussed and analyzed the interconnected factors that cause disasters. Even though our country
has a high exposure to different hazards due to physical and geographical location, we must acknowledge
that disaster is not just a natural event but also a consequence of the unsustainable economic, political
and environmental practices of people.
It is important to understand that disaster resilience can only be achieved when the most marginalized
people are empowered – when their vulnerabilities have decreased, and their capacities have increased. It
is the government’s responsibility as the duty-bearers to provide appropriate solutions and services to the
peoples’ needs before, during and after a calamity strikes.
To achieve this, the root causes of vulnerabilities such as poverty, marginalization and inequality must be
addressed. The people must also be given the opportunities to capacitate themselves. It has been proven
that when given the tools and opportunity, the people and communities work together to learn new
knowledge and skills on how to find solutions to the problems that affect them.
The COVID-19 pandemic is an unprecedented disaster that exposed the pressing need to address the root
causes of vulnerabilities in our country.
It is our hope and prayer that we learn from the practices of the likes of Sitio San Roque who were able to
help each other even with their meager resources.
Let us also be inspired by our fellow Thomasians who used

their talent and skills in music to raise funds through
organizing an online concert for the security guards, janitors
and contractual employees of our University who were not
able to work due to the suspension of classes because of
the community quarantine.26
Like them, we have the capacity to overcome our limitations

and look for ways on how we can collectively help alleviate
the suffering of others.
We may be physically distant from each other, but we can

still practice social solidarity.
Let the “new normal” be a “better normal”. Let us envision a

society where everyone has access to the resources that
they need to live a life with dignity. The Thomasian core
values of Competence, Commitment and Compassion must be upheld now more than ever as we come
up with ideas on how to implement the lessons we have learned in this module.
As a Thomasian, how can you work with your fellow classmates or family members or community in
achieving a “better normal” for all?
26
https://www.facebook.com/BenguetToUste
Page | 27
Lesson Three
BASIC LIFE SUPPORT AND BASIC FIRST AID ON DIFFERENT
EMERGENCIES
LESSON GUIDE INTRODUCTION TO FIRST AID
Introduction to First Aid
1. Definition What is FIRST AID?
2. Scene Size Up
3. Primary Assessment First aid is the temporary and immediate care given to a
4. Secondary Assessment person who is injured or who suddenly becomes ill. It
can also involve home care if medical assistance is
Introduction to Basic Life Support
delayed or not available. First aid includes recognizing
1. Definition
2. Updates for 2015 life-threatening conditions and taking effective action to
3. Cardiac Chain of Survival keep the injured or ill person alive and in the best
4. Heart Attack (Myocardial Infarction) possible condition until medical treatment can be
a. Definition obtained or until the chance for recovery without
b. Signs and symptoms medical care is assured.
c. Management
5. Cardiac Arrest First aid does not replace the physician, nurse, or
a. Definition paramedic. In fact, one of the primary principles of first
b. Signs aid is to obtain medical assistance in all cases of
c. Management
serious injury.
6. Hands-only Cardiopulmonary Resuscitation
a. For Teens
b. CPR (Hands-Only) with Covid-19
Precaution by Philippine Heart Scene Size-Up (Survey the Scene)
Association In any emergency situation, there are three simple steps
7. Breathing Emergencies to take to guide your actions. If you ever feel nervous or
a. Airway Obstruction
confused, remember these three emergency action
i. Anatomical obstruction
steps to get you back on track:
ii. Foreign Body Obstruction
iii. Signs and Symptoms
iv. Management
iv.1. Backslap a) CHECK the scene and the person.
iv.2. Abdominal Thrust b) CALL 9-1-1 or the local
iv. 3. Chest Thrust emergency hotline.
b. Respiratory Arrest c) CARE for the person.
i. Definition
ii. Sign
iii. Management Before approaching an ill or injured person, stop and
Focusing on Hands Only CPR take a good look at the scene:
 Is it safe?
Wounds  Are there any hazards?
1. Bleeding  What happened?
a. Types of bleeding  How did it happen?
b. Way to Control bleeding
2. injuries
b. Closed wounds
i. Definition
ii. Signs and symptoms
iii. Management

Lesson Three: Basic Life Support and Basic First Aid On Different Emergencies
Page | 28
LESSON GUIDE Primary Assessment
c. Open wounds CHECK THE PERSON
i. Definition If the scene is safe, quickly check the person:
ii. Signs and symptoms 1. Check whether the person is responsive.
iii. Types
2. Check the person’s ABCDs:
iv. Management
a) Airway
d. Burns Make sure the person has an open airway. If the
i. Definition person is speaking, moaning, or crying, the
ii. Signs and symptoms person’s airway is open.
iii. Management b) Breathing
Check for normal breathing for 5 to 10 seconds.
Muscle, Bone, and Joint Injuries A person is breathing normally if air is moving into
1. Definition and out of the lungs and the chest is rising and
2. Types falling in a normal, regular pattern. Someone who
a. Sprain can speak or cry is breathing.
b. Strain c) Circulation
c. Dislocation Quickly look at the person from head to toe for
d. Fracture
signs of life-threatening bleeding.
3. Signs and Symptoms
4. Management d) Disability
Assess neurological status of the person (Alert,
Medical Emergencies Voice, Pain, Unresponsive)
1. Asthma Attack
a. Definition
b. Signs and symptoms CALL
c. Management If an individual is unresponsive or has a life-threatening
2. Severe Allergic Reaction (Anaphylaxis) condition, you must call 9-1-1 or the local emergency
a. Definition contact.
b. Signs and symptoms
c. Management
If a person becomes unresponsive, his or her vital signs
3. Hypoglycemia and Hyperglycemia
a. Definition deteriorate, or your secondary assessment reveals a
b. Signs and symptoms condition that requires emergency care, call 9-1-1 or the
c. Management local emergency contact.
4. Stroke (Cerebrovascular Accident)
a. Definition
b. Signs and Symptoms CARE
c. Management Care for any life-threatening conditions first.
Give the care that is needed, within the scope of your
Environmental Emergencies knowledge and training. Continue to Check, Call, and
1. Heat Related Emergencies
Care, providing continual care with these guidelines:
a. Heat cramps
b. Heat Exhaustion  Monitor the person’s breathing, level of
c. Heat stroke responsiveness, and overall condition.
2. Definition  Help the person rest in a comfortable
3. Signs and symptoms position.
4. Management  If necessary, roll the person into the
recovery position.
Poisoning  Keep the person from getting chilled or
1. General Care for Poisoning
overheated.
2. Types of Poisoning
3. Bites and Sting  Reassure the person.

Page | 29
LESSON GUIDE RECOVERY POSITION
A person who is unresponsive or has an altered level

Transfer Techniques of responsiveness should be rolled into the recovery
position.
Additional Videos:
Bandaging When placing a person in the recovery position,
Splinting
remember:
Bleeding
Muscle and Bone Injury  Support and protect the head while rolling
the person.
 Try to roll the person as one unit (head,
back, and legs at the same time).
 Roll the person into a position where the
body will stay safely on its side.
 Check the ABCs after you complete the
roll.
Secondary Assessment
Once you are confident that all life-threatening
conditions have been addressed, perform a
secondary assessment to check for conditions that
may not be as obvious.
The secondary assessment consists of three steps:
1. Ask SAMPLE Questions 3. Perform an Injury Check

Interview the ill or injured person and any Look carefully for injuries that were not identified
bystanders at the scene using the acronym during the primary assessment. An injury check
SAMPLE to guide your questions: may involve a focused examination or a hands-
on check. If you find a medical-identification
product during your check, read it carefully.
2. Check the Vital Signs

Level of Responsiveness
Is the person alert, sleepy, or confused?
Is the person’s responsiveness changing?
Breathing
Listen for sounds. Is the breathing fast or slow?
Skin
Is the skin dry or wet? Color? Temperature?

Page | 30
INTRODUCTION TO BASIC LIFE SUPPORT
What is Basic Life Support (BLS)?
Basic life support is the act of sustaining life-sustaining functions after events which may have rendered a
victim unresponsive with no visible breathing or gasping breathing. This is accomplished with
Cardiopulmonary Resuscitation or CPR.
CPR Updates for 2015

In the 2015 guidelines, several steps in traditional CPR were removed while some were improved. The
summary of major changes is the following:
 A simplified universal adult BLS algorithm was created.

 Refinements were made for recognition of victims in need of CPR from unresponsiveness,
absence of pulse and breathing to unresponsiveness and absence of breathing or no normal
breathing (victim is gasping).
 Untrained lay rescuers should provide compression-only (Hands-Only) CPR, with or without
dispatcher guidance, for adult victims of cardiac arrest. The rescuer should continue
compression-only CPR until the arrival of an AED or rescuers with additional training.
 Look, listen, and feel for breathing has been removed.
 Emphasis for rapid identification of potential cardiac arrest by dispatcher with immediate
dispatch-guided CPR.
 Emphasis was placed on high-quality CPR (Adequate rate and depth, complete chest recoil
after each compression, minimize interruptions in compressions and avoiding excessive
ventilation).
 A change from Airway-Breathing-Compression (ABC) sequence to Compression-Airway-
Breathing (CAB) sequence.
 Compression rate is 100-120/min rather than at least 100/min.
 Compression depth for adults is at least 2 inches (5cm) but not greater than 2.4 inches
(6cm).
Cardiac Chain of Survival

CPR alone may not be enough to help someone survive cardiac arrest. Advanced medical care is needed
as soon as possible. A person in cardiac arrest will have the greatest chance of survival if you follow the
four links in the Cardiac Chain of Survival:
1. Early recognition and early access to the

emergency medical services (EMS)
system.
The sooner someone calls 9-1-1 or the local
emergency number, the sooner EMS
personnel will take over.
2. Early CPR.
CPR helps supply blood containing oxygen
to the brain and other vital organs. This Retrieved from: https://www.aedbrands.com/resource-
helps to keep the person alive until an AED center/choose/chain-of-survival
is used or advanced medical care is
provided.
Page | 31
3. Early defibrillation.
An electrical shock, called defibrillation, may help to restore an effective heart rhythm.
4. Early advanced medical care.
EMS personnel provide more advanced medical care and transport the person to a hospital.
Heart Attack (Myocardial Infarction)
What is Heart Attack (Myocardial Infarction)?

When blood flow to the heart muscle is reduced,
people experience chest pain. This reduced blood
flow usually is caused by coronary heart disease
and when the blood and oxygen supply to the heart
is reduced, a heart attack may result.
Signs and symptoms

 Chest pain, discomfort or pressure
The most common signal is persistent
pain, discomfort or pressure in the chest
that lasts longer than 3 to 5 minutes or
goes away and comes back. Build-up of fatty materials on the inner walls of the arteries
reduces blood flow to the heart muscle and may cause a heart
 Discomfort in other areas of the upper attack.
body in addition to the chest such as the
shoulder, arm, neck, jaw, stomach or back.
 Trouble breathing
The person may be breathing faster than normal because the body tries to get the much-
needed oxygen to the heart. The person may have noisy breathing or shortness of breath
 Other signals
The person’s skin may be pale or ashen (gray), especially around the face. Some people
suffering from a heart attack may be damp with sweat or may sweat heavily, feel dizzy,
become nauseous or vomit. They may become fatigued, lightheaded or lose consciousness.
Management
 If you suspect the person is having a
heart attack based on his or her signals,
call 9-1-1 or your local emergency
number immediately
 Have the person stop what he or she is
doing and rest comfortably (photo on
the right).
This will ease the heart’s need for
oxygen. Many people experiencing a
heart attack find it easier to breathe
while sitting.
Ask that person to stop what they are doing and rest. Comfort
 Loosen any tight or uncomfortable the person helps to reduce anxiety and discomfort. Retrieved
clothing. from American Red Cross First Aid/CPR/AED Participant’s
Manual

Page | 32
 Closely watch the person until advanced medical personnel take over. Notice any changes
in the person’s appearance or behavior. Monitor the person’s condition.
 Be prepared to perform CPR and use an AED, if available, if the person loses consciousness
and stops breathing.
 Ask the person if he or she has a history of heart disease.
Some people with heart disease take prescribed medication for chest pain. You can help by
getting the medication for the person and assisting him or her with taking the prescribed
medication.
 Offer aspirin, if medically appropriate and local protocols allow, and if the patient can
swallow and has no known contraindications. Be sure that the person has not been told by
his or her health care provider to avoid taking aspirin
 Be calm and reassuring. Comforting the person helps to reduce anxiety and eases some of
the discomfort.
 Talk to bystanders and if possible the person to get more information.
 Do not try to drive the person to the hospital yourself. He or she could quickly get worse on
the way.
Cardiac Arrest
What is Cardiac Arrest? Did you know?
Cardiac arrest occurs when the heart stops beating or
beats too ineffectively to circulate blood to the brain and Without oxygen, brain damage
other vital organs. The beats, or contractions, of the heart can begin in about 4 to 6 minutes,
become ineffective if they are weak, irregular or and the damage can become
uncoordinated, because at that point the blood no longer irreversible after about 10
flows through the arteries to the rest of the body. When the minutes.
heart stops beating properly, the body cannot survive.
Breathing will soon stop, and the body’s organs will no
longer receive the oxygen they need to function.
A person in cardiac arrest is unconscious, not breathing and has no heartbeat. The heart has either stopped
beating or is beating weakly and irregularly so that a pulse cannot be detected.
Cardiovascular disease is the primary cause of cardiac arrest in adults. Cardiac arrest also results from
drowning, choking, drug abuse, severe injury, brain damage
and electrocution.
Did you know?
Cardiac arrest can happen suddenly, without any of the
The most common life-threatening warning signs usually seen in a heart attack. This is known as
abnormal arrhythmia is ventricular sudden cardiac arrest or sudden cardiac death. Sudden
fibrillation (V-fib). cardiac arrest is caused by abnormal, chaotic electrical
activity of the heart (known as arrhythmias).
Signs
 The main signals of cardiac arrest in an adult, a child and an infant are unconsciousness
and no breathing.
 The presence of these signals means that no blood and oxygen are reaching the person’s
brain and other vital organs.

Page | 33
Management
 Call 9-1-1 or the local emergency number immediately if you suspect that a person is in
cardiac arrest or you witness someone suddenly collapse.
 Perform CPR until an AED is available and ready to use or advanced medical personnel take
over.
 A person in cardiac arrest needs immediate CPR and defibrillation. The cells of the brain and
other important organs continue to live for a short time—until all of the oxygen in the blood
is used.
Component of High-quality CPR
What is CPR?
CPR, or cardiopulmonary resuscitation, is a combination of chest compressions and rescue breaths. Chest
compressions are required when the heart is not beating in order to pump oxygen-containing blood. Rescue
breaths and chest compressions, given together, help to take over the heart and lungs. CPR increases a
person's chances of survival during cardiac arrest.
For this chapter, you are only required to learn the Hands-only
CPR (Teens and Adults) for lay bystanders (With COVID19
Precautions).
Hands-only CPR is basically summarized into 4Cs which are:

a. Check
b. Call
c. Cover
d. Care/ Compress
CHECK
Checking the Scene (Survey the Area)

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 Creator: JIM WATSON | Credit: AFP/Getty Images

Page | 34
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 a victim yourself.
The scene can also provide clues to whether the victim is injured or ill. For example, if you note a ladder
next to a person lying on the ground, you would assume the victim is injured from a fall. This is referred to
as the mechanism of injury. If a person is found sitting in a chair in a restaurant, you would assume the
victim is ill.
Knowing the mechanism of the injury will allow you to give useful information to the EMS personnel who
will later attend to the victim. This will enable the physician to fully recognize the extent of injuries.
Also determine the number of injured people. Once you have determined the number of victims, you can
then have a bystander contact the necessary resources. You may request more than one ambulance if you
find several people who are injured or ill. And, if there is
more than one victim, you will have to prioritize which one
you should give attention first. Take Note
Ask for consent and introduce
To begin, establish rapport with the victim by introducing
yourself after checking
yourself and explaining that you are there to help. It would
be very helpful to demonstrate competence, confidence unresponsiveness and
and compassion. Obtain consent to treat before preparing for CPR
assessing the victim.
CHECK
Checking for Responsiveness
Determine unresponsiveness by tapping the victim on both shoulders and ask loudly, “Are you okay?”.
You are not looking for an answer per se, any kind of response will do such as fluttering eyelids, muscle
movement, turning to the sound, and so on. If there is no response, the victim is unresponsive.
Assessing the victim is one of the most important and critical parts of first aid. The assessment is
conducted to identify and care for immediate life threats to the airway, breathing and circulation. Some
injuries are obvious; others are hidden. A conscious victim may be able to guide you to the problem – but
an unconscious victim will be of no help at all.
The respiratory, circulatory and nervous systems include the most important organs in the body: the heart,
lungs, brain and spinal cord. A serious problem in any of those three body systems generally produces a
serious threat to life. And if any one of those systems stops functioning, death occurs within minutes. The
goal of the primary survey is to quickly assess the three most important body systems to determine any
life-threatening condition so that it can be corrected immediately.
Unless you find a life threatening situation that needs to be treated immediately, you should be able to
complete the primary survey in approximately 60 seconds. The effectiveness of your first aid will depend
on effective assessment – you need to find what is wrong before you can treat it.

Page | 35
Start with the following steps:
1. Determine unresponsiveness by tapping the victim on both shoulders and ask loudly, “Are you
okay?” or "Ate/Kuya, ayos lang po ba kayo?".
“If the victim is conscious and responsive, proceed to step 2. However, if the victim is
unresponsive, proceed to the 2nd C (Call), the 3rd C (Compress) and the 4th C (Care/Compress)
immediately.”.
2. Ask for consent, then 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.
5. If there are any life threatening condition, call 911 or your local emergency numbers.
CALL
Activating the Emergency Medical Service (EMS) System During the first minutes of an
emergency, it is essential that the EMS system be activated. Calling anyone else first only wastes
time. If the situation is not an emergency, call your doctor. However, if you are in any doubt as to
whether the situation is an emergency, activate the EMS system.
As a general rule, activate EMS whenever a

situation is more than you can handle. Did you know?
9-1-1 is the national emergency hotline for You are a vital link between the EMS
any other emergencies, check this link system and the victim. Delaying these
https://www.gov.ph/hotlines actions present significant dangers to
the victim.
COVER
Cover
Cover the mouth of the victim with any cloth or facemask to minimize the transmission of
possible COVID19 (see CPR (Hands-Only) with Covid-19 Precaution by Philippine Heart
Association for more COVID19 related CPR)

Page | 36
CARE/COMPRESS
Performing Hands-only CPR (Teen and Adult Victims) by Chest Compressions
After determining the unresponsiveness of the victim and calling for help, you may now proceed
in administering high quality Chest Compressions.
Here are the steps in Administering Chest

Compressions:
1. Position your body correctly by kneeling

beside the person’s upper chest and
placing your hands in the correct position
by keeping your arms and elbows as
straight as possible so that your shoulders
are directly over your hands. Your body
position is important when giving chest
compressions Compressing the person’s
chest straight down will help you reach the
necessary depth and Using the correct
body position also will be less tiring for
you.
2. Locate the correct hand position by placing the heel of one hand on the person’s sternum
(breastbone) at the center of his or her chest (see picture below, left). Place your other hand
directly on top of the first hand and try to keep your fingers off of the chest by interlacing
them or holding them upward (see picture below, right).
Place your other hand directly on top of the first

hand. Try to keep your fingers off of the chest by
interlacing them or holding them upward.
3.Push hard, push fast at a rate of at least 100-120 compressions per minute. Note
that the term “100-120 compressions per minute

Page | 37
Give compressions by pushing the sternum down at least 2 inches but not greater
than 2.4 inches. The downward
and upward movement should be
smooth, not jerky. Push straight
down with the weight of your
upper body, not with your arm
muscles.
This way, the weight of your
upper body will create the force
needed to compress the chest.
Do not rock back and forth.
Rocking results in less-effective
compressions and wastes much
A-B. To give chest compressions:
needed energy. If your arms and A. Push straight down with the weight of your body.
shoulders tire quickly, you are not B. Release, allowing the chest to return to its normal position
using the correct body position.
4. Keep pushing and continue Hands-only CPR until the following conditions are met:
Double click on the picture to play and watch the demonstration

Page | 38
CPR (Hands-Only) with Covid-19 Precaution by Philippine Heart Association

Page | 39
For Trained and Untrained Lay Rescuers
1. For All witnessed and unwitnessed cardiac arrests with known or Suspected COVID
infection, it is reasonable for Lay rescuers to do the following:
a. Check for scene safety and Call EMS

b. Check for unresponsiveness ONLY if with standard recommended PPE.
Otherwise, wait for EMS or call for nearest help for PPE. Strictly NO more feeling
for breaths (“Look, Listen and Feel”).
c. No Rescue Breaths.
d. Do Standard Chest compressions ONLY at a rate of 100-120/min until EMS
arrives, provided there is available standard recommended PPE. Otherwise, wait
for EMS or call for nearest help for PPE.
e. Use AEDs appropriately with the same usual procedures provided rescuer has
standard recommended PPE.
2. For All witnessed and unwitnessed cardiac arrests with proven absence or if with
doubt of COVID infection, it is reasonable to do Chest compressions only with standard
recommended PPE until EMS arrives.27
Breathing Emergencies
A breathing emergency is any respiratory problem that

can threaten a person’s life. It happens when the air
cannot travel easily to the lungs. A common cause of
breathing emergency is airway obstruction. When the
airway is blocked by swollen tissues of the mouth,
throat or other airway structures it is called
Anatomical Airway Obstruction while partial or
complete obstruction by any foreign object is called
Mechanical Airway Obstruction. Recognizing whether
a person is having trouble breathing or not breathing
Retrieved from at all and giving immediate care are keys in preventing
https://www.medicinenet.com/image-collection/airway_picture/picture.htm
them to cause more serious emergencies.
The Breathing Process
Humans need oxygen to live. When we breathe through the mouth and nose, the air travels down the throat,
through the windpipe, and into the lungs. This pathway from the mouth and nose to the lungs is called
airway. Infants and children have smaller airway, therefore they are more susceptible to airway blockage
by small objects, swelling, or fluids.
27
Out of Hospital Cardiac Arrests (OHCA), Interim Consensus Guidelines for Basic and Advanced Resuscitation
in Cardiac Arrest Patients during COVID-19 Outbreak, PHA CPR Guidelines for COVID
Page | 40
SIGNALS (signs and symptoms) OF BREATHING EMERGENCIES:
 Trouble or no breathing  Shortness of breath

 Slow or rapid breathing  Dizziness or light headedness
 Unusually deep or shallow breathing
 Pain in the chest
 Gasping for breath
 Wheezing or making high pitch-noises  Tingling in the hands, feet or lips
 Flushed, ashen, pale or bluish skin  Apprehensive or fearful feeling
 Unusually moist or cool skin
CHOKING A person choking can quickly become unresponsive, unable to cough,

speak, or breathe. An immediate response should be given. It is more
common in children but it can happen anytime regardless of age. It occurs
when choking hazard partially or completely blocked the airway
What to do when an adult or child is choking?28 29
1. VERIFY if the person is choking “Hey, hey are you okay?”
 If the person can speak, encourage the person to keep coughing

but be prepared to give first aid if the conditions change.
 If unable to speak, call for help or ask someone to call for help. Get
Retrieved from: consent and start giving first aid.
https://medlineplus.gov/ency/images/e
ncy/fullsize/17107.jpg
2. GIVE 5 BACK BLOWS. 3. GIVE 5 ABDOMINAL

Position yourself to the side, THRUST.
slightly behind the person. Place Have the person stand up
one arm diagonally across the straight.
person’s chest. Bend the person place a fist with the thumb
forward at the waist (the upper side against the middle of the
body is as close to parallel to the person’s abdomen, just above
ground a possible) and give 5 the navel. Cover your fist with
back blows between the your other hand and give 5
shoulder blades with the heel of quick, inward and upward
your hand. abdominal thrusts.
28
The American Red Cross (2017). Responding to emergencies: comprehensive first aid/cpr/aed, retrieved from:
http://pchs.psd202.org/documents/mopsal/1539703875.pdf
29
“How to help a Choking Person” YouTube, uploaded by The LIFESAVER, Nov. 28, 2019, https://youtu.be/pzlwOI7xQRc
Page | 41
4. CONTINUE CARE
IF THE PERSON BECOMES UNCONCIOUS.
Continue giving 5 back blows and 5 abdominal Carefully lower the person to the ground and
administer CPR. Open and check the mouth for
thrusts until the object is forced out, person can
obstruction after each set of compressions,
cough forcefully or breathe, or if the person remove if seen. Do not put your finger inside the
becomes unconscious. mouth unless the obstruction is visible.
What to do when an infant is choking?30
If the conscious infant cannot cough, cry or breathe, you will need to give a combination 5 back
blows followed by 5 chest thrusts. Watch the following video for a detailed instruction.
REVIEW THE VIDEOS

RESPIRATORY ARREST
Click the play button
These are types of breathing emergencies;
What to do when an adult
respiratory distress is when breathing becomes
(or child) is choking?
difficult, like shortness of breath, gasping for
breath, or breathing faster than normal What to do when an
(hyperventilation) while respiratory arrest is the infant is choking?
absence of breathing. Respiratory distress can

lead to respiratory arrest. Hyperventilation
occurs when a person’s breathing is faster and more shallow than normal. The carbon dioxide
levels in the bloodstream decreases, resulting for people feeling as if they cannot get enough air.
Signs and Symptoms

 Wheezing, gurgling, or high-  Pale, gray or flushed
pitched noise  Deep, shallow, or irregular
 Breathing is unusually slow or fast breathing
30
“How to help when an infant is choking” YouTube, uploaded by The LIFESAVER, Feb. 26, 2020 https://youtu.be/gfUd19Ibp9I
Page | 42
WHAT TO DO?
1. Call for help (9-1-1 or the local emergency hotline)

2. If the person is responsive, help the person to sit and check for other conditions. If they
are having difficulty to talk, phrase the questions as “yes” or “no” so the person can nod or
shake their head.
3. If the person is unresponsive and not breathing it is most likely a cardiac emergency.
Immediately begin hands only- CPR. Refer to the Hands only- CPR with CoVid-19
precaution of this chapter
WOUNDS
I. 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 is the escape of blood from arteries, capillaries or veins. A large amount
of bleeding in a short amount of time is called hemorrhage.
THERE ARE TWO TYPES OF BLEEDING:
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.
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.
HOW TO CONTROL THE BLEEDING?

Whenever you help a victim who is bleeding or losing other body fluids, take the following
precautions to protect yourself against transmission of infectious disease:
 Place a barrier between you and the victim’s blood. If you can, wear protective gloves; if
not, use plastic wrap, aluminum foil, extra gauze bandages, or a clean, thick, folded cloth.
As a last resort, use the victims own hand.
 Avoid touching your mouth, nose, or eyes or handling food while providing first aid care.

Page | 43
 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.
A. External Bleeding
Using Direct Pressure to Control External Bleeding
1. Expose the wound by removing or cutting the clothing to see where the blood is coming
from.
2. Place a sterile gauze pad or a clean cloth (such as

handkerchief, sanitary napkin or towel) over the entire
wound and apply direct pressure with your fingers or the
palm of your hand. The gauze or cloth allows you to apply
even pressure. Be sure the pressure remains constant. Do
not remove blood -soaked dressings; simply apply new
dressings over the old ones. If bleeding does not stop in 10
minutes, the pressure may be too light or in the wrong
location. Press harder over a wider area for another 10 minutes. If the bleeding is from an
arm or leg, while still applying pressure, elevate the injured area above heart level to reduce
blood flow.
3. 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. Control of external
bleeding tourniquet.
4. After the bleeding stops or to free you to attend to other

injuries or victims, use a pressure bandage to hold the
dressing on the wound. Wrap a roller gauze bandage
tightly over the dressing and above and below the
wound site.
5. The use of tourniquet to control bleeding should be a

last resort only, when all other methods have failed. It
can be used only on an extremity; using it may lead to
amputation of the extremity below the tourniquet
B. Internal Bleeding
It 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.

Page | 44
The signs and symptoms of internal bleeding are similar to those of shock: restlessness
and anxiety; cool clammy skin; weak rapid pulse; rapid breathing; and ultimately, a drop in
blood pressure. There may be additional signs and symptoms depending on the source
of bleeding some of which are:
 Bruises or contusions of the skin

 Painful, tender, rigid, bruised abdomen
 Fractured ribs or bruise on the chest
 Vomiting or coughing up blood
 Stools that are black or contain bright red blood
Internal bleeding may not cause signs or symptoms for hours or days and it may be
occurring even if there are no signs and symptoms. For victims of internal bleeding,
activate the EMS system, then:
1. Secure and maintain an open airway, and monitor the ABCDs.
2. Check for fractures; splint if appropriate.
3. Keep the victim quiet. Position and treat the victim for shock by elevating the feet 8 to 12
inches and covering him or her to maintain body heat. (Do not elevate the feet if you
suspect leg or spine injuries.) If the victim starts to vomit, position his or her side with
face pointing downward to allow for drainage.
4. Monitor vital signs every 5 minutes until emergency personnel arrive.
5. Internal bleeding can be a serious cause of shock, and almost always requires
surgical intervention
II. Injuries
Soft tissues are the layers of skin and the fat and muscle beneath the skin’s outer layer. An injury
to the soft tissue is commonly called a wound. Any time the soft tissue is damaged or torn, the
body is threatened. Injuries may damage the soft tissue at or near the skin’s surface or deep in
the body. Severe bleeding can occur at the skin’s surface or beneath, where it is harder to detect.
Germs can enter the body through the wound and cause infection.
A. Closed Wound
Bruise is the simplest kind of a closed wound is called a bruise. A bruise develops when the
body is bumped or hit, such as when you bump your leg on a table or chair. The force of
the blow to the body damages the soft tissue layers beneath the skin. This causes internal
bleeding. Blood and other fluids seep into the surrounding tissues, causing the area to swell
and change color. If a more violent force hits the body though, this causes a more serious
heavy bleeding internally and may further damage internal organs.
WHAT TO LOOK FOR:

 Tender, swollen, bruised or hard areas of the body, such as the abdomen.
 Rapid, weak pulse.
 Skin that feels cool or moist or looks pale or bluish.
Page | 45
 The person’s abdomen is tender and distended.
 The person is vomiting blood or coughing up blood.
 The person shows signals of shock or becomes
confused, drowsy or unconscious.
WHAT TO DO UNTIL HELP ARRIVES:

a. Apply an ice pack to the area to decrease bleeding
beneath the skin
b. Fill a plastic bag with ice and water or wrap ice in a
wet cloth and apply it to the injured area for periods
of about 20 minutes
Apply ice to help control pain
c. Place a thin barrier between the ice and bare skin
d. Remove the ice and wait for 20 minutes before reapplying and swelling
f. If the person is not able to tolerate a 20–minute application, apply the ice pack for
periods of 10 minutes on and off
B. Open Wound
In an open wound, the break in the skin can be as minor as a scrape of the surface layers
or as severe as a deep penetration. The amount of bleeding depends on the location
and severity of the injury.
Types of Open Wound:
1. Abrasion is caused by something rubbing roughly
against the skin. Abrasions do not bleed much and any
bleeding that occurs comes from capillaries (tiny blood
vessels). Dirt and germs frequently have been rubbed into
this type of wound, which is why it’s important to clean an
abrasion thoroughly with soap and water to avoid
infection.
Figure 1: Abrasion
2. Laceration is a cut in the skin, which commonly is caused

by a sharp object, such as a knife, scissors or broken
glass. A laceration also can occur when a blunt force
splits the skin. Deep lacerations may cut layers of fat and
muscle, damaging both nerves and blood vessels.
Bleeding may be heavy or there may be none at all.
Lacerations are not always painful because damaged
nerves cannot send pain signals to the brain. Infection Figure 2: Laceration
can easily occur with lacerations if proper care is not

given.
Page | 46
3. Avulsion is a serious soft tissue injury that happens
when a portion of the skin, and sometimes other soft
tissue, is partially or completely torn away. This type of
injury often damages deeper tissues, causing significant
bleeding. Sometimes a violent force may completely
tear away a body part, including bone, such as a finger.
This is known as an amputation. With amputations,
sometimes bleeding is easier to control because the
Figure 3: Avulsion
tissues close around the vessels at the injury site. If there
is a violent tearing, twisting or crushing of the extremity,
the bleeding may be hard to control.
4. Puncture, usually occur when a pointed object, such as

a nail, pierces the skin. A gunshot wound is another
example of this. Puncture wounds do not bleed much
unless a blood vessel has been injured. However, an
object that goes into the soft tissues beneath the skin
can carry germs deep into the body. These germs can
cause infections and sometimes serious ones. If the
object remains in the wound, it is called an embedded Figure 4: Puncture
object.
Specific Care Guidel ines f or Minor Open Wounds

In minor open wounds, such as abrasions, there is only a small amount of damage and minimal
bleeding.
To care for a minor open wound, follow these general guidelines:

1. Use a barrier between your hand and the wound.
2. If readily available, put on disposable gloves and place a sterile dressing on the wound.
3. Apply direct pressure for a few minutes to control any bleeding.
4. Wash the wound thoroughly with soap and water.
5. If possible, irrigate an abrasion for about 5 minutes with clean, warm, running tap water.
6. Apply an antibiotic ointment to a minor wound if the person has no known allergies or
sensitivities to the medication.
7. Cover the wound with a sterile dressing and a bandage or with an adhesive bandage to keep
the wound moist and prevent drying.

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Specific Care Guidel ines f or Major Open Wounds
A major open wound has serious tissue damage and severe bleeding.
To care for a major open wound, you must act at once. Follow these steps:
1. Put on disposable gloves. If you suspect that blood might splatter, you may need to wear
eye and face protection.
2. Control bleeding by:
3. Covering the wound with a dressing and firmly pressing against the wound with a gloved
hand until the bleeding stops.
4. Applying a pressure bandage over the dressing to maintain pressure on the wound and to
hold the dressing in place. If blood soaks through the bandage, do not remove the blood-
soaked bandages. Instead, add more dressings and bandages and apply additional direct
pressure.
5. Continue to monitor the person’s condition.
6. Observe the person closely for signals that may indicate that the person’s condition is
worsening, such as faster or slower breathing, changes in skin color and restlessness.
7. Care for shock. Keep the person from getting chilled or overheated.
8. Have the person rest comfortably and provide reassurance.
9. Wash your hands immediately after giving care, even if you wore gloves.
Using Dressings and Bandages

All open wounds need some type of covering to help control bleeding and prevent infection. These
coverings commonly are referred to as dressings and bandages.
Dressings are pads placed directly on the wound to absorb blood and other fluids and to prevent
infection. To minimize the chance of infection, dressings should be sterile. Most dressings are
porous, allowing air to circulate to the wound to promote healing

Page | 48
Bandages are any material that are used to wrap or cover any part of the body.
Bandages are used to, a.) hold dressings in place, b.) to apply pressure to control bleeding, c.) to
protect a wound from dirt and infection, and d.) to provide support to an injured limb or body part.
Any bandage applied snugly to create pressure on a wound or an injury is called a pressure bandage.
There are different types of bandages that can be used on holding wounds in place but the most
common ones are Roller bandages, Adhesive Bandages and Triangular Bandages (see Sample 1).
As a general principle, a bandage should never be applied directly over a wound; it should be used
only to hold in place the dressing which covers a wound. It should not be applied so tightly that it
stops circulation or so loosely that it allows the dressing to slip.
General guidelines when applying a Roller bandage:

 Check for feeling, warmth and color of the area below the injury site, especially
fingers and toes, before and after applying the bandage.
 Elevate the injured body part only if you do not suspect that a bone has been
broken and if doing so does not cause more pain.
 Secure the end of the bandage in place with a turn of the bandage. Wrap the
bandage around the body part until the dressing is completely covered and the
bandage extends several inches beyond the dressing. Tie or tape the bandage in
place.
 Do not cover fingers or toes. By keeping these parts uncovered, you will be able to
see if the bandage is too tight. If fingers or toes become cold or begin to turn pale,
blue or ashen, the bandage is too tight and should be loosened slightly.
Another method of applying bandage to secure a wound is

called the Triangular bandage. A triangular bandage is used for
the temporary or permanent bandaging of wounds, the
immobilization of factures and dislocations, and as a sling for
the support of an injured part of the body. It is valuable in
emergency bandaging since it is quickly and easily applied,
stays on well, and can be improvised from a piece of shirt, an old
sheet, a large handkerchief, or any other pliable material of
suitable size.
Retrieved from
https://nursing411.org/Courses/MD0533_Treat_
Fract_Field/MD0533/images/MD0533_img_6.jpg

Page | 49
Basic Steps in Treati ng of Wounds or Ext ernal Bl eeding
III. Burn
They are a special kind of soft tissue injury. Like other types of soft tissue injury, burns can damage the
top layer of skin or the skin and the layers of fat, muscle and bone beneath. They are classified by their
depth. The deeper the burn, the more severe it is. Below are the classification and signals to look for:
1. Superficial or 1st Degree Burn

a. Involve only the top layer of skin.
b. Cause skin to become red and dry, usually painful and the area may swell.
c. Usually heal within a week without permanent scarring.
2. Partial Thickness or 2nd Degree Burn

a. Involve the top layers of skin.
b. Cause skin to become red; usually painful; have blisters that may open and weep clear
fluid, making the skin appear wet; may appear mottled; and often swells.
c. Usually heal in 3 to 4 weeks and may scar.
Page | 50
Figure 1, A–C The three classifications of burns are A, superficial burns, B, partial-thickness burns and C, full-thickness burns.
3. Full Thickness or 3rd Degree Burn

a. May destroy all layers of skin and some or all of the underlying structures—fat, muscles,
bones and nerves.
b. The skin may be brown or black (charred), with the tissue underneath sometimes
appearing white, and can either be extremely painful or relatively painless (if the burn
destroys nerve endings).
c. Healing may require medical assistance; scarring is likely.
WHEN TO CALL 9-1-1 OR YOUR LOCAL EMERGENCY HOTLINES
You should always call 9-1-1 or the local emergency number if the burned person has:
a. Trouble breathing.
b. Burns covering more than one body part or a large surface area.
c. Suspected burns to the airway. Burns to the mouth and nose may be a sign of this.
d. Burns to the head, neck, hands, feet or genitals.
e. A full-thickness burn and is younger than 5 years or older than 60 years.
f. A burn caused by chemicals, explosions or electricity.
WHAT TO DO UNTIL H ELP ARRIVES
Basic steps when caring for a heat burn:

a. Check the scene for safety.
b. Stop the burning by removing the person from the source of the burn.
c. Check for life-threatening conditions.
d. As soon as possible, cool the burn with large amounts of cold running water, at least until
pain is relieved.
e. Cover the burn loosely with a sterile dressing.
f. Take steps to minimize shock. Keep the person from getting chilled or overheated.
g. Comfort and reassure the person.
h. Do not apply ice or ice water to any burn. Ice and ice water can cause the body to lose heat
rapidly and further damages body tissues.
i. Do not touch a burn with anything except a clean covering.
j. Do not remove pieces of clothing that stick to the burned area.
k. Do not try to clean a severe burn.
l. Do not break blisters.
m. Do not use any kind of ointment on a severe burn.

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Basic steps when caring for an electrical burn:
a. Never go near the person until you are sure he or she is not still in contact with the power
source.
b. Turn off the power at its source and care for any life-threatening conditions.
c. Call 9-1-1 or the local emergency number. Any person who has suffered an electrical shock
needs to be evaluated by a medical professional to determine the extent of injury.
d. Be aware that electrocution can cause cardiac and respiratory emergencies. Therefore, be
prepared to perform CPR or use an automated external defibrillator (AED).
e. Care for shock and thermal burns.
f. Look for entry and exit wounds and give the appropriate care.
g. Remember that anyone suffering from electric shock requires advanced medical care.
MUSCLE, BONE and JOINT INJURIES

The musculoskeletal system is made up of muscles and bones that form the skeleton, as well
as connective tissues, tendons and ligaments. Together, these structures give the body shape,
form and stability. Bones and muscles connect to form various body segments. They work
together to provide body movement.
Muscle, Bone and Joint Injuries

What is injuries to muscles, bones and joints?
Injuries to muscles, bones and joints happen to people of all ages at home, work and play. A
person may fall while walking in the park and bruise the muscles of a leg. Equipment may fall on
a worker and break bones. These injuries are painful and make life difficult, but they seldom are
life threatening. However, if they are not recognized and care is not given, they can cause serious
problems. In the rare case of a head, neck or spinal injury, lifelong disability, or even death, can
result if immediate care is not given.
Types
1. Sprain
A sprain is the tearing of ligaments at a joint. Mild
sprains may swell but usually heal quickly. The
person might not feel much pain and is active again
soon. If a person ignores the signals of swelling and
pain and becomes active too soon, the joint will not
heal properly and will remain weak. There is a good
chance that it will become reinjured, only this time
more severely. A severe sprain also can involve a
fracture or dislocation of the bones at the joint. The
joints most easily injured are at the ankle, knee,
wrist and fingers. A sprain is the tearing of ligaments at a joint

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2. Strain
A strain is a stretching and tearing of muscles or tendons. Strains often are caused by
lifting something heavy or working a muscle too hard. They usually involve the muscles in
the neck, back, thigh or the back of the lower leg. Some strains can reoccur, especially in
the neck and back.
A dislocation is the
movement of a bone at a
joint away from its normal
position
stretching and tearing of

muscles or tendons.
3. Dislocation
Dislocations usually are more obvious than fractures. A dislocation is the movement of a
bone at a joint away from its normal position. This movement usually is caused by a violent
force tearing the ligaments that hold the bones in place.
When a bone is moved out of place, the joint no longer
functions. The displaced end of the bone often forms a
bump, a ridge or a hollow that does not normally exist
4. Fracture
A fracture is a complete break, a chip or a crack in a
bone. A fall, a blow or sometimes even a twisting
movement can cause a fracture. There are two types of
this. First is an open fracture that involves an open
wound. It occurs when the end of a bone tears through
the skin. An object that goes into the skin and breaks
the bone, such as a bullet, also can cause an open
fracture. The 2nd type of fracture is a closed fracture
wherein the skin is not broken. Closed fractures are
more common, but open fractures are more dangerous
because they carry a risk of infection and severe
bleeding.
A fracture is a crack, complete break or chip
in a bone.

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Signs and Symptoms
 One of the most common signals in any muscle, bone or joint injury is pain. The injured area
may be very painful to touch and move.
 There is significant bruising and swelling. The area may be swollen and red or bruised.
 There is significant deformity. The area may be twisted or strangely bent. It may have
abnormal lumps, ridges and hollows.
 The person is unable to use the affected part normally.
 There are bone fragments sticking out of a wound.
 The person feels bones grating or the person felt or heard a snap or pop at the time of injury.
 The injured area is cold, numb and tingly.
 The cause of the injury suggests that it may be severe.
 It can be difficult to tell if an injury is to a muscle, bone or joint. Sometimes an x-ray,
computer assisted tomography (CAT) scan or magnetic resonance imaging (MRI) is needed
to determine the extent of the injury.
Management
The general care for injuries to muscles, bone and joints includes following the mnemonic
RICE:
REST
do not move or straighten the injured area.
IMMOBILIZE
stabilize the injured area in the position it was found. Splint the injured part only if the
person must be moved or transported to receive medical care and it does not cause
more pain (see Splinting an Injury below). Minimizing movement can prevent further
injury.
COLD
fill a plastic bag with ice and water or wrap ice with a damp cloth and apply ice to the
injured area for periods of about 20 minutes (Fig. 8-9). Place a thin barrier between
the ice and bare skin. If 20-minute icing cannot be tolerated, apply ice for periods of
10 minutes. If continued icing is needed, remove the pack for 20 minutes, and then
replace it. Cold reduces internal bleeding, pain and swelling. Do not apply heat as there
is no evidence that applying heat helps muscle, bone or joint injuries.
ELEVATE
elevate the injured part only if it does not cause more pain. Elevating the injured part
may help reduce swelling
Splinting
Splinting is a method of immobilizing an injured part to minimize movement and prevent
further injury and should be used only if you have to move or transport the person to seek
medical attention and if it does not cause more pain.

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Splint an injury in the position in which you find it.
For fractures, splint the joints above and below the site of the injury. For sprains or joint
injuries, splint the bones above and below the site of the injury. If you are not sure if the
injury is a fracture or a sprain, splint both the bones and joints above and below the point
of injury. Splinting materials should be soft or padded for comfort.
Different Methods of Splinting:

a. Anatomical
The person’s body is the splint. For
example, you can splint an arm to the
chest or an injured leg to the
uninjured leg
b. Soft Splints
soft materials such as a folded
blanket, towel, pillow or folded
triangular bandage can be used as
splints. A sling is a specific kind of
soft splint that uses a triangular
bandage tied to support an injured
arm, wrist or hand.
c. Rigid Splints
padded boards, folded magazines or newspapers, or padded metal strips that do
not have any sharp edges can serve as splints.
d. The Ground
an injured leg stretched out on the ground is supported by the ground

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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 Splinting of a femur fracture
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,
then gently bandage. Avoid excessive pressure on the wound.
 If there is a severe deformity or the distal extremity is cyanotic or lacks pulse, align the
injured limb with gentle traction before splinting, following the guidelines above.
 Never intentionally replace protruding bone ends.

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

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 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.

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MEDICAL EMERGENCIES
I. Asthma
It is a condition when the air passages are inflamed which results in a temporary narrowing of the airways
that carry oxygen to the lungs. Exercise, allergens, cold air, or other irritants can trigger asthma. You can
tell that a person is having an asthma attack when they are experiencing shortness of breath, wheezing
sounds when exhaling, or tightness in the chest.
What to do (Assisting with an Asthma Inhaler)?
1. Help the person to sit-up and lean slightly forward to ease breathing
2. Verify with the person that the medication of for quick relief or acute attacks
3. Shake the inhaler
4. Remove the mouthpiece cover. If the person uses a spacer, attach it to the mouthpiece
5. Ask the person to breath out as much as possible through the mouth
6. Help the person with the medication
7. Time it. The person’s breathing should improve within 5 to 15 minutes upon first dosage. Stay
with the person until help arrives.

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II. Allergic Reactions
A response of the immune system to a foreign substance that enters the body. Allergic reactions can
cause breathing problems. At first the reaction may appear to be just a rash and a feeling of tightness
in the chest and throat, but this condition can become life threatening. The person’s face, neck and
tongue may swell, closing the airway. A severe life-threatening allergic reaction can cause a condition
called anaphylaxis, also known as
anaphylactic During anaphylaxis, air REVIEW THE VIDEOS
passages swell and restrict a person’s Click the play button
breathing. Anaphylaxis can be brought on
when a person with an allergy comes into What to do during
contact with allergens which causes them Asthma Attack
to have rashes, tightness in the chest and

throat, or swelling of the face, neck and BFA for Anaphylactic
Shock
tongue.
Watch the video for more information on

how to manage a severe allergic reaction.
III. Hypoglycemia and Hyperglycemia (Diabetic Emergency)
A diabetic emergency is caused by an imbalance between sugar and insulin in the body. It can happen
when there is:
1. Too much sugar in the blood (hyperglycemia): Among other causes, the person may not have
taken enough insulin or the person is reacting adversely to a large meal or a meal that is high in
carbohydrates.
2. Too little sugar in the blood (hypoglycemia): The

person may have taken too much insulin, eaten too little
food, or overexerted him- or herself. Extremely low blood
sugar levels can quickly become life threatening.
Signals of a diabetic emergency include:
 Changes in the level of consciousness.

 Changes in mood.
 Rapid breathing and pulse.
 Feeling and looking ill.
 Dizziness and headache.
 Confusion.

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WHAT TO DO?
If the diabetic person is awake, can follow
simple commands, is able to swallow and REVIEW THE VIDEOS
advises you that they need sugar:31 Click the play button
1. Give 15 to 20 grams of sugar in the form
of 3 to 4 glucose tablets, a handful of
candies containing sucrose or glucose
Manage Diabetic
that can be chewed, 8 ounces of milk, a Emergency
non-diet soft drink, fruit strips or 4 to 5
teaspoons of table sugar dissolved in a
glass of water or juice. Most fruit juices
and non-diet soft drinks have enough
sugar to be effective.
2. If the problem is hyperglycemia (too much sugar in the body), this amount of sugar will not
cause immediate harm.
3. If symptoms persist for more than 10 to 15 minutes, repeat the administration of sugar and
call 9-1-1 or the local emergency number.
IV. Stroke (Cerebrovascular Accident)

REVIEW THE VIDEOS
According to WHO, stroke is the second leading
cause of death in the world. A stroke, also called a
brain attack, is caused when blood flow to a part
of the brain is cut off or when there is bleeding into
the brain. Strokes can cause permanent brain Spot Signs of Stroke
damage, but sometimes the damage can be
stopped or reversed. Risk factors for stroke are
sometimes beyond control like age, gender, or
predisposition due to family history while others
can be controlled such as lifestyle and diet. 32
SIGNS AND SYMPTOMS:
1. Weakness or numbness of the face, arm or leg. This usually happens on only one side
of the body.
2. Facial droop or drooling.
3. Trouble with speech. The person may have trouble talking, getting words out or being
understood when speaking and may have trouble understanding.
31
“How to manage a diabetic emergency” YouTube, uploaded by THE LIFESAVER, November 11, 2019,
https://youtu.be/mI4vTwfzyJE
32
“How to spot early sign of stroke” YouTube, uploaded by THE LIFESAVER, December 4, 2019,
https://youtu.be/fBcMIfPP_g0
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4. Loss of vision or disturbed (blurred or
dimmed) vision in one or both eyes. The pupils may be
of unequal size.
5. Sudden severe headache. The person will not
know what caused the headache and may describe it
as “the worst headache ever.”
6. Dizziness, confusion, agitation, loss of
consciousness or other severe altered mental status.
7. Loss of balance or coordination, trouble
walking or ringing in the ears.
8. Incontinence.
WHAT TO DO?
Call 9-1-1 or the local emergency number immediately if you encounter someone who is having or has had
a stroke, or if the person had a mini-stroke (even if the signs and symptoms have gone away).
In addition:
1. Note the time of onset of the signs and symptoms if witnessed or the last time the person was
known to be well, and report it to the 9-1-1 call taker or EMS personnel when they arrive.
2. If the person is unresponsive, make sure that they have an open airway and care for any life-
threatening conditions:
 If fluid or vomit is in the person’s mouth, position them in a recovery position.
 You may have to remove some fluids or vomit from the mouth by using one of your fingers (use
precautions when possible).
 Stay with the person and monitor their breathing and for changes in their condition.
3. If the person is awake, check for non-life-threatening conditions:

 Offer comfort and reassurance as a stroke can make the person fearful and anxious.
 Often, they do not understand what has happened. Have the person rest in a comfortable
position.
 Do not give them anything to eat or drink.
ENVIRONMENTAL EMERGENCY
Diseases, illness and injury are not the only causes of medical emergencies. Much of our environment
appears to be relatively harmless. For instance, a casual outing can bring you closer to the joys of nature
such as animals, mountains, rivers, blue skies but it also can expose you to disease-carrying insects, other
biting or stinging creatures and rapid changes in the weather. Whereas many environmental emergencies
can be avoided, even with the best prevention efforts, emergencies do occur.
In this chapter you will discover how to prevent heat-related illnesses, as well as bites and stings from
insects and other animals in the Philippine context.

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I. Heat Related Emergencies
a. Heat Cramps- are the least severe of the heat-related illnesses. They often are the first signals
that the body is having trouble with the heat. Heat cramps are painful muscle spasms and usually
occur in the legs and abdomen. Think of them as a warning of a possible heat-related illness.
WHAT TO DO?
For heat cramps, help the person move to a
cool place to rest. As much as possible, give
an electrolyte- and carbohydrate-containing
fluid such as a commercial sports drink, fruit
juice or milk. Lightly stretch the muscle and
gently massage the area.
The person should not take salt tablets. They

can worsen the situation. When cramps
stop, the person usually can start activity
again if there are no other signals of illness.
He or she should keep drinking plenty of
Figure above showing how exposure to heat can make a person
fluids. Watch the person carefully for further seriously ill
signals of heat-related illness.
b. Heat Exhaustion
When a heat-related illness is recognized in its early stages, it usually can be reversed. Firstly, get
the person out of the heat. Move the person to a cooler environment with circulating air. Loosen or
remove as much clothing as possible and apply tepid sponge bath or cool, wet cloths, such as
towels or sheets, taking care to remoisten the cloths periodically avoid rubbing the cloth, this
induces heat by friction.33
WHAT TO DO?
1. Get the person out of the heat. Move the person to a cooler environment with circulating
air.
2. Loosen or remove as much clothing as possible and apply cool, wet cloths, such as towels
or sheets.
3. Spraying the person with water and fanning also can help.
4. If the person is conscious and able to swallow, give him or her small amounts of a cool fluid
such as a commercial sports drink or fruit juice to restore fluids and electrolytes.
33
“First Aid for Heat Exhaustion and other Things You Need to Know” YouTube, uploaded by THE LIFESAVER, April
23, 2020, https://youtu.be/_jBFUKbJIDw
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5. Let the person rest in a comfortable position and watch carefully for changes in his or her
condition.
6. The person should not resume normal activities the same day. If the person’s condition
does not improve or he or she refuses fluids, has a change in consciousness or vomits, call
9-1-1 or your local emergency number, as these are indications that the person’s condition
is getting worse.
c. Heat Stroke is the least common but most severe heat-related illness. It usually occurs when
people ignore the signals of heat exhaustion. Heat stroke develops when the body systems are
overwhelmed by heat and begin to stop functioning thus making it a very serious medical
emergency. Signals of heat stroke include extremely high body temperature, red skin that can be
either dry or pulse; rapid, shallow breathing; confusion; vomiting; and seizures.
WHAT TO DO?
Heat stroke is a life-threatening emergency so
when signals occur, call 9-1-1 or your local
REVIEW THE VIDEOS emergency immediately. While waiting for help
Click the play button to arrive, rapidly cool the body by immersing
the person up to the neck in cold water, if
possible or douse/ spray the person with cold
water. Next, sponge the person with ice water-
Heat Related doused towels over the entire body, frequently
Emergencies
rotating the cold, wet towels. Cover with bags
of ice. If you are not able to measure and
monitor the person’s temperature, apply rapid
cooling methods for 20 minutes or until the
person’s condition improves.
Reminders to avoid Heat-related illnesses:

 As much as possible, do not go outdoors during the hottest part of the day.
 Change your activity level according to the temperature.
 Take frequent breaks.
 Dress appropriately for the environment.
 Drink large amounts of fluids.

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POISONING
A poison is any substance that causes injury, illness or death when introduced into the body. It can be
ingested accidentally or intentional. Some poisons—including many medications—are not deadly or
harmful in small doses but become dangerous if taken into the body in larger amounts.
SPECIFIC GENERAL CARE FOR POISONING:
After you have checked the scene and determined that there has been a poisoning, you should follow these
general care guidelines:
1. Remove the person from the source of poison if the scene is dangerous. Do this only if you are
able to do so without endangering yourself or bystanders.
2. Check the person’s level of consciousness and breathing:
 For life-threatening conditions, such as if the person is unresponsive or is not breathing,
or if a change in the level of consciousness occurs, call 9-1-1 or the local emergency
number immediately.
 Care for any life-threatening conditions.
3. If the person is awake, ask questions to get more information about the current situation.
4. Look for any containers and/or packaging and take them with you to the telephone.
TYPES OF POISONING
A. Ingested Poisons
Poisons that can be swallowed
include foods, such as certain
mushrooms and shellfish; an
overdose of
drugs, such as sleeping pills,

tranquilizers and alcohol;
medications, such as a high quantity
of aspirin; household items, such as
cleaning products and pesticides; and
certain plants. Many substances that
are not poisonous in small amounts
are poisonous in larger amounts.
Combining certain substances can
result in poisoning, although if taken
by themselves they might not cause
harm.
Figure: A-D: A:Ingested, B:Inhaled, C: Absorbed, D: Injected

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B. Inhaled Poisons
A person can be poisoned by breathing in (inhaling) toxic fumes. Examples of poisons that can be
inhaled include:
a. Gases, such as:

 Carbon monoxide from an engine or car exhaust.
 Carbon dioxide from wells and sewers.
 Chlorine, found in many swimming pools.
b. Fumes from:
 Household products, such as glues and paints.
c. Drugs, such as crack cocaine.
C. Absorbed Poisons
Poisons that can be absorbed through the skin come from many sources including plants, such
as poison ivy, poison oak and poison sumac, and fertilizers and pesticides.
D. Injected Poisons
Injected poisons enter the body through the bites or stings of insects, spiders, ticks, some marine
life, snakes and other animals or through drugs or medications injected with a hypodermic needle.
BITES AND STINGS
A. Insect stings most of the time, insect stings are

harmless. If the person is allergic, an insect sting can
lead to anaphylaxis, which is a life-threatening
condition
What to look for:
 Presence of a stinger
 Pain
 Swelling If someone is stung by an insect, scrape the stinger away
 Signals of an allergic reaction from the skin with a clean fingernail or a plastic card,
such as a credit card.
WHAT TO DO WHEN STUNG BY AN INSECT:
1. Remove any visible stinger. Scrape it away from the skin with a clean fingernail or a plastic
card, such as a credit card, or use tweezers. In the case of a bee sting, if you use tweezers,
grasp the stinger, not the venom sac.
2. Wash the site with soap and water.
3. Cover the site and keep it clean.
4. Apply a cold pack to the are to reduce pain and swelling.
5. Call 9-1-1 or your local emergency if the person has any trouble breathing or for any other
signals of anaphylaxis.

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B. Animal Bites
The bite of a domestic or wild animal can cause
infection and soft tissue injury. The most serious
possible result is rabies. Rabies is transmitted
through the saliva of diseased animals such as
dogs, cats, bats, cattle and foxes. If an animal bites
someone, try to get the person away from the
animal without putting yourself in danger. Do not try
to stop, hold or catch the animal. Do not touch a pet
that may have come in contact with the animal’s
saliva without using or wearing some form of
protection like disposable gloves. Retrievedfrom:
https://cornettscorner.com/wp-content/uploads/2018/09/first-aid-
What to look for: animal-bites-720x400.jpg
 A bite mark
 Bleeding
When to call for Emergency:
9. Call the local emergency number if the wound is bleeding seriously or you suspect the animal
might have rabies.
10. If possible, try to remember the animal’s appearance and where you last saw it. When you call
the local emergency number, the call taker should direct the proper authorities, such as animal
control, to the scene.
WHAT TO DO UNTIL HELP ARRIVES:
1. Control bleeding first if the wound is bleeding seriously

2. Do not clean serious wounds. The wound will be cleaned at a medical facility.
3. If bleeding is minor, wash the wound with soap and water then irrigate with clean running tap
water.
4. Apply an antibiotic ointment to a minor wound, if the person has no known allergies or
sensitivities to the medication, and cover the wound with a dressing.
5. Watch for signals of infection.
Marine Life Stings
The stings of some forms of marine life are not only painful, but they can make you sick, and
in some parts of the world, can kill you. The side effects include allergic reactions that can
cause breathing and heart problems, as well as paralysis and death. Some of the common
marine life stings are jellyfish, stingrays, sea anemones and sea urchins.
What to look for:
 Possible puncture marks

 Pain
 Swelling
 Signs of a possible allergic reaction

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When to call for help?
Call the local emergency number if the person does not know what stung him or her, has a
history of allergic reactions to marine-life stings, is stung on the face or neck, or starts to have
trouble breathing
WHAT TO DO IF YOU ENCOUNTER A MARINE-LIFE STING:
1. Get a lifeguard to remove the person from the water as soon as possible. If a lifeguard is not
available, use a reaching assist, if possible. Avoid touching the person with your bare hands,
which could expose you to the stinging tentacles. Use gloves or a towel when removing any
tentacles.
2. If you know the sting is from a jellyfish, irrigate the injured part with large amounts of vinegar
as soon as possible for at least 30 seconds. This can help to remove the tentacles and stop
the injection of venom. Vinegar works best to offset the toxin, but a baking soda slurry also
may be used if vinegar is not available.
3. If the sting is known to be from a bluebottle jellyfish, also known as a Portuguese man-of-war,
use ocean water instead of vinegar. Vinegar triggers further envenomation.
4. Do not rub the wound, apply a pressure immobilization bandage or apply fresh water or other
remedies because this may increase pain.
5. Once the stinging action is stopped and tentacles removed, care for pain by hot-water
immersion. Have the person take a hot shower if possible, for at least 20 minutes. The water
temperature should be as hot as can be tolerated (non-scalding) or about 45° C (113° F) if the
temperature can be measured.
6. If you know the sting is from a stingray, sea urchin or spiny fish, flush the wound with tap water.
Ocean water also may be used. Keep the injured part still and soak the affected area in non-
scalding hot water (as hot as the person can stand) for at least 20 minutes or until the pain
goes away. If hot water is not available, packing the area in hot sand may have a similar effect
if the sand is hot enough. Then carefully clean the wound and apply a bandage. Watch for
signals of infection and check with a health care provider to determine if a tetanus shot is
needed.

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TRANSFER TECHNIQUES
Although speed is important in cases where a victim is exposed to hazards, it is always more important to
accomplish the handling and moving of a victim in a way that will not further injure the victim. As a rule of
thumb, you should not move a victim until you absolutely have to or until you are completely ready to-and,
if you can avoid it, you should not try to move a victim by yourself if you can wait and get help.
Guidelines
 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.
 Generally, you should not move a victim if moving the person will make the injuries worse.
 Provide all necessary emergency care; splint all fractures, especially those of the neck and back.
 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.
 If it is necessary to move the victim, your speed will depend on the reason for the move. For
example, a victim who needs to be moved away from a fire should be moved as quickly as possible;
a victim who needs to be moved so you have access to others victims should be moved with due
considerations to his or her injuries before and after the move.
A. Emergency Move
Under life threatening conditions, you may have to risk injury to the victim in order to save his or her life.
You should make an emergency move only when no other options are available, such as in conditions
involving:
 Uncontrolled traffic
 Physically unstable surroundings (such as a vehicle that you cannot stabilize and that is in
danger of toppling off an embankment)
 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 Spine board
If there is a suspected spine injury, you need to
immobilize the spine. Manually support the victim’s
head and neck in normal anatomical position until
the victim is supine on the backboard; apply a rigid
cervical collar to the victim’s neck. But before you
move the victim into the backboard, stabilize
airway, breathing, circulation, and hemorrhage;
correct any life threatening problems, then provide
other care as needed. Bandage all wounds, splint all
fractures, and give psychological support. To get
the victim onto a backboard, follow these steps:
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.
Illustrations (From US National Safety Council. “First Aid and CPR 3rd Edition”.1999. Jones and Bartlett)

Page | 73
b. One Rescuer Techniques
A rescuer may be required to move a victim on his own during flood, fire, building collapse, or
other life threatening situations.
Walking Assist
A method of moving a victim in which a single rescuer functions as a “crutch” in assisting the
injured victim to walk
1. Stand at the 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.
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.

Page | 74
Sheet Drag
A method of moving a victim in which a single rescuer forms a drag harness out of a sheet,
passes it under the victim’s arms at the armpits, and uses it to pull the victim.
1. Fold a sheet several times lengthwise to form a narrow, long “harness”; lay the folded
sheet centered across the victim’s chest at the nipple line.
2. Pull the ends of the sheet under the victim’s arms at the armpits and behind the
victim’s head; twist the ends of the sheet together to form a triangular support for the
head. Be careful not to pull the victim’s hair.
3. Grasping the loose ends of the sheet, pull the victim toward you.
Firefighter’s Carry
A method of lifting and carrying a victim in which one rescuer carries the victim over his or her
shoulder, is not as safe as most ground level moves because it places the victim’s center of mass
high-usually at the rescuer’s shoulder level- and because it requires a fair amount of strength. It
is, however, preferred if a rescuer will move a victim over irregular terrain. Unless there is life
threatening situations, do not attempt this move especially if neck or spinal injuries are
suspected.
1. Position the victim on his or her back with both knees bent and raised; grasp the back
side of the victim’s wrists.
2. Stand on the toes of both the victim’s feet; lean backward and pull the victim up
toward you. As the victim nears a standing position, crouch slightly and pull the victim
over your shoulder, then stand upright.
3. Pass your arm between the victim’s legs and grasp the victim’s arm that is nearest
your body.
c. Two and Three-Rescuer Techniques

Seat Carry
A method of lifting and moving a victim in which two rescuers form a “seat” with their arms.
1. Raise the victim to a sitting position; each First Aider steadies the victim by positioning
an arm around the victim’s back.
2. Each First Aiders slips his or her other arm around the victim’s thighs, then clasps the
wrist of the other First Aider. One pair of arms should make a seat, the other pair a
backrest.
3. Slowly raise the victim from the ground, moving in unison. In one variation, the First
Aiders make a seat with all four hands; the victim then supports him or herself by placing
his or her arms around the First Aider’s shoulders.

Page | 75
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.
Page | 76
3. The First Aider at the victim’s shoulder works his or her hands underneath the victim’s
neck and shoulders; the next First Aider’s hands go underneath the victim’s hips and
pelvis; and the final First Aider’s hands go underneath the victim’s knees.
4. Moving in unison, the First Aiders raise the victim to knee level and slowly turn the victim
towards themselves until the victim rests on the bends of their elbows.
5. Moving in unison, all three rise to a standing position and walk with the victim to a place
of safety or to the stretcher. To place the victim on the stretcher, simply reverse the
procedure.
This may also be done by four rescuers positioned at the victim’s head, chest, hips and
knees. Support is then given to the head, chest, hips, pelvis, knees and ankles.
Alternative: Flat life and Carry for two-rescuers, Make sure that the tallest
rescuer is at the head area, and one hand is under the head.
(Image from Wikipedia.org)

Page | 77
Illustrations for the lifts and carries
From US National Safety Council. “First Aid and CPR 3rd Edition”.1999. Jones and Bartlett

Page | 78
Page | 79
Additional Videos
BANDAGING
Applying bandage
REVIEW THE VIDEOS

References:
(1) “How to Bandage a Hand - First Aid Training - St
John Ambulance” YouTube, uploaded by St. John
Hands Ambulance, May 28, 2020,
https://youtu.be/fKzdiuseEIw
(2) “How to Apply Underarm Sling?” YouTube,
Underarm sling uploaded by THE LIFESAVER, August 3, 2020,
https://youtu.be/Ih-Bzg18LNU
SPLINTING
How to apply splint, sling, and swathe possible arm fracture
REVIEW THE VIDEOS

References:
(1) “How to apply Sling and Swathe for a patient
who has a possible fracture or deformities in the
Splint, Sling, And Swathe Arm” YouTube, uploaded by THE LIFESAVER, July
2,2020 https://youtu.be/MgJqY_vTKwA

Page | 80
BLEEDING
External Bleeding
REVIEW THE VIDEOS

References:
(1) “First aid management for external bleeding”
YouTube, uploaded by THE LIFESAVER, September
Management for External 4, 2020, https://youtu.be/1WqjwR3W3FQ
Bleeding
MUSCLE AND BONE INJURIES
References:
(1) “The difference and first aid for strains and
REVIEW THE VIDEOS sprains” YouTube, uploaded by THE LIFESAVER,
Click the play button May 28, 2020, https://youtu.be/vcbupDu-PJI
(2) “How to Treat an Open Fracture?” YouTube,
uploaded by THE LIFESAVER, Oct 19, 2020,
https://youtu.be/lfh_OUvIdWk
Sprains and Strains (3) “How to Give First Aid and Treat a Fracture”
YouTube, uploaded by THE LIFESAVER, July 16,
2019, https://youtu.be/88s4LGZFhIc
Open Fracture
Treating a Fracture

Page | 81
SOURCES
ACCORD, CARE Nederland, & CNDR. (2012). Training on Disaster Preparedness and Contingency
Planning: Community based disaster risk management (CBDRM).
ACCORD, CARE Nederland, & CNDR. (2012). Training on Disaster Preparedness and Contingency
Planning: Manual for Disaster Preparedness.
Blanchard, K. (2018, November 16). #NoNaturalDisasters - Changing the discourse of disaster

reporting. Retrieved August 11, 2020, from https://www.preventionweb.net/experts/oped/view/61996
CDRC. (2014). Philippine Disaster Situation 2014: Understanding the Roots Causes of the Country's
Vulnerability. Retrieved 2020, from http://www.cdrc-phil.com/wp-content/uploads/2015/08/2014-
Philippine-Disaster-Report.pdf
Chambers, R. (1994). Participatory rural appraisal (PRA): Challenges, potentials and paradigm. World
Development, 22(10), 1437–1454. https://doi.org/10.1016/0305-750X(94)90030-2
Gaillard, J. C. (2011). Peoples response to disasters vulnerability, capacities and resilience in

Philippine context. Angeles City: Center for Kapampangan Studies, Holy Angel University
Gaillard, J., & Cadag, J. R. D. (2009). From marginality to further marginalization: Experiences from the
victims of the July 2000 Payatas trashslide in the Philippines. Jàmbá: Journal of Disaster Risk
Studies, 2(3), 197–215. https://doi.org/10.4102/jamba.v2i3.27
Geilfus, F. (2008). 80 tools for participatory development: Appraisal, planning, follow-up and
evaluation. San Jose, Costa Rica: Inter-American Institute for Cooperation on Agriculture.
Manalili, A. G. (2012). Pag-oorganisa ng pamayanan tungo sa kaunlaran na mula tao para sa tao.
Quezon City: Sentro ng Wikang Filipino.
UNDDR. (2020). Hazard, Definition & Classification Review. Technical Report. 88.
https://www.undrr.org/publication/hazard-definition-and-classification-review
UNDRR. (2019). Disaster Risk Reduction in the Philippines. United Nations Office for Disaster Risk
Reduction (UNDRR), Regional Office for Asia and the Pacific, 32.
USAID. (2017). Climate Change Risk in the Philippines: Country Fact Sheet. February.
https://www.climatelinks.org/sites/default/files/asset/document/2017_Climate Change Risk
Profile_Philippines.pdf
Victoria, L. P. (2000). COMMUNITY BASED DISASTER MANAGEMENT IN THE PHILIPPINES: MAKING

A DIFERENCE IN PEOPLE’S LIVES Lorna P. Victoria Director, Center for Disaster Preparedness.
Training, 0–8.
Victoria, L. P., & Luneta, M. D. (2011). Kahandaan, katatagan at kaunlaran ng komunidad, gabay sa
pagsasanay sa disaster risk management, pagsanib ng karanasan ng mga lungsod dagupan at
pasig(Ikalawang Edisyon ed.). Diliman, Quezon City: Center for Disaster Preparedness.
Wisner, B., Gaillard, JC., & Kelman, I. (2012). Framing Disaster: theories and stories seeking to
understand hazards, vulnerability and risk. In B. Wisner, JC. Gaillard, & I. Kelman(Eds.), The Routledge
Handbook of Hazards and Disaster Risk Reduction. Routledge Handbooks Online
World Economic Forum. (2019). Global Risks Report 2019. In Geneva Switzerland. World Economic
Forum.
World Risk Report 2020: Forced Displacement and Migration.

https://reliefweb.int/sites/reliefweb.int/files/resources/WorldRiskReport-2020.pdf

Page | 82
SOURCES
Information, Education and Communication Materials for Disaster Prevention visit:

https://www.ocd.gov.ph/iec.html
https://www.doh.gov.ph/2019-nCov/infographics
“How to help a Choking Person” YouTube, uploaded by The LIFESAVER, Nov. 28, 2019,
https://youtu.be/pzlwOI7xQRc
“How to help when an infant is choking” YouTube, uploaded by The LIFESAVER, Feb. 26, 2020
https://youtu.be/gfUd19Ibp9I
The American Red Cross (2017). Responding to emergencies: comprehensive first aid/cpr/aed,
retrieved from: http://pchs.psd202.org/documents/mopsal/1539703875.pdf
Chapter 2: Cardiac Emergencies and CPR (2016). In American Red Cross first aid/CPR/AED:
Participant's manual (pp. 34-36)
Gaillard, J., & Cadag, J. R. D. (2009). From marginality to further marginalization: Experiences from the
victims of the July 2000 Payatas trashslide in the Philippines. Jàmbá: Journal of Disaster Risk
Studies, 2(3), 197–215. https://doi.org/10.4102/jamba.v2i3.27
Ellao, J., 2013. From danger zones to a death zone. www.bulatlat.com, [online] Available at:
<https://www.bulatlat.com/2013/10/22/from-danger-zones-to-a-death-zone/> [Accessed 30 August
2020].
To know more about development aggression in Lumad communities

WATCH AND LISTEN: MINDANAW
https://www.youtube.com/watch?v=FjxB9sWxO3Q
https://www.helpage.org/what-we-do/climate-change/climate-change-policy/
Read the reflections of NSTP students during their interaction with Lumad Bakwit
https://tothinktofeelandtodo.wordpress.com/2018/09/29/to-think-to-feel-and-to-do/
To know more about Lumad Bakwit

Watch: I-Witness: ‘Ang Iskul Kong Bakwit’
https://www.youtube.com/watch?v=XrHveqNRvb0
Download the DepEd SWApp:

https://play.google.com/store/apps/details?id=com.adec_innovations_swapp&hl=fil
KADAMARS Vlog: Sitio San Roque

https://www.facebook.com/watch/?v=630767534193454&extid=d42BA2QtIMT0mOEu
For more inquiries on Sitio San Roque:

Visit: https://www.facebook.com/SaveSitioSanRoque
and twitter: @SaveSanRoque

Page | 83

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Chapter 4: Disaster Risk Reduction and Management | 1

ARE YOU READY? LEARNING OBJECTIVES

With this, the UST NSTP CWTS/LTS advocates

Chapter 4: Disaster Risk Reduction and Management

Figure 1. 17 Sustainable Development Goals - United Nations

In the Philippines, Republic

Chapter 4: Disaster Risk Reduction and Management

 Lack of biodiversity resources

Editorial Cartoon by Arlene Pasaje in Edge Davao November

 The decline of risk regulating

Chapter 4: Disaster Risk Reduction and Management

 Access to essential social services

UST Main Building as first earthquake-resistant building

 There is broad participation in

Chapter 4: Disaster Risk Reduction and Management

Disaster Risk (DR) is HIGH if:

Chapter 4: Disaster Risk Reduction and Management

It is important to clarify that “natural” disaster10 11 is a misnomer because:

Chapter 4: Disaster Risk Reduction and Management

Why is the Philippines VULNERABLE to disaster??

A. Geographical and physical location

Chapter 4: Disaster Risk Reduction and Management

Did you know?

 the country’s temperature will increase 1.8°–2.2°C;

IMPACT OF CLIMATE CHANGE IN THE PHILIPPINES12

C. Poverty, Marginalization & Inequality

Chapter 4: Disaster Risk Reduction and Management

D. Development Aggression and Environmental Degradation

Chapter 4: Disaster Risk Reduction and Management

PAYATAS TRASHSLIDE 2000

Despite being a garbage dumpsite, around 3000

However, this did not make them less vulnerable to disasters.

For the victims of the July 2000

Chapter 4: Disaster Risk Reduction and Management

Lafayette denied the fish-kill. Mines

Mining is not only a political issue in the Philippines

Chapter 4: Disaster Risk Reduction and Management

As an NSTP student, how can you help

The Community-Based Disaster Risk Reduction and

Rights-Based Approach can be used as a

CLICK THE LINK TO SEE THE UNIVERSAL DECLARATION OF HUMAN RIGHTS

Chapter 4: Disaster Risk Reduction and Management

CBDRRM and RBA focuses on:

2. Inclusivity and Responsiveness

Eg. Early warning systems, community shelters or

3. Participatory and Empowering19

5. Proactive and Comprehensive

Chapter 4: Disaster Risk Reduction and Management

Did you know? Tips in Facilitating Community Risk Assessment 21

Community Awareness, Education & Advocacy

Below are some examples of Community Awareness, Education & Advocacy:

DRRM Seminar of UST NSTP CWTS/LTS

Click the link to see is a peek on DRRM Seminar 2019. https://bit.ly/346IpNN

Chapter 4: Disaster Risk Reduction and Management

As part of their Fieldwork, NSTP CWTS/LTS students trained approximately

Lumad Bakwit School in UST

TUKLAS Innovation Labs

One of the featured inventions was the ANIA Disaster

Being a student of your course, how can

Community Early Warning and Risk Communication

Photo Credit: Dave Martinez

Characteristics of an effective community-based early

KADAMAY: Community-Led Kusinang