First Aid is the immediate and temporary care given to an injured or sick person until the services of a qualified doctor are obtained with such material as may be available. The first aid is not an end by itself. It indicates that the person is in need of a secondary aid. First aid is based on the knowledge of a life saving skill.
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CYCLONES
- Tropical Cyclones are large rotating, migratory storms that form over the tropical oceans
- Tropical Cyclones are called Hurricanes in Atlantic, Caribbean, and Eastern Pacific
- Typhoon in western Pacific
- Cyclone in Indian Ocean
- They occur primarily during the late summer month
CYCLONE CATEGORY:
Cyclone are rated according to their wind speed on the Saffir-Simpson scale. This scale ranges from categories 1 to 5, with 5 being the most devastating. Under the right atmospheric conditions, cyclone can sustain themselves for as long as a couple of weeks. Upon reaching cooler water or land, cyclone rapidly lose intensity.
Category/Wind Speed
- 74-95 mph
- 96-110 mph
- 111-130 mph
- 131-155 mph
- 156+ mph
Cyclone are formed from simple thunderstorms. However, these thunderstorms can only grow to cyclone strength with cooperation from both the ocean and the atmosphere. First of all, the ocean water itself must be warmer than 81 degrees F. The heat and moisture from this warm water is ultimately the source of energy for hurricanes/cyclone. Cyclones will weaken rapidly when they travel over land or colder ocean waters -- locations where their heat and/or moisture sources do not exist.
Hurricane/Cyclone Structure
- Hurricane/Cyclone winds blow in a counterclockwise spiral around the calm, roughly circular center called the eye. In the eye, which is roughly 20 to 30 miles wide, it is relatively calm and there is little or no rain. The eye is the warmest part of the storm. Surrounding the eye is the eyewall, a wall of thunderclouds. The eyewall has the most rain and the strongest winds of the storm, gusting up to 225 mph (360 km/h) in severe storms. The smaller the eye, the stronger the winds. The winds spiral in a counterclockwise direction into the storm's low-pressure center.
- Long bands of rain clouds appear to spiral inward to the eyewall -- these are called spiral rainbands. Hurricanes/Cyclone can be hundreds of miles across.
- In addition to rotating with wind speeds of at least 74 mph, a hurricane/cyclone travels relatively slowly across the ocean or land, usually at about 20 to 25 mph.
- If you are facing in the direction that the hurricane/cyclone is traveling, the right side generally has the fastest winds, and the left side usually has the most rain.
Vulnerability to Tropical Cyclones:
- Settlement located in low lying coastal areas (direct impact);
- Geography of immediate vicinity;
- Poor building design, or construction;Irregular;
- Terrain Insufficient lead time for warning and evacuation;
- Non compliance with evacuation procedures;
- Inadequate shelter.
Immediate Effect:
- The most serious immediate consequence of cyclones is the loss of human lives. The death rate is significantly higher where communications are poor and warning systems and evacuation plans are inadequate.
- The most dramatic impact of cyclones is the damage they cause to houses and other physical structures. In addition to damaging homes and buildings, cyclones destroy or damage critical facilities, supply lines, crops, and/or food stocks, disrupt economic activities and create financial burdens.
- They may destroy or damage facilities that are critical for responding to disasters;. among these are communications installations; electrical generating and transmission facilities; water storage, purification, and pumping facilities; sewage treatment facilities; hospitals; police stations; and various other public and private buildings.
- High winds destroy some standing crops, especially grains, and damage orchards and forests. Flooding from intense rains damages certain crops, and may cause excessive erosion. Storm surges scour and erode top soils; deposit salts on fields, and may increase salinity in subsurface water, damage to roads, bridges, railways, etc.
- During the emergency, people must leave their jobs and devote their time to disaster-related activities such as search-and-rescue or caring for survivors.
- In addition, the cost of relief and reconstruction creates a financial burden on the government. Increased expenditures for preventive and curative medicine, aid to the unemployed, and repair or replacement of housing are required, at a time when there is a decrease in public resources due to an overall decrease in economic activity and tax receipts.
Immediate Needs in Cyclone Situation:
The occurrence of a disaster is a critical time and the response must be quick and complete. The initial response by local authorities after a cyclone includes:
- Search and Rescue operation
- Emergency Medical assistance
- Emergency Shelter for evacuation
- Food & Water for short term
- Special Nutritional need for children
- Water purification
- Debris clearance
- Re-establishment of communications network
- Damage assessment
- Epidemiological surveillance
- Strengthen Communities livelihood for; recovery, rehabilitation & reconstruction
Long Term Risk Reduction Coping Mechanism
Risk Mapping, Assessment and Analysis:
The first and probably the most complex task of cyclone mitigation is to map the hazard, risks and vulnerabilities of cyclone at all levels, analyze and assess the levels of risks and monitor it continuously. It is only on the basis of such a knowledge base that a proper and effective strategy for cyclone risk mitigation and preparedness can be developed.
Cyclone Shelter:
A large number of people in the coastal areas live in thatched houses which cannot withstand the high velocity of wind and storm surges resulting in extensive damages of such houses and deaths and injuries of a large number of poor people.
The high rates of casualties in cyclones in Pakistan are primarily due to unsafe buildings in the coastal areas. The poor economic conditions of the people may not permit them to rebuild their houses as per the cyclone resistant designs and specifications.
Therefore, community cyclone shelters constructed at appropriate places within the easy access of the habitations of the vulnerable communities can provide an immediate protection from deaths and injuries due to the collapse of houses.
Early Warning and Communication:
Early warning of cyclones and its dissemination to the coastal habitations is an important preparatory measure to reduce the losses of life and property during cyclones.
It is important that warning should reach every one in least possible time and in right (understandable language) format particularly to people living in the shoreline/coastline.
People should be oriented about the warning signals and system. Warning message should be short & clear; in phases to avoid panic.
Community Based Disaster Preparedness:
Communities are the first real time responder to any disaster situation. However developed or efficient a response mechanism could be there would always be a time gap between the disaster and the actual response from the government and other agencies.
If the communities are mobilized and trained to assess their own risk through participatory risk assessment process, develop their own contingency plans and set up their own teams for evacuation, search and rescue, emergency shelter, first aid etc, the risks of cyclones can be managed with significant reduction in number of deaths and injuries.
Capacity Development and Training:
Capacity development is the most cost effective method of reducing the vulnerabilities of the people living in the coastal areas. The coastal communities have a certain degree of capacities built into their social systems and practices acquired through inherited experiences of generations. Therefore, the local capacities have to be continuously upgraded and further developed according to the changing needs and the developments of science and technology and other improved practices in various sectors.
Training programs have to be practical, scenario based and exercise and problem solving oriented so that the functionaries are aware of their specific responsibilities and are able to discharge those responsibilities efficiently before, during and after the cyclonic disasters.
Such trainings may include maroon search and rescue, first aid, evacuation, temporary shelter management, arrangements of drinking water and sanitation, provision of cooked food etc.
Awareness and Education:
While training and capacity development target specific groups according to their specific training needs, awareness generation is more of a general in nature which sensitizes common masses about the risks, vulnerabilities of cyclones and the preventive, mitigative and preparedness measures that can be taken at the government, community, household and individual level.
General (Repair Work):
Roads/culverts/bridges in the cyclone prone areas need to be maintained well and if they are in a bad shape their repair and strengthening works also to be given utmost attention.
Roads are always associated with culverts and bridges as the terrain demands, and routine maintenance of these infrastructures is crucial for post disaster response.
Where the general road condition is found to be bad due to poor sub grade, and the bridges and culverts are in a distressed condition their restoration work has to be accorded high priority.
Awareness Programs for population prone to cyclone
Preparation for Cyclone:
- Listen to radio and TV for warnings. If possible have a battery radio available.
- Well before the storm, move your vehicle out of low lying areas to a higher ground and park away from trees or other high wind hazards.
- Secure your facilities and bring outdoor object to indoor.
- Store several days water & food for each member of family.
- Act quickly when advised to evacuate to other safe areas.
- Follow instructions of local authorities or follow your own evacuation plan If not required to evacuate, stay indoor.
- Secure yourself & away from windows & blast doors.Have access to flashlights. Do not use candles or any open flame lantern, etc. These are highly dangerous in a power outage.
- Since the floors can get wet, all articles such as shoes, rugs, clothes, bags, suitcases, etc., should be placed on closet shelves, in dresser drawers, or on a bed.
What to do after a Cyclone:
- Stay turned to local news organizations, such as a radio or television station, for important announcements, bulletins, and instructions concerning the storm area, medical aid and other forms of assistance, such as food, water and shelter.
- Remember that you may not have immediate access to your home. Emergency rescue crews, power crews, and other personnel may be attending to special needs. Roads could be blocked, power lines could be down, and people may be trapped and in need of assistance.
- Make sure that you have current identification. You may have to pass through identification check points before being allowed access to your home/neighborhood.
- Avoid driving, as roads may be blocked. Avoid sight-seeing, or entering a storm ravaged area unnecessarily. You could be mistaken for a looter.
- Avoid downed power lines, even if they look harmless. Avoid metal fences and other metal objects near downed lines.
- DO NOT use matches in a storm ravaged area, until all gas lines area checked for leaks (Keep flashlights and plenty of batteries at hand).
- Avoid turning the power on at your home if there is flooding present. Have a professional conduct a thorough inspection first.
- Consider having professionals/licensed contractors inspect your home for damage and help in repairs. This includes electricians, as well as professionals to inspect gas lines, remove uprooted trees, and check plumbing. Remember that downed or damaged trees can contain power lines that can be a hazard.
- Use a camera or camcorder to record thoroughly any damage done to your home, before any repairs are attempted.
- In certain areas, the flooding rains that accompany a storm can create pest problems. Be aware of potential pest problems in your area, such as mice, rats, insects or snakes, that may have "come with the storm".
- Telephone lines will likely be busy in the area; use a phone only for emergencies.
- Flooding brings with it the risk of waterborne bacterial contaminations. You should assume that the water is not safe and use properly stored water, or boil your tap water.
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FLOODS
FLOODS What are the Causes of Flood? Impact of Floods There are many factors that contribute to the suffering of individuals affected by flooding: What to do before a flood? What to do during a flood? Secure your facility What to do after a flood? Consider your family health & safety needs: What is flood risk management? Flood risk management aims to reduce the likelihood and/or the impact of floods. Experience has shown that the most effective approach is through the development of flood risk management program incorporating the following elements: Prevention: preventing damage caused by floods by avoiding construction of houses in present and future flood-prone areas; by adapting future developments to the risk of flooding; and by promoting appropriate land-use, agricultural and forestry practices; Protection: taking measures, both structural and non-structural, to reduce the likelihood of floods and/or the impact of floods in a specific location; Preparedness: informing the population about flood risks and what to do in the event of a flood; Emergency Response: developing emergency response plans in the case of a flood; Recovery and lessons learned: returning to normal conditions as soon as possible and mitigating both the social and economic impacts on the affected population.
Floods are the most common climate-related disaster in the region and include seasonal floods, flash floods, and floods associated with tidal events induced by tsunami and cyclone in coastal areas.
Type of Floods:
FLASH FLOOD
Flash flood is a sudden and extreme volume of water, can flows rapidly, sometimes in just a few minutes by dam failure, breakup of ice jam. Flash floods often have a dangerous wall of roaring water that carries a deadly cargo of rocks, mud and other debris and can sweep away most things in its path.
RIVER FLOODS
Slow building up usually seasonal by heavy rainfall, some times over a period of days.
COASTAL FLOODS
Associated with storm surges, tsunami waves, tropical cyclones
Flood effects can be very local, impacting a community, or very large, effecting entire river basins and multiple districts.
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VICTIM EVACUATION/CASUALTIES HANDLING TECHNIQUES
Required to evacuate a injured person from an emergency scene to a location of safety.- Manual carries are tiring for the rescuer and involve the risk of increasing the severity of the casualty's injury.
- Choose the evacuation techniques that will be least harmful, both to rescuer and the victim.
- Causalities carried carefully and correctly handled, otherwise their injuries may become more serious or possibly fatal.
- Situation permitting, evacuation of a casuality should be organized and un-hurried.
- Each movement should be performed as deliberately and gently as possible.
Victim Drag and Carry Techniques
Tied-Hands Crawl
The tied-hands crawl may be used to drag an unconscious casualty for a short distance.
- It is particularly useful when you must crawl underneath a low structure, but it is the least desirable because the casualty's head is not supported.
- Use a triangular bandage, a torn shirt, etc to tie the casualty's hands together and place them around your neck. This way you can move a person much heavier than yourself.
One Person Arm Carry
Single rescuer to lift a victim safely by arm carries. Rescuer holding the victim around the victim’s back and under the knees.
One Person Pack-Strap Carry
This method is better for longer distances to lift a victim safely.
- Place both the victim's arms over your shoulders.
- Cross the victim's arms, grasping the victim's opposite wrist.
- Pull the arms close to your chest.
- Squat slightly and drive your hips into the victim while bending slightly at the waist.
- Balance the load on your hips and support the victim with your legs.
Fire Man Carry
This technique is for carrying a victim longer distances. It is very difficult to get the person up to this position from the ground. Getting the victim into position requires a very strong rescuer or an assistant.
- The victim is carried over one shoulder.
- The rescuer's arm, on the side that the victim is being carried, is wrapped across the victim's legs and grasps the victim's opposite arm.
Two Person Carry(by arms & legs)
- Rescuer 1 squats at the victim’s head and grasps the victim from behind at the midsection.
- Rescuer 2 squats between the victim’s knees, grasping the outside of the knees. o Both rescuers rise to a standing position.
Chairs Carry
This is a good method for carrying victims up and down stairs or through narrow or uneven areas.
- Pick the victim up and place them or have them sit in a chair.
- The rescuer at the head grasps the chair from the sides of the back, palms in.
- The rescuer at the head then tilts the chair back onto its rear legs.
- For short distances or stairwells, the second rescuer should face in and grasp the chair legs.
- For longer distances, the second rescuer should separate the victim's legs, back into the chair and, on the command of the rescuer at the head, both rescuers stand using their legs.
Ankle Pull
The ankle pull is the fastest method for moving a victim a short distance over
a smooth surface. This is not a preferred method of patient movement.
- Grasp the victim by either ankles or pant cuffs.
- Pull with your legs, not your back.
- Keep your back as straight as possible.
- Try to keep the pull as straight and in-line as possible.
- Keep aware that the head is unsupported and may bounce over bumps and surface imperfections.
Shoulder Pull
The shoulder pull is preferred to the ankle pull. It supports the head of the v
ictim. The negative is that it requires the rescuer to bend over at the waist while pulling.
- Grasp the victim by the clothing under the shoulders.
- Keep your arms on both sides of the head.o Support the head.
- Try to keep the pull as straight and in-line as possible.
Blanket Drag
This is the preferred method for dragging a victim from confined area
- Place the victim on the blanket by using the "logroll" or the three-person lift.
- The victim is placed with the head approx. 2 ft. from one corner of the blanket.
- Wrap the blanket corners around the victim.
- Keep your back as straight as possible.
- Use your legs, not your back.
- Try to keep the pull as straight and in-line as possible
Two Handed Seat
This technique is for carrying a victim to the longer distances and can support an unconscious victim. - Pick up the victim by having both rescuers squat down on either side of the victim.
- Reach under the victim's shoulders and under their knees.
- Grasp the other rescuer's wrists.o From the squat, with good lifting technique, stand.
- Walk in the direction that the victim is facing.
Four Handed Seat
This technique is for carrying conscious and alert victims to moderate distanc
es. The victim must be able to stand unsupported and hold themselves upright during transport.
- Position the hands as indicted in the graphic.
- Lower the seat and allow the victim to sit.
- Lower the seat using your legs, not your back.
- When the victim is in place, stand using your legs, keeping your back straight.
Three Person Carry
This technique is for lifting a patient into a bed or stretcher, or for transporting to short distances
- Each person kneels on the knee nearest the victim's feet.
- On the command of the person at the head, the rescuers lift the victim up and rest the victim on their knees.
If the patient is being placed on a low stretcher or litter basket:
- On the command of the person at the head, the patient is placed down on the litter/stretcher.
If the victim is to be placed on a high gurney/bed or to be carried:
- At this point, the rescuers will rotate the victim so that the victim is facing the rescuers, resting against the rescuers' chests.
- On the command of the person at the head, all the rescuers will stand.
- To walk, all rescuers will start out on the same foot, walking in a line abreast.
Improvised Stretcher
This technique requires two poles/pipes strong enough to support the victim's weight and at least two shirts.
- While the first rescuer is grasping the litter poles, the second rescuer pulls the shirt off the head of rescuer one.
- All buttons should be buttoned up with the possible exception of the collar and cuffs.
- The rescuers then reverse the procedure and switch sides.
Blanket Stretcher
This technique requires two poles and a blanket.
- Place the blanket down on the ground.
- Place one pole approx. 1 foot from the middle of the blanket.
- Fold the short end of the blanket over the first pole.
- Place the second pole approx. 18 inches or 2 feet from the first (this distance may vary with victim or blanket size).
- Fold both halves of the blanket over the second pole.
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LIGHT SEARCH AND RESCUE PART 3
Assessing damage to the Building
There are no hard and fast rules for assessing damage. However, the damage categories will serve as a reference point for defining your primary search and rescue mission.
Light Damage:
• Superficial or cosmetic damage.
• Broken windows.
• Fallen or cracked plaster.
• Minor damage to contents of structure.
Moderate Damage:
• Visible signs of damage.
• Decorative work of damage.
• Many visible cracks in plaster.
• Major damage to contents of structure.
Heavy Damage:
• Obvious structural instability.
• Partial or total collapse.
• Titling.
• Building off foundation.
Assessing Resources
The very first step in search and rescue operations is to identify local resources available to assist in rescuing victims, which include personnel, equipment and tools.
Rescue Operation
Once the decision is made to initiate search operations within a specific structure or area, Search and Rescue members must systematically inspect the area for searching and rescuing the victims – but take care
• The safety Search & Rescue Team members.
• Life safety for victims and others.
• Use of search & Rescue techniques appropriate to the operation.
• Protection of the environment.
• Formation of Teams
Make at-least two teams with two or more members.
Be equipped with complete safety and rescue equipments.
Proper distribution of responsibilities for collecting and carrying the equipment to the disaster site.
Distribution of responsibilities at the affected area.
Signals of communication decided beforehand.
Search Methodology
• Gather at a safe location to assess the building.
• Shut off all the Utilities of the building.
• Mark the building with the “X” before entering it.
• Use force if necessary to get to a victim.
• If you suspect a leakage of Gas in the building exit immediately & leave all doors open.
• Walk slowly and carefully at every step.• Mark every primary unit separately.
• Complete the search and try to get back to the X sign.
How to Mark the Search Area?
BEFORE you enter MARK search areas with a “X”.
• Write date & time of the search (on top quadrant)
• Write the name of the responding agency (in left quadrant)
• Write number of victims rescued & still inside (right quadrant)
• Write degree of search, full or partial (bottom quadrant).
• Use a zero “0” if no victim is found.
• Put a box around the “X” if it is not safe to conduct search and rescue efforts.
While searching the trapped victims!
• Call Out: Begin the search by shouting something like, “If anyone can hear my voice” If any victims respond, give them further directions such as “Stay calm & wait”.
• Listen Carefully: Stop frequently and just listen carefully for tapping sounds, movements or voices.
• Be Systematic: Use a systematic search pattern to ensure that all areas of the building are covered.
• Bottom-Up/Top-Down: Searching from the bottom of the building up and/or from the top down is well suited to multi-story buildings.
• Right Wall/Left Wall: Moving systematically from one side to the other is well suited to single-floor structures and avoids repetition.
• The wall is the rescuer’s lifeline: If you or your partner becomes disoriented, reverse your steps, staying close to the wall until you get back to the doorway.
• Throughout your search: Maintain voice contact with your partner so you do not get separated.
Evaluate Progress
• This is the most important step from a safety standpoint.
• The rescuers must continually monitor the situation to prevent any harm to the rescuers.
• Also, they determine if their plan is working, and if not, how it can be changed to make it work.
Emergency Evacuation
Evacuation is the process of identifying a threat to public safety, warning people of the danger, instructing them on what action to take to ensure their safety, moving all or part of the population in the affected area to a place of safety.
Some evacuations involve a small number of people; some involve a very large number.
In the event that evacuation becomes necessary, use the following steps:
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LIGHT SEARCH AND RESCUE PART 2
Basic Principles of Search & Rescue
How to approach the damaged buildings; Dos & Don’ts
* Damaged buildings and facilities should only be approached from the least dangerous side
* While surveying indoor space in buildings, do not use open fire (Matches, kerosene lamps) for lighting
* When searching for casualties DO NOT walk or stay near badly damaged and collapse-prone buildings
* DO NOT Allow many people to gather in one spot, in shafts, or floors.
* DO NOT go near collapse-prone walls or other constructions.
* Move very carefully over building ruins (only if it is absolutely necessary) as they are unstable heaps of fragments.
* When removing rubble from ruins DO NOT permit abrupt jerks, shaking, or strong blows at the site.
* When clearing ruins, first drag away and extinguish any smoldering or burning objects.
* Open doors to burning rooms very cautiously. Be aware of possible flame or hot gas ejection.
* In burning spaces move by bending low or else on your knees. Try to stay near windows, making it possible to get quickly out of the danger zone if need be.
* If an electrical cable is discovered, suspend it, in order to avoid further damage or tearing; DO NOT step on wires.
Search & Rescue Planning
• Size up – involves assessing the situation and determining a safe action plan.
• Search – involves locating victims and documenting their location.
• Rescue – involves the procedure and methods to extricate victims.
Search & Rescue Size Up
Size-up is a continuous analysis of facts that forms the basis for decision making and planning. It includes following steps:
Gather facts.
* Assess damage to the building.
* Identify your resources.
* Establish the rescue priorities.
* Develop a rescue plan.
* Conduct the rescue.
* Evaluate your progress.
* Each of the size-up steps will provide information that may be critical to search and rescue efforts.
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LIGHT SEARCH AND RESCUE PART 1
Light Search and Rescue
The search and rescue function is really two separate activities:
Search: To look through in a place or in an area carefully in order to find something missing or lost.
Rescue: To free a trapped victim from confinement or under the rubble.
Search and Rescue operations require three components:
- Rescuers include trained personnel and volunteers.
- Tools depend on their availability and the needs of the situation. For example, storm or earthquake damage may require tools for lifting debris whereas flood damage may require boats, ropes, and life preservers.
- Time may be very limited for some victims. The first 24 hours after a disaster has been called the “Golden Day” that period during which injured or trapped victims have an 80 percent chance of survival if rescued.
Survival rates for persons trapped in collapsed structure.
- 30 Minutes 91.0% Survive
- 1 Day 81.0% Survive
- 2 Days 36.7% Survive
- 3 Days 33.7% Survive
- 4 Days 19.0% Survive
- 5 Days 7.4% Survive
The Golden Day of Survival
Objectives of Search & Rescue
The objectives of search and rescue are to:
- Safeguard the life of a rescuer - acknowledge that the most important person in a rescue attempt is the rescuer.
- Rescue lightly trapped victims first in order to rescue the greatest number of people in the shortest amount of time.
- As a volunteer worker, confine your efforts to light search and rescue; that is, the relatively uncomplicated extrication of victims from situations that pose minimal risk to the rescuer.
FRACTURES
What is Fracture? 
A fracture is a broken or cracked bone. There are a number of signs and symptoms, which can indicate that a person has a fracture:
- The injured part cannot be moved normally.
- The injured part may have an unnatural shape or position.
- There is swelling and sometimes bruising.
- There is loss of strength.
- There may be an irregularity or shortening of the affected limb.
Signs & Symptoms of Fracture
- A fracture is an injury to a bone.
- Fractures are the result of too much pressure being put on the bone.
- Fractures can be caused by hits, falls, or repeated pressure (as in running) to a bone.
- A dislocation is when two connected bones separate. They are common in the knee, shoulder, fingers, and other joints.
- Dislocations are the result of too much pressure being put on a joint.
- The symptoms of a fracture include pain, swelling, bruising, or not being able to move the injured area.
- Fractures or Dislocations are usually treated with rest, ice, compression, and elevation.
- To prevent these injuries, wear helmets and other protective gear during physical activities. Children should use car seats and seatbelts. Take steps to prevent falls.
Types of Fractures
- Simple
- Compound
- Comminuted
- Complicated
- Green Stick
- Impacted
- Spinal
Simple Fracture
A simple fracture is a broken bone that does not break the overlying skin. Tissue beneath the skin may be damaged.
Compound Fracture
A compound (open) fracture is a broken bone that breaks (pierces) the overlying skin. The broken bone may come through the skin, any trauma can also cause the phenomena.
An open fracture is contaminated and subject to infection.
Comminuted Fracture
This refers to a fracture when part of the broken bone is splintered into several fragments.
It is usually used when implying that exact anatomical restitution is difficult or impossible.
Usually occur in bone damaged by direct trauma.
Greenstick fractures
These occur in children as they have bones which are more springy than adult bones
The bone buckles or bends rather than snapping, often producing slight bulge in or altered curve to the edge of the bone on radiograph
Reduction is easy
Healing is quick
Typically seen in the clavicle, and the radius & ulna at the wrist
First Aid for Fractures
Treat severe bleeding and difficulty in breathing first.
Treat on the spot. Avoid unnecessary movement.
Immobilize the injured part; splint the joint above and the joint below the injury.
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BANDAGING
DEFINITION OF A BANDAGE:
A strip of material used mainly to support and immobilize a part of the body.
USES:
- To support - fractured bone
- To immobilize – Dislocated shoulder/Jaw
- To apply pressure – Stop bleeding & Improve venous blood flow.
- To secure a dressing in place.
- To retain splints in place.
Principles & Procedures for applying Bandages
- Wash hands. (Wear gloves where necessary)
- Assist victim to assume comfortable position on bed or chair and support the body part to be bandaged.
- Always stand in front of the part/victim to be bandaged except when applying a bandage to the head, eye and ear.
- Be sure the bandage is rolled firm.
- Make sure the body part to be bandaged is clean and dry.
- Assess skin before applying bandage for any breakdown.
- Observe circulation by noting pulse, surface temperature, skin color and sensation of the body part to be wrapped.
- Always start bandaging from inner to outer aspect and far to near end.
- When bandaging a joint, ensures flexibility of the joint. (except if immobilization of joint is required).
- Always start and end with two circular turns.
- Cover the area 2 inches above and 2 inches below the affected area (wound).
- Overlap turns and slightly stretch the bandage.
- Cover two third 2/3 of the previous turn.
- Where possible, leave fingertips or toe tips exposed for observation (adequacy of blood circulation).
- End the bandage on the outer side of the body. Do not end a bandage on wound or at the back of the body.
Methods of applying Bandages
- Circular
- Spiral
- Reverse Spiral
- Figure of Eight
Circular Turn
Circular turns are used chiefly to anchor bandages and to terminate bandages.
Apply the end of the bandage to the part of the body to be bandaged- Encircle the body part a few times or as needed, each turns directly covering the pervious turn.
- Secure the end of the bandage with tape, metal clips or a safety pin over an uninjured area.
Spiral Turn
Spiral turns are used to bandage cylindrical parts of the body that are fairly uniform in circumference, such as upper arm and upper leg. - Make two circular turns to begin the bandage.
- Continue spiral turns at about a 30-degree angle, each turn overlapping the preceding one by two-thirds the width of the bandage.
- Terminate the bandage with two circular turns, and secure the end as described for circular turns.
Spiral Reverse Turn
Spiral reverse turns are used to bandage cylindrical parts of the body that are not uniform in circumference, such as the lower leg or lower fore arm
- Begin the bandage with two circular turns, and bring the bandage upward at abo
ut a 30-degree angle. - Place the thumb of the free hand on the upper edge of the bandage.
- The thumb will hold the bandage while it is folded on it self.
- Unroll the bandage about 4-6” then turn the hand so that the bandage is folded down
- Continue the bandage around the limb, overlapping each previous turn by two-thirds the width of the bandage.
- Make each bandage turn at the same position on the limb so that the turns of the bandage will be aligned.
- Terminate the bandage with two circular turns, and secure the end as described for circular turns.
Figure of Eight Turn
The figure-of-eight method of bandage permits flexibility of elbow, knee and ankle without disturbing the dressing. - Begin the bandage with two circular turns.
- Carry the bandage above the joint, around it, and then below it, making a figure eight-continue above and below the joint, overlapping the previous turn by two-thirds the width of the bandage.
- Terminate the bandage above the joint with two circular turns, and secure the end appropriately.
Apply a Triangular Bandage Sling
A triangular bandage sling is usually made from a muslin bandage, but any
material that does not stretch (such as a fatigue shirt, trousers, poncho, blanket, or shelter-half) can be used. Fold, cut, or tear the material into a triangular shape.- Insert the material under the injured arm so that the arm is in the center, the apex of the sling is beyond the elbow, and the top corner of the material is over the shoulder of the injured side.
- Position the forearm so that the hand is slightly higher than the elbow (about a 10 degree angle).
- Bring the lower portion of the material over the injured arm so that the bottom corner goes over the shoulder of the uninjured side.
- Bring the top corner behind the casualty's neck.
- Tie the two corners together so that the knot will not slip. The knot should fit into the "hollow" at the side of the neck on the uninjured side.
Triangular Bandage to the Head
Turn the base (longest side) of the bandage up and center its base on center of the forehead, letting the point (apex) fall on the back of the neck.
- Take the ends behind the head and cross the ends over the apex.
- Take them over the forehead and tie them.
- Tuck the apex behind the crossed part of the bandage and/or secure it with a safety pin, if available.
Head Bandaging
Vertical bandage carried twice forwards and once backwards. Continue to pass the vertical bandage backwards and forwards each time a little to the left and right alternately, locking it with the horizontal bandage. Finally, pass horizontal bandage twice around the head, and pin in front.
Eye Injury & Bandaging
A penetrating eye injury is usually caused by a sharp object which has gone in, or is protruding from the eye.Warning:
- Do not touch the eye or any contact lens.
- Do not allow casualty to rub eye.
- Do not try to remove any object which is penetrating the eye.
- Do not apply pressure when bandaging the eye.
Support casualty’s head to keep it as still as possible.
- Ask casualty to try not to move eyes.
- Place sterile pad or dressing over injured eye.
- Ask casualty to hold this in place.
- Bandage dressing in place, covering injured eye.
- If penetrating eye injury, lie casualty on back, place pad around object and bandage in place.
- If chemical or heat burn, or smoke in eyes, flush with water
Jaw Injuries & Bandaging
- Before applying a bandage to a casualty's jaw, remove all foreign material from the casualty's mouth. If the casualty is unconscious, check for obstructions in the airway.
- The dressing and bandaging procedure outlined for the jaw serves a two fold purpose. In addition to stopping the bleeding and protecting the wound, it also immobilizes a fractured jaw. •When applying the bandage, allow the jaw enough freedom to permit passage of air and drainage from the mouth.
Bandaging:
- Place the bandage under the chin and carry its ends upward. Adjust the bandage to make one end longer than the other.
- Take the longer end over the top of the head to meet the short end at the temple and cross the ends over.
- Take the ends in opposite directions to the other side of the head and tie them over the part of the bandage that was applied first.
Finger Bandaging
For finger and hand bandaging take a roller bandage varying in width from one inch to three inches wide and five yards long.
- After the dressing has been applied take two or three turns around the finger to hold the bandage from slipping, then from left to right making the distances neat and even, carry the roll around the finger.
- The figure of eight, which has the advantage of giving better compression is made by carrying, the bandage away from the person applying it on the upper stroke, then around the hand and toward the person on the down stroke, making the crossing point in the middle of finger, as illustrated, and having each crossing point one half inch higher up than the one preceding.
Securing Bandage
To the secure bandage apply the following:
- Tape
- Metal
- Safety Pin
- Binders:
- Binders used to secure a dressing in the rectum and perineal area.
- Abdominal binders (Scultetus).
- Ensure that there are no wrinkles or creases in the binder.
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BURNS & SCALDS
Burns & Scalds
Burns: Injuries to the skin & other tissue caused by Heat, Radiation or Chemicals.
Scalds: Burns caused by the Moist Heat, such as hot liquids & steam.
Types of Burns
1. Heat/Thermal Burns
2. Corrosive/Chemical Burns
3. Electrical Burns
4. Radiation Burns
Degree of Burns 
• 1st Degree
Signs: Skin is red or bright pink but not broken; there are no blisters.
• 2nd Degree
Signs: Skin is red, tender, swollen, and blistered.
• 3rd Degree
Signs: Skin will look white and leathery or charred.
Treating Burns and Scalds
- First-aid treatment for burns involves removing the source of the burn, cooling the burn, and covering it. To treat burn victims:
- Remove the victim from the burn source. Put out any flames and remove smoldering clothing.
- Cool skin or clothing that is still hot by immersing in cool water for no longer than one minute or covering with clean compresses that have been wrung out in cool water. Water may be obtained from the bathroom, kitchen and garden hose.
- Use soaked towels, sheets, or other cloths. Use clean water. Do not apply water to third-degree burns except to put out flames. Treat all victims of third-degree burns for shock.
- WATCH FOR SIGNS OF HYPOTHERMIA. Cover loosely with dry, sterile dressings that keep air out, reduce pain, and prevent infection.
- Elevate burned extremities higher above the victim's heart.
Cool the burnt area with running water
If clothing sticks to the skin, leave it there and cut away the remaining fabric
Do not break blusters
Do not apply lotions, ointments or fat to the injured area.
Cover the burnt area with plastic bag
Cover the burn with a sterile bandage
Remove the chemical from the skin or eyes by flushing the area with large amounts of cool running water
CALL Doctor or emergency medical services (EMS)
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WOUNDS & BLEEDING
What is WOUNDS?
Any break in soft tissue of the body that results in bleeding.
Types of Wounds
Open Wound:
Break in the outer layer or skin, results in bleeding & allow Microorganisms (germs) to enter the body.
Close Wound:
No break in the outer layer of skin.
Wound Care
Objectives of wound care are to control bleeding and prevent secondary infection.
- Clean the wound by irrigating with water, flushing with a mild concentration of soap and water, then irrigating with water again. Do not scrub.
- Apply a dressing and bandage, after thoroughly cleaning the wound, to help keep the wound clean. (A dressing is applied directly to the wound. A bandage is used to holding the dressing in place.)
Use the following rules for dressings and bandages:
- If the wound is still bleeding, apply the bandage with enough pressure to help control bleeding without interfering with circulation. Check for color, warmth, and sensation to determine if the bandage is too tight.
- If active bleeding continues (the dressing is soaked with blood) redress over the existing dressing and maintain pressure and elevation.
Bleeding
Escape of blood from injured vessels. Severe bleeding is called Hemorrhage.
Severe bleeding treatment
- Put on disposable gloves.
- Apply direct pressure to the wound with a pad (e.g. a clean cloth) or fingers until a sterile dressing is available.
- Raise and support the injured limb. Take particular care if you suspect a bone has been broken.
- Lay the casualty down to treat for shock.
- Bandage the pad or dressing firmly to control bleeding, but not so tightly that it stops the circulation to fingers or toes.
- If bleeding seeps through first bandage, cover with a second bandage. If bleeding continues to seep through bandage, remove it and reapply.
- Treat for shock.
Loss of a finger, hand, arm, or leg can be extremely dangerous. But, if you act quickly, you may be able to save the victim’s life.
When part of the body has been torn off, treat the victim:
Administer first aid:
Control bleeding, watch for signs of shock, and treat for shock as necessary.
Protect Body Part:
- Try to find out the severed part of the body.
- If found, save the tissue parts, wrap it in a plastic bag.
- Put a bag on ice, but don’t freeze.
- Take the part with victim to the Hospital.
- Mention name of victim and time of incident on plastic bag.
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PREPAREDNESS FOR AN EARTHQUAKE
Be prepared for an earthquake
“Earthquakes don’t kill people, un-safe buildings do”
By planning and practicing what to do before, during and after an earthquake, your family can learn to react correctly and automatically when the shaking begins. During an earthquake, most deaths and injuries are caused by collapsing building materials and heavy falling objects. Learn the safe spots in each room of your home. Participating in an earthquake drill will help children understand what to do in case you are not with them during an earthquake.
Before the tremors:
- Secure heavy furnishings and keep heavy objects on lower shelves
- Secure your water heater with wall and floor
- Do not hang decorative items, fancy lights, pictures and mirrors above beds or seating areas.
- Store weeds killers, pesticides and flammable products securely in close cabinets with latches and on bottom shelves.
- Check roofs and wall foundation for stability
- Repair defective electrical wiring and leaky gas connections
- Keep list of Emergency phone numbers, Police, Fire Service, Ambulance Service, Rescue, Electric & Gas Depts.
- Develop an emergency survival Kit
Food items (rice, noodles, canned food, milk power, beverages, water) Solid fuel and matches – A First Aid Kit – A portable battery-operated transistor radio. - Decide where family members will reunite if separated
Ground shaking in earthquake is lasting for not more than 15-30 seconds During these few seconds, stay calm, do not run or panic.
- If indoor, stay indoor and minimize your movements to a few steps to reach a nearby safe place. Know the danger & safe spot in home.
- Take shelter under a sturdy table, desk or bed and protect your head and face as that will provide you with provide you with air space and protection against falling objects.
- Stay away from windows, doors, walls, display shelves and heavy objects that could fall and hurt you, like lightings, furniture or fixtures.
- Do not use elevators, use stairways in multi-story buildings.
- If you are outdoors, stay away from buildings, trees, overhead power lines and overpass. Remain in the open until the tremor stops.
- If you are driving, stop as quickly as safety permits & stay in your vehicle. Avoid stopping near or under trees, buildings, bridges, over passes or overhead electrical cables.
After the tremor stops
- Check yourself and others for injuries…administer first aid quickly and carefully.
- Do not touch any damaged electrical wiring. Also, report to concerned authorities. Learn how to cut off utilities.
- Do not use candles, matches and other naked flames during and after tremors, as there might be a gas leak.
Check your home for any structural defects. Get expert advice if there are signs of structural defects. - Use the telephone to report life-threatening emergencies only.
Be prepared for aftershocks which may cause additional damage and may bring weakened structures down. Aftershocks may occur hours, days, weeks, or even months after the quake.
- Avoid unnecessary movement so that you don’t kick up dust.
- Maintain moral and fighting sprits high.
- Periodically move your fingers and toes to ensure blood circulation.
- Cover your mouth and nose with anything you have on hand. Try to breathe through the available cotton material.
- Shout only as a last resort -shouting can cause a person to inhale dangerous amounts of dust.
- Tap on a pipe or wall so that rescuers can hear where you are.If available use a flashlight to signal your location.
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EARTHQUAKE
Earthquakes are sudden, rapid vibrations of the earth caused by sudden rupturing and shifting of rock beneath the earth surface.
The vibration of earth can range from barely noticeable to extremely destructive.
Earthquake vibrations occur in a variety of frequencies and velocities. The actual rupture process may last from a few seconds to as long as one minute for a major earthquake.
Classes of earthquake:
There are three classes of earthquake that are known & recognized as, tectonic, volcanic and artificially produced
- Tectonic: Tectonic quake are by far the most common, devastating and most difficult to predict. They are caused by stresses set up by movements of a dozen or so huge plates that form the earth’s crusts. Most earthquakes occur at the boundaries of these plates. Where two plates slides over and collides against each other; some earthquakes do occur in the middle of plates.
- Volcanic: Volcanic quakes are seldom very large or destructive; they often precede or accompany volcanic eruption.
- Artificial: Artificially produced earthquake are induced by activities such as the filling of new reservoir or the pumping of fluid deep into the earth through wells. This type of earthquake can be noticeable but are hardly destructive.
Affects of earthquake
Earthquakes are one of the most destructive of natural hazards. They may occur at any time of year, day or night, with sudden impact and little warning. Destroy buildings and or damage structure of the building, bridges, and communications -
- Loss of human lives
- Dense casualties/injuries
- Extensive property damages
- Disruption/Disturbance to normal human life activities
- Destabilize the government, economy and social structure of a country.
Secondary Hazards
When earthquake occur, a variety of secondary and related hazards can happen simultaneously. The ground shaking from earthquakes can cause landslides, rock fall, debris flow, soil liquefaction, avalanches, tsunami, fire etc.
Factors contributing the vulnerability
Several key factors contribute to vulnerability of human populations:
- Location of settlements in seismic areas, especially on poorly consolidated soils, on ground prone to landslides or along fault lines.
- Building structures, such as homes, bridges, dams, which are not resistant to ground motion.
- Dense groupings of buildings with high occupancy.
- Lack of access to information about earthquake risks.
Earthquake Fault line
An earthquake fault is a zone within the earth’s crust where the rocks have been weakened by previous earthquake, and where we expect earthquake slip to occur.
Where earthquakes most often occur?
The earth’s surface is broken into a dozen or so major plates, plus a number of smaller plates and those plates are moving with respect to each other. The motion between two major tectonic plates is the main causes of occurring of earthquakes.
Whether earthquakes are predicted?
The seismological research has indicated the seismic zones and geologic fault and has warned that where earthquakes are going to occur, but difficulty is that it cannot be predict when it will occur.
Foreshock and after shock
Foreshocks are small scale earthquakes that occur before a large earthquake. Aftershocks may occur hours, days, weeks, or even months following the large quake.
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What is Disaster Risk Management?
What is Disaster Risk Management?
Disaster Risk Management is a process of mobilizing a group of people in a systematic way towards achieving a common risk reduction objective which takes place in a geographically-defined living area (or) in sector groups.
The local people must know what disaster management and risk reduction stand for, what their own responsibilities are, how they can help prevent disasters, how they must react during a disaster and what they can do to support themselves when necessary.
Awareness and knowledge will built the risk perceiption of local people. The analysing and understanding the risk of particular hazard to their lives properties, local people can take steps to reduce those risks and minimize the damages caused by the hazard.
The involvement and awareness of local community are therefore a critical element of disaster risk management.
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Cycle of Disaster Risk Management
Prevention
Measures taken to avert a disaster from occurring, If possible! To impede a hazard so that it does not have any harmful effects. (Risk identification, analysis and prioritize)
Mitigation
Measures taken prior to the impact of a disaster to minimize its effects, sometimes referred to as structural and non-structural measures. (Planning and implementation of structural interventions and non-structural measurers for reducing the risk exposed to particular hazard).
Preparedness
Measures taken in anticipation of a disaster to ensure that appropriate and effective actions are taken in the aftermath. (activities and measures taken in advance to ensure effective response to the impact of a hazard).
Early Warning
Early Warning system is the provision of timely and effective information that allows individuals exposed to a hazard to take action to avoid or reduce their risk and prepare for effective action.
Response
Actions taken immediately following the impact of a disaster when exceptional
measures are required to meet the basic needs of the survivors.
Recovery
The process undertaken by a disaster-affected community to fully restore itself to pre-disaster level of functioning.
Reconstruction
Permanent measures to repair or replace damaged dwellings and infrastructure and to set the economy back on course.
