Module 4: Disaster Risk Reduction and Management AwarenessLearning

Outcomes:

After completion of the module, the students will be able to:

1. Recall knowledge on Disaster Risk Reduction and Management. 2. Recognize
the importance of DRRM awareness in building a resilient community. 3.
Recognize the hazards and disasters affecting the Philippines.
4. Acquaint themselves with the Philippine Disaster Management System (PDMS) and
with laws and policies pertinent to its implementation.
5. Define key concept and principles of disaster management.
6. Internalize the principles of disaster preparedness and be ready for involvement in
times of crisis.
7. Enhance awareness of the tasks and responsibilities of key players in
disaster management.
8. Develop skills in responding on disaster incidents applying basic knowledge on
first aid and life support.

Introduction:

Our country, being in the- pacific belt of fire is always subject to constant natural
disaster and calamity. The Great Ocean and seas around the Philippine island serve as
spawning areas for destructive typhoons and monsoons as well as providing a wide
avenue for trade source of marine resources.

This module will discuss how to reduce risk brought about by disaster whether it
is natural or manmade because other calamities are unpredictable especially disastrous
earthquake. Since, Philippines is prone to this event being in the pacific ring of fire, all
we need to do is to prepare to lessen the damage in the lives and properties.

That is why Republic Act 10121 or the Philippine Disaster Risk Reduction and
Management act of 2010 fortifies the disaster management and preparation of the
Philippine government. Signed on May 27, 2010, this law aims to develop a disaster
management framework as well as specify the resources that will be utilized to facilitate
the rebuilding of communities when disasters strike through the help of the national
government, local and other stakeholders.

Lesson Proper:
Lesson 1. Geographic Profile of the Philippines

The Philippines is an archipelago state, consisting of some 7,100 islands and

islets, and covering a land area of approximately 300,000 km2 . The country comprises
three groups or large islands: (1) the Luzon group in the north and west, consisting of
Luzon, Mindoro, and Palawan, (2) the Visaya group in the
center, consisting of Bohol, Cebu, Leyte, Masbate, Negros, Panay and Samar,
and (3) Mindanao in the South. Manila and nearby Quezon City, the country’s
most-populous cities, are part of the National Capital Region (NRC or Metro
 Manila), located on the largest island Luzon

The islands and groups are divided into four main classes of
administrative divisions, which consist of 17 autonomous regions, 81 provinces,
1,489 municipalities, and the smallest political units, 42,044 Barangays as of
2018 (PSA, 2018).The Philippines is governed by a presidential form, in which
power is divided among three juridical branches; executive, legislative and
judicial, which seek democracy and balance by carrying their equally weighted
duties to uphold law, rights and representation of the interests of the people .

In terms of disaster risk, Philippines ranked third among all of the

countries with the highest risks worldwide according to the World Risk Report
2018, with index value of 25.14% (World Economic Forum, 2018). At least 60%
of the country’s total land area is exposed to multiple hazards, and 74% of the
population is susceptible to their impact (GFDRR, 2017). This is largely due to
the location and geographical context as the risk involving coastal hazards such
as typhoons, storm surges and rising sea levels is high. Also, as the islands are
located within the ―Ring of Fire‖ between the Eurasian and Pacific tectonic
plates, earthquakes and volcanoes are posing serious risks to the safety of the
populace. Flooding, landslides, droughts and tsunamis further contribute to the
exposure to natural hazards (CFE-DM, 2018). Of these, hydro-meteorological
events including typhoons and floods, accounted for over 80% of the natural
disasters in the country during the last half-century

Lesson 2. Disaster Risk Profile of the Philippines

The geographical location of the Philippines makes the country uniquely exposed
to a plethora of hazards, including recurrent typhoons, earthquakes and 53 active
volcanoes, eruptions of which are classified as the most deadly and costly globally. The
subduction zone between the two tectonic plates (Eurasian and Pacific) creating the
seismic activity in the region are predicted to have the capacity to generate major
earthquakes in the near future, and in the vicinity of metropolitan cities (Pailoplee &
Status Report 2019 Pages // 10 Boonchaluay, 2016). Other hazards include floods,
landslides, tsunamis and wildfires, all of which are occurring in a frequency which has
fundamentally changed the perception of hazards in the country.
Disasters in the past, measured during the period between 1900-2014, illustrate
extreme spatial variability. Frequency and the extent of impacts are unevenly distributed
across the regions, with majority of the events affecting Central Luzon, Cordillera
Administrative Region and the Central Visayas (Doroteo, 2015). On average, about 20
tropical cyclones enter the Philippines waters each year, with approximately eight or
nine making landfall (ESCAP/WMO, 2009; Bankoff, 2003). They are also the largest
contributors to disaster damage. Of all the disasters, cyclones and the accompanying
landslides, storm surges and floods have caused the largest losses of life and property
(Huigen & Jens, 2006; Bankoff, 2003), mostly because majority of the population is
living within 60km from the coast. However, 80% of all the damages and deaths caused
by typhoons between 1970-2014 have been caused by 6 super-scale events, Haiyan
included (Espada, 2018). Based on vulnerability studies, the most vulnerable regions to
tropical cyclones in the country are the National Capital Region (NCR), Southern
Tagalog, Cagayan Valley, Central Luzon, the Cordillera Administrative Region, and
Bicol Province (Cruz, et al., 2017). Visayas and Mindanao are likewise becoming more
at risk due to an increasing number of tropical cyclones entering the southern part of the
country. Furthermore, the varying geomorphology affects the distribution of hazards. For
example, the Baguio district is most landslide prone region due to highest recorded
rainfalls resulting from the interaction of the monsoon season, cyclones, and the
orographic lifting of air by the Cordillera mountains (Nolasco-Javier, et al., 2015).
Severe, reoccurring flooding on the other hand is common in the lowland areas
(Bankoff, 2003). Earthquakes also tend to have their unique characteristics depending
on the local context. Seismic activity produces severe secondary impacts in areas with
cohesionless soil conditions. Liquefaction is a significant concern in central Luzon,
especially in the provinces of Pangasinan and Tarlac (Bankoff, 2003). Extremely
destructive earthquakes and associated tsunamis have been known to occur during the
known history and are a likely threat in the future.
Lesson 3. Overview of The Philippine Disaster Management System

1. Republic Act 10121, also known as the “Philippine Disaster

Risk Reduction and Management Act of 2010”

”AN ACT STRENGTHENING THE PHILIPPINE DISASTER RISK REDUCTION

AND MANAGEMENT SYSTEM, PROVIDING FOR THE NATIONAL DISASTER
RISK REDUCTION AND MANAGEMENT FRAMEWORK AND
INSTITUTIONALIZING THE NATIONAL DISASTER RISK REDUCTION AND
MANAGEMENT PLAN, APPROPRIATING FUNDS THEREFOR AND FOR OTHER
PURPOSES.”

RA 10121 was sign into law by then President Gloria Macapagal-Arroyo

on May 27, 2010. It recognizes among other things, the need to adopt a
disaster risk reduction and management (DRRM) approach that is holistic,
comprehensive, integrated, and proactive in lessening the socio-economic
and environmental impacts of disasters including climate change. It aims to
promote the involvement and participation of all sectors and all stakeholders
concerned, at all levels, especially the local community (Section 2, RA No.
10121).

RA 10121 provides a strong legal and institutional basis for DRRM in the
country and provided basis for the development of policies and plans,
implementation of actions and measures pertaining to all aspects of DRRM,
including (1) good governance, (2) risk assessment and early warning,(3)
knowledge building and awareness raising, (4) reducing underlying risk factor,
and (5) preparedness for effective response and early recovery (Section 4,
RA No. 10121).

Section 2. Declaration of Policy. – It shall be the policy of the State to:

(a) Uphold the people’s constitutional rights to life and property by

addressing the root causes of vulnerabilities to disasters, strengthening the
country’s institutional capacity for disaster risk reduction and management
and building the resilience of local communities to disasters including climate
change impacts;

(b) Adhere to and adopt the universal norms, principles and standards of
humanitarian assistance and the global effort on risk reduction as concrete
expression of the country’s commitment to overcome human sufferings due to
recurring disasters;

(c) Incorporate internationally accepted principles of disaster risk

management in the creation and implementation of national, regional and
local sustainable development and poverty reduction strategies, policies,
plans and budgets;

(d) Adopt a disaster risk reduction and management approach that is

holistic, comprehensive, integrated, and proactive in lessening the
socioeconomic and environmental impacts of disasters including climate
change, and promote the involvement and participation of all sectors and all
stakeholders concerned, at all levels, especially the local community;Develop,
promote, and implement a comprehensive National Disaster Risk Reduction
and Management Plan (NDRRMP) that aims to strengthen the capacity of the
national government and the local government units (LGUs), together with
partner stakeholders, to build the disaster resilience of communities, and’ to
institutionalize arrangements and measures for reducing disaster risks,
including projected climate risks, and enhancing disaster preparedness and
response capabilities at all levels;

(e) Adopt and implement a coherent, comprehensive, integrated, efficient

and responsive disaster risk reduction program incorporated in the
development plan at various levels of government adhering to the principles
of good governance such as transparency and accountability within the
context of poverty alleviation and environmental protection;

(f) Mainstream disaster risk reduction and climate change in development

processes such as policy formulation, socioeconomic development planning,
budgeting, and governance, particularly in the areas of environment,
agriculture, water, energy, health, education, poverty reduction, land-use and
urban planning, and public infrastructure and housing, among others;

(g) Institutionalize the policies, structures, coordination mechanisms and

programs with continuing budget appropriation on disaster risk reduction from
national down to local levels towards building a disaster-resilient nation and
communities;

(h) Mainstream disaster risk reduction into the peace process and conflict
resolution approaches in order to minimize loss of lives and damage to
property, and ensure that communities in conflict zones can immediately go
back to their normal lives during periods of intermittent conflicts;

(i) Ensure that disaster risk reduction and climate change measures are
gender responsive, sensitive to indigenous know ledge systems, and
respectful of human rights;

(j) Recognize the local risk patterns across the country and strengthen the
capacity of LGUs for disaster risk reduction and management through
decentralized powers, responsibilities, and resources at the regional and local
levels;

(k) Recognize and strengthen the capacities of LGUs and communities in

mitigating and preparing for, responding to, and recovering from the impact of
disasters;

(l) Engage the participation of civil society organizations (CSOs), the

private sector and volunteers in the government’s disaster risk reduction
programs towards complementation of resources and effective delivery of services to
the Citizenry;

(m) Develop and strengthen the capacities of vulnerable and marginalized

groups to mitigate, prepare for, respond to, and recover from the effects of
disasters;

(n) Enhance and implement a program where humanitarian aid workers,

communities, health professionals, government aid agencies, donors, and the
media are educated and trained on how they can actively support
breastfeeding before and during a disaster and/or an emergency; and

(o) Provide maximum care, assistance and services to individuals and

families affected by disaster, implement emergency rehabilitation projects to
lessen the impact of disaster, and facilitate resumption of normal social and
economic activities.

2. The National Disaster Risk Reduction Management Council

(NDRRMC)

The National Disaster Risk Reduction and Management Council

(NDRRMC), formerly known as the National Disaster Coordinating Council
(NDCC), is a working group of various government, non-government, civil
sector and private sector organizations of the Government of the Republic of
the Philippines established by Republic Act 10121 of 2010. It is administered
 by the Office of Civil Defense (OCD) under the Department of National
Defense (DND). The Council is responsible for ensuring the
protection and welfare of the people during disasters or emergencies. The
NDRRMC plans and leads the guiding activities in the field of communication,
warning signals, emergency, transportation, evacuation, rescue, engineering,
health and rehabilitation, public education and auxiliary services such as fire -
fighting and the police in the country. The Council utilizes the UN Cluster
Approach in disaster management. It is the country's focal for the ASEAN
Agreement on Disaster Management and Emergency Response (AADMER)
and many other related international commitments.

The National Disaster Risk Reduction and Management Council (NDRRMC)

is the agency tasked to prepare for, and respond to, natural calamities, like
typhoons and earthquakes. It also monitors human-induced emergencies,
such as armed conflicts and maritime accidents.
3. The Office of the Civil Defense

The Office of Civil Defense (OCD), as the implementing arm of the

National Disaster Risk Reduction and Management Council, shall have the
primary mission of administering a comprehensive national civil defense and
disaster risk reduction and management program by providing leadership in
the continuous development of strategic and systematic approaches as well
as measures to reduce the vulnerabilities and risks to hazards and manage
the consequences of disasters. Its mission is to administer a comprehensive
civil defense and disaster risk reduction and management program towards a
safer and resilient community. The vision is by 2022, OCD is a fully
capacitated agency that leads the implementation of an integrated civil
defense and DRRM Program.

4. Organizational Network

The Philippine Disaster Management System (PDMS), as embodied in

PD 1566 and RA 10121, is carried out at various political subdivision and
administrative regions of the country through the National Disaster Risk
Reduction and Management Council (NDRRMC), 17 Regional Disaster Risk
Reduction and Management Council (RDRRMC), 80 Provincial Disaster Risk
Reduction and Management Council (PDRRMC), 113 City Disaster Risk
Reduction and Management Council (CDRRMC) 1,496 D Municipal Disaster
Risk Reduction and Management Council (MDRRMC), and 41,956 Barangay
Disaster Risk Reduction and Management Council (BDRRMC) respectively.

Lesson 4. Disaster Risk Reduction and Management Concept, Principles and

Trends
 Disaster risk reduction (DRR) is a systematic approach to identifying,
assessing and reducing the risks of disaster. It aims to reduce socio-economic
vulnerabilities to disaster as well as dealing with the environmental and other
hazards that trigger them. It should be an integral part of the way such
organizations do their work, not an add-on or one-off action. DRR is very wide
ranging: Its scope is much broader and deeper than conventional emergency
management. There is potential for DRR initiatives in just about every sector of
development and humanitarian work.

Disaster risk reduction (DRR) is a term used for reducing and preventing
disaster risks. It is founded on the principle that while hazards are inevitable, its
adverse effects like lost lives and/or destruction of property are not. There are
steps that we can do to ensure reduction of risks. DRR actions can be political,
technical, social and economic.

1. Definition of Disaster Management Terms.

a. Hazards. Defined as a ―dangerous phenomenon, substance, human

activity or condition that may cause loss of life, injury or other health impacts,
property damage, loss of livelihoods and services, social and economic
disruption, or environmental damage‖.

b. Risks. Refers to the potential (not actual) disaster losses, in lives,

health status, livelihoods, assets and services, which could occur in a
particular community or society over some specified future time period.

c. Vulnerability. Vulnerability is a set of prevailing or consequential

conditions arising from various physical, social, economic and environmental
factors which increase the susceptibility of a community to the impact of
hazards Vulnerability also comprise various physical, social, economic,
political and environmental factors that affect the ability of communities to
respond to events.

d. Disasters. a serious disruption of the functioning of a community or a

society involving widespread human, material, economic or environmental
losses and impacts, which exceeds the ability of the affected community or
society to cope using its own resources.

Disasters are often described as a result of the combination of several

things: the exposure to a hazard; the conditions of vulnerability that are
present; and insufficient capacity or measures to reduce or cope with the
potential negative consequences.

Effect of Disasters
 1. Human toll; dead, injured and missing.

2. Community displaced

3. Lost sources of livelihoods

4. Environmental damages

5. Infrastructure damages
6. Economic losses
7. Hampered delivery of services
2. The Disaster Equation

∙ Hazards (H), Physical impact of disturbance

∙ Risk ®, Likelihood of harm, loss, disaster
∙ People or Community (Exposure), Elements affected by Hazard ∙
Vulnerability (V), Susceptibility and capacity to prepare, absorb
and recover from hazard

H x R + V = Disaster

Where:

∙ Hazards (H)
∙ Risk (R)
∙ People or Community
∙ Vulnerability (V)
∙ Exposure, Elements affected by hazard

∙ Hazards- a dangerous phenomenon, substance, human activity or condition that

may cause loss of life, injury or other health impacts, property damage, loss of
livelihood and services, social and economic disruption or environmental
damage.

Natural Hazards Human induced hazards 1. Typhoon 1. Civil

disturbance
2. Thunderstorm 2. Armed conflict
3. Flood/Flashflood 3. Terrorism
4. Hailstorm 4. Aircraft crash
5. Tornado 5. Industrial accidents
6.Storm Surge 6. Maritime accidents
7.Lighting 7. Fire
8. Landslide 8. Pollution
9.Tsunami
 10.Volcanic eruption
11. Earthquake
12. Drought
13. Biological
∙ Exposure – defined as ― the people, property, system or other elements present
in hazard zones that are thereby subject to potential losses.

Philippine Risk profile

⮚ Located in the Pacific ring of fire- earthquake and volcanic eruption ⮚ Lies
along the western part of pacific ocean (pacific typhoon belt)- typhoons

∙ Vulnerability – the diminished capacity of an individual or group to anticipate,

copes with, resist and recover from the impact of a natural or manmade hazard. *
Capacity – combination of all the strengths, attributes and resources available within a
community, society or organization.

Disaster Prevention and Mitigation

Measures are needed to be drawn to minimize the loss and destruction of

life and property. These include the formulation and implementation of long term
policies and programs to prevent or eliminate the occurrence of disaster based
on risk analysis.
The measure covers legislation and regulatory measures principally in the
fields of physical and urban planning, public works, and construction. Drills and
shelters for times of disaster are also needed.
Among the activities that may minimize the impact of disaster are:
1. Identification of areas prone to typhoon and some other
calamities. 2. Display and teaching of structural improvements.
3. Preparation of educational materials.
4. Community system
5. Media liaison.

3. Disaster Risk Management: What and Who

Disaster risk reduction and management (DRRM) includes administrative

decisions and operational activities that involve:

a. Prevention
b. Mitigation
c. Preparedness
d. Response
e. Recovery
f. Rehabilitation
4. Disaster Risk Management Cycle
 The disaster life cycle describes the process through which
emergency managers prepare for emergencies and disasters, respond to
them when they occur, help people and institutions recover from them,
mitigate their effects, reduce risks of loss and prevent disasters from
occurring.

The Disaster Management Cycle is shown in the figure below.

∙ Mitigation. Measures put in place to minimize the results from a disaster.

Examples: building codes and zoning; vulnerability analyses;
public education.

∙ Preparedness. Planning how to respond.

Examples: preparedness plans; emergency exercises/training;

warning systems.
∙ Response. Initial actions taken as the event takes place. It involves efforts
to minimize the hazards created by a disaster.

Examples: evacuation; search and rescue; emergency relief. }

∙ Recovery. Returning the community to normal. Ideally, the affected area

should be put in a condition equal to or better than it was before the
 disaster took place.

Examples: temporary housing; grants; medical care.

Disaster Prevention and Mitigation

Measures are needed to be drawn to minimize the loss and destruction of

life and property. These include the formulation and implementation of long term
policies and programs to prevent or eliminate the occurrence of disaster based
on risk analysis.
The measure covers legislation and regulatory measures principally in the
fields of physical and urban planning, public works, and construction. Drills and
shelters for times of disaster are also needed.
Among the activities that may minimize the impact of disaster are: 1.
Identification of areas prone to typhoon and some other calamities. 2.
Display and teaching of structural improvements.
3. Preparation of educational materials.
4. Community system
5. Media liaison.

Disaster Preparedness

Certain principles of disaster preparedness will guide us to be more

responsive and alert in times of crisis.
1. Principles
a. The risk must be known.
* Potential hazards must identified
* Incidence of hazards occurrence must be calculated
* Secondary risk must be identified
b. Vulnerability must be known
* Who and what are the risks must be determined
*Likely damage and disruption must be assessed
*human needs must be anticipated
c. Mitigation system must be in place
*Structural mitigation must be built
*Nonstructural mitigation measure must be installed
d. Preparedness system must be in readiness.
*All parties should be in state of readiness.
*A focal point for preparedness must exist
*A management system for emergency response must be in
place.
* Training, drills and practice must be routine.
*Effective warning system must be on alert.
*Authorities and public must be fully informed.
2. Effective warning Message
a. Clear, simple language
b. Consistent context
c. Convincing
 d. community- include clearly state precaution and action.
e. Repetitiveness
3. Risk Zoning.
a. Survey of mountainsides, riverbanks, coastal areas for their
suitability as housing sites, farming, mining, and any other
productive activities.
b. Rational plans for urban centers, forest preservation and some
other nature conservation measures.
c. Building codes regulating height, type of materials, and any other
specification for structures, particularly in risk areas.
4. Public awareness
a. Mitigation Awareness. When risk is high but perception
preparedness is low, people need technical explanation
about causes, possible and mitigating strategies.
b. Preparedness Awareness. When a risk is imminent, the
community needs detailed explanation of what is going to happen
and how, and what to and what not to do.
c. Emergency Response awareness. After the disaster has struck,
people need to know what to do next.

5. Rationale for Risk Management

a. Comprehensive risk management process has the potential to break

the cycle of damage and reconstruction when a community is
subjected to repeated natural hazards.
b. To be effective, a strategy must be in place and ready for immediate
implementation when necessary.
c. This can only be done through advance preparation and planning.

6. Disaster Risk Management Objectives

a. Reduce vulnerabilities in the community.

b. When sustained over a long term, reduce unacceptable risk to
acceptable levels and make the community become disaster
resistant/resilient.
7. Range of Risk Management Measures

1. Engineering measures (keep hazard away from people)

2. Land use planning and management measures 9keep people away
from hazard)
3. Control and protection works (modifying the hazard)
4. Early warning (predicting hazard)
5. Preparedness planning (prepare in anticipation of a hazard event) 6.
Reconstruction planning after a disaster with the aim of reducing the
vulnerability
7. Mainstreaming risk management in development practice and
 institutionalization.

Lesson 5. Role of Youth in Disaster Preparedness and Management, Basic

Disaster Preparedness, and Response Training

1. First Aid /and other Basic Life Support

What is first aid?

First aid refers to the emergency or immediate care you should provide
when a person is injured or ill until full medical treatment is available. For minor
conditions, first aid care may be enough. For serious problems, first aid care
should be continued until more advanced care becomes available.
The decision to act appropriately with first aid can mean the
difference between life and death. Begin by introducing yourself to the
injured or ill person. Explain that you are a first aid provider and are willing
to help. The person must give you permission to help them; do not touch
them until they agree to be helped. If you encounter a confused person or
someone who is critically injured or ill, you can assume that they would
want you to help them. This is known as “implied consent.”

What are first aid basics?

The first step in any emergency is the recognition of the problem and
providing help. When in doubt or when someone is seriously injured or ill, you
should always activate the emergency response system. If you’re not sure how
serious the situation is, the operator will ask you a series of questions to
determine the seriousness of it.

Remain on the line until additional help arrives, or until the operator tells
you to hang up. Emergency system dispatchers can guide you through the steps
of performing cardiopulmonary resuscitation (CPR), using an automatic external
defibrillator (AED), or delivering basic care until additional help arrives.

Whether you are at home, work, or school, know where the first aid kit and
the AED are kept and be familiar with their contents. Know how to activate the
emergency response system. Be aware of any policies in the workplace
regarding medical emergencies.

After determining the problem, the next step in providing help is to

determine the unresponsiveness of the injured or ill person. The best way to
determine this is to tap the person and talk loudly to them: ―Are you okay?‖ After
determining unresponsiveness, yell for help. Look for any medical identifications,
such as a necklace or a bracelet. This may provide a valuable clue to the cause
of the situation. One set of goals to keep in mind for first aid would be what we
like to call the ―Three P’s.‖
 ∙ Preserve life – your main goal should be to keep the person alive. ∙ Prevent
further injury – keep the injured person safe and frombecoming injured any
more. It is always recommended that you do not move them until help
arrives.
∙ Promote recovery – try to help fix their injuries as best as you can.

What is Basic Life Support?

Basic Life Support, or BLS, generally refers to the type of care that first -
responders, healthcare providers and public safety professionals provide to
anyone who is experiencing cardiac arrest, respiratory distress or an obstructed
airway. It requires knowledge and skills in cardiopulmonary resuscitation (CPR),
using automated external defibrillators (AED) and relieving airway obstructions in
patients of every age.
Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in
many emergencies, including a heart attack or near drowning, in which
someone's breathing or heartbeat has stopped. The American Heart Association
recommends that everyone — untrained bystanders and medical personnel alike
— begin CPR with chest compressions.
It's far better to do something than to do nothing at all if you're fearful that
your knowledge or abilities aren't 100 percent complete. Remember, the
difference between your doing something and doing nothing could be someone's
life.
Here's advice from the American Heart Association:

∙ Untrained. If you're not trained in CPR, then provide hands-only CPR. That
means uninterrupted chest compressions of 100 to 120 a minute until
paramedics arrive (described in more detail below). You don't need to try
rescue breathing.
∙ Trained and ready to go. If you're well-trained and confident in your ability,
check to see if there is a pulse and breathing. If there is no breathing or a
pulse within 10 seconds, begin chest compressions. Start CPR with 30 chest
compressions before giving two rescue breaths.
∙ Trained but rusty. If you've previously received CPR training but you're not
confident in your abilities, then just do chest compressions at a rate of 100 to
120 a minute. (Details described below.)

The above advice applies to adults, children and infants needing CPR, but
not newborns (infants up to 4 weeks old).
CPR can keep oxygenated blood flowing to the brain and other vital organs
until more definitive medical treatment can restore a normal heart rhythm.
When the heart stops, the lack of oxygenated blood can cause brain
damage in only a few minutes. A person may die within eight to 10 minutes.
 To learn CPR properly, take an accredited first-aid training course, including
CPR and how to use an automated external defibrillator (AED). If you are
untrained and have immediate access to a phone, call your local emergency
number before beginning CPR. The dispatcher can instruct you in the proper
procedures until help arrives.

Before you begin

Before starting CPR, check:

∙ Is the environment safe for the person?

∙ Is the person conscious or unconscious?
∙ If the person appears unconscious, tap or
shake his or her shoulder and ask
loudly, "Are you OK?"
∙ If the person doesn't respond and two people are available, have one person
call 911 or the local emergency number and get the AED, if one is available,
and have the other person begin CPR.
∙ If you are alone and have immediate access to a telephone, call 911 or your
local emergency number before beginning CPR. Get the AED, if one is
available.
∙ As soon as an AED is available, deliver one shock if instructed by the device,
then begin CPR.
Remember to spell C-A-B

The American Heart Association uses the letters C-A-B —

compressions, airway, breathing — to help people remember the order to
perform the steps of CPR.

Compressions: Restore blood circulation

1. Put the person on his or her back on a firm surface.

2. Kneel next to the person's neck and shoulders.
3. Place the heel of one hand over the center of the
person's chest, between the nipples. Place your other
hand on top of the first hand. Keep your elbows straight
and position your shoulders directly above your hands.
4. Use your upper body weight (not just your arms) as you
 push straight down on (compress) the chest at least 2
inches (approximately 5 centimeters) but not greater than
2.4 inches (approximately 6 centimeters). Push hard at a
rate of100 to 120 compressions a minute.
5. If you haven't been trained in CPR, continue chest
compressions until there are signs of movement or until
emergency medical personnel take over. If you have
been trained in CPR, go on to opening the airway and
rescue breathing.

Airway: Open the airway

∙ If you're trained in CPR and you've performed 30 chest

compressions, open the person's airway using the head-tilt,
chin-lift maneuver. Put your palm on the person's forehead
and gently tilt the head back. Then with the other hand, gently
lift the chin forward to open the airway.

Breathing: Breathe for the person

Rescue breathing can be mouth-to-mouth breathing or mouth

to-nose breathing if the mouth is seriously injured or can't be
opened.

1. With the airway open (using the head-tilt, chin-lift maneuver),

pinch the nostrils shut for mouth-to-mouth breathing and
cover the person's mouth with yours, making a seal.
2. Prepare to give two rescue breaths. Give the first rescue
breath — lasting one second — and watch to see if the
chest rises. If it does rise, give the second breath. If the
chest doesn't rise, repeat the head-tilt, chin-lift maneuver
and then give the second breath. Thirty chest compressions
 followed by two rescue breaths is considered one cycle. Be
careful not to provide too many breaths or to breathe with
too much force.
3. Resume chest compressions to restore circulation.
4. As soon as an automated external defibrillator (AED) is
available, apply it and follow the prompts. Administer one
shock, then resume CPR — starting with chest
compressions — for two more minutes before administering
a second shock. If you're not trained to use an AED, a 911
or other emergency medical operator may be able to guide
you in its use. If an AED isn't available, go to step 5 below.
5. Continue CPR until there are signs of movement or
emergency medical personnel take over.