Cert Ig Unit3 Jan20112

UNIT 3: DISASTER MEDICAL
OPERATIONS PART 1
In this unit you will learn about:
Life-Threatening Conditions: How to recognize and treat an airway

obstruction, bleeding, and shock.
Triage: Principles of triage and how to conduct triage evaluations.
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COMMUNITY EMERGENCY RESPONSE TEAM

UNIT 3: DISASTER MEDICAL OPERATIONS PART 1
OBJECTIVES
At the conclusion of this unit, the participants should be able to:
SCOPE
Identify the killers.

Apply techniques for opening airways, controlling bleeding, and
treating for shock.
Conduct triage under simulated disaster conditions.
The scope of this unit will include:
ESTIMATED
Introduction and Unit Overview

Treating Life-Threatening Conditions
Triage
Unit Summary
2 hours 30 minutes
COMP
LETIO
N
TIME
CERT BASIC TRAINING: INSTRUCTOR GUIDE
JANUARY 2011
PAGE 3-1

TRAINING
METH
ODS
The lead instructor will begin this session by welcoming the

participants to Unit 3: Disaster Medical Operations Part 1, and
will introduce the instructors for the session. The instructor will then
provide an overview of the topics included in the unit: Treatment of
life-threatening conditions that may be encountered (airway
obstruction, bleeding, and shock) and conducting triage.
Next, the instructor will discuss and demonstrate the immediate
procedures required for opening the airway, controlling bleeding, and
treating for shock. The participants will have the opportunity to
practice techniques for treating each of these conditions. During this
period, some discussion will take place about the differences
between disaster medical operations and the participants image of
everyday first aid. (For example, mouth-to-mouth resuscitation and
cardiopulmonary resuscitation [CPR] lose some of their importance
in disaster situations when there are multiple casualties needing
immediate attention and limited resources.)
The next topic of this session will deal with triage. The instructor will
open with a discussion of what triage is, when it is used, and the four
categories into which victims are sorted. The instructor then explains
the 6 steps of using triage in a disaster environment.
TRAINING
METH
ODS
(CON
TINUE
D)
RESOURCES
REQU
IRED
OTHER
RESO
URCE
S
PAGE 3-2
Finally, the participants will practice triage evaluation and immediate

treatment in a multi-casualty exercise. This exercise will illustrate the
need to conduct triage effectively and expeditiously under pressure
and to focus on rescuer safety.
Community Emergency Response Team Instructor Guide

Community Emergency Response Team Participant Manual
PowerPoint slides 3-0 through 3-27
If time permits, the 23-minute video, CERT Triage: Handling Mass

Causality Situations, is recommended for this unit. The video
portrays triage procedures and treatment of obstructed airway,
uncontrolled bleeding, and shock, as well as sizeup and rescuer
safety. The video is available for download at the national CERT
Web site: www.citizencorps.gov/cert/
JANUARY 2011

EQUIPMENT
In addition to the equipment listed at the front of this instructor Guide,

you will need the following equipment for this unit:
PREPARATION
A computer with PowerPoint software

A computer projector and screen
One mannequin
Non-latex examination gloves (1 pair for each participant)
One can of shaving cream
4- by 4-inch dressings (1 dressing for every 2 students)
Note cards, markers, and masking tape
Triage Exercise
The triage exercise near the end of this session requires materials
prepared in advance of the activity.
Before the session, prepare victim status cards, each documenting
the status of one disaster victim. Create at least 1 victim description
for every 3 participants in the group (e.g., 7 different descriptions for
a group of 21 participants). Make three sets of the victim status
cards.
JANUARY 2011
PAGE 3-3

PREPARATION
(CON
TINUE
D)
Sample victim status descriptions
Victim #1:
Ambulatory responds to voice triage

Minor bleeding
Normal blanch
Victim #2:
Bleeding extremity
Unconscious
After two attempts to open airway, still not
breathing
Victim #3:
Victim #4:
Standing, but does not respond to voice

commands
No signs of bleeding
Unconscious
Blanch takes 5 seconds
Victim #5:
No bleeding
Conscious
Doesnt squeeze hand when asked
Victim #6:
Minor bleeding
Conscious but disoriented
Breathing rate is 40 per minute
Culturally Sensitive Topics

Working with a representative of the community in which you will be
teaching, identify any potentially culturally sensitive topics in this
module. This module features a variety of topics that may require
care in how they are presented, including the prioritization of injury
required to conduct triage. Some content in this unit discusses
touching victims (also featured in the end-of-unit role-playing
activity), an activity that may be uncomfortable to some cultures or
individuals.
Develop strategies for presenting any such topics in ways that will
engage, rather than offend, participants.
PAGE 3-4
JANUARY 2011

NOTES
A suggested time plan for this unit is as follows:

Introduction and Unit Overview............................................10 minutes
Treating Life-Threatening Conditions..................................90 minutes
Triage...................................................................................45 minutes
Unit Summary........................................................................5 minutes
Total Time: 2 hours 30 minutes
REMARKS
Be sure to emphasize throughout the session the importance of

rescuer safety (e.g., using safety equipment, working with a buddy,
and doing a thorough sizeup). These points cannot be made too
often or too strongly. CERT members cannot help anyone if they
become victims.
JANUARY 2011
PAGE 3-5

Unit 3: Disaster Medical Operations

Part I
INSTRUCTOR GUIDANCE
CONTENT
Introduction and Overview

Welcome
Introduce this unit by welcoming the participants to
Unit 3 of the CERT Basic Training.
Display Slide 3-0
Introduce the new instructors for this unit and ask each
to describe briefly his or her experience in medical
operations.
Briefly review the fire safety lesson.
What are the five classes of fire?
Correct responses:
Class A Fires: Ordinary

combustibles such as
paper, cloth, wood, rubber,
and many plastics
Class B Fires: Flammable

liquids (e.g., oils, gasoline)
and combustible liquids
(e.g., charcoal lighter fluid,
kerosene)
Class C Fires: Energized

electrical equipment (e.g.,
wiring, motors) .
PAGE 3-6
JANUARY 2011

INSTRUCTOR GUIDANCE
Class D Fires:
Combustible metals (e.g.,
aluminum, magnesium,
titanium)
Class K Fires: Cooking oils

in restaurants and
cafeterias (e.g., vegetable
oils, animal oils, fats). This
does not apply to
residential kitchens.
CONTENT
Remind participants that the method used to

extinguish each must be appropriate for the type of
fire.
Before making the decision to extinguish a fire,
CERTs should complete a thorough sizeup. What
are the 9 sizeup steps in the right order?
Correct response:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Gather Facts
Assess and Communicate
Consider Probabilities
Assess Your Own Situation
Establish Priorities
Make Decisions
Develop Plan of Action
Take Action
Evaluate Progress
Should CERTs enter a smoke-filled building?
Correct response:
Never.
JANUARY 2011
PAGE 3-7

INSTRUCTOR GUIDANCE
CONTENT
There are some questions we need to ask to
decide whether to extinguish a fire. What are
they?
Correct responses:
Can I escape quickly and

safely from the area if I
attempt to extinguish the
fire? (The first priority for
you and your buddy is
safety.)
Do I have the right type of

extinguisher?
Is the extinguisher large

enough for the fire?
Is the area free from other

dangers, such as
hazardous materials and
falling debris?
Is the fire extinguished in 5

seconds?
How should CERT members treat a hazardous
material placard?
Correct response:
As a stop sign
Answer any questions that the students may have
about fire safety. Then continue with the session.
PAGE 3-8
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Explain that the need for CERT members to learn
disaster medical operations is based on two
assumptions:
The number of victims could exceed the local

capacity for treatment.
Survivors will attempt to assist others. CERT

members will need to know lifesaving first aid or
post-disaster survival techniques.
Display Slide 3-1

Emphasize the need for CERT medical operations by
describing the phases of death from trauma:
1. Phase 1: Death within minutes as a result of
overwhelming and irreversible damage to vital
organs
2. Phase 2: Death within several hours as a result
of excessive bleeding
3. Phase 3: Death in several days or weeks as a
result of infection or multiple-organ failure (i.e.,
complications from an injury)
Display Slide 3-2
Explain that these phases underlie why disaster

medical operations are conducted as they are (by
identifying those with the most serious injuries as soon
as possible and treating those with life-threatening
injuries first).
Point out that some disaster victims in the second and
third phases of death could be saved by providing
simple medical care.
JANUARY 2011
PAGE 3-9

INSTRUCTOR GUIDANCE
CONTENT
Add that in a disaster, there may be more victims than
rescuers, and assistance from medical professionals
may not be immediately available. CERT personnel
are trained to be part of disaster medical operations
and to provide:
Display Slide 3-3
Treatment for life-threatening conditions airway

obstruction, bleeding, and shock and for other,
less urgent conditions
The greatest good for the greatest number of

people by conducting simple triage and rapid
treatment
START
Explain that Simple Triage And Rapid Treatment
(START) is a critical concept for initially dealing with
casualties in a disaster.
Display Slide 3-4
History has proven that 40% of disaster victims can be

saved with simple (rapid!) medical care. START is
based on the premise that a simple medical
assessment and rapid treatment based on that
assessment will yield positive often lifesaving
results.
STart = Simple Triage: The first phase of START is
the process by which victims are sorted based on
injury and priority of treatment.
stART = And Rapid Treatment: The second phase of
START consists of rapid treatment of the injuries
assessed and prioritized in the first phase.
Poll the group to see how many have taken first aid
courses.
PAGE 3-10
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Explain that all CERT participants are encouraged to
take basic first aid and CPR training; however, those
who have taken first aid courses will need to
understand that CERT covers disaster medical
operations where time is critical to conduct triage and
treat many victims. CPR is not taught in this course
because it is labor intensive and not appropriate when
there are many victims and professional help will be
delayed.
Unit Objectives
Tell the group that at the end of this unit, they should
be able to:
Identify the killers.
Apply techniques for opening the airway,

controlling bleeding, and treating for shock.
Conduct triage under simulated disaster

conditions.
Display Slide 3-5
Stress once more that the goal of disaster medical

operations is to do the greatest good for the greatest
number. In a disaster with many victims, time will be
critical. CERT members will need to work quickly and
efficiently to help as many victims as possible.
JANUARY 2011
PAGE 3-11

INSTRUCTOR GUIDANCE
CONTENT
Unit Topics
Reiterate that this session will introduce the
participants to the principles of triage, including
treating the three killers: airway obstruction,
excessive bleeding, and shock.
Tell the group that, throughout the unit, they will have
opportunities to practice the treatment techniques and,
at the end of the unit, they will have the opportunity to
conduct triage evaluations in a simulated disaster.
Display Slide 3-6
PAGE 3-12
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Treating Life-Threatening Conditions

Introduce this section by telling the group that, in
emergency medicine, airway obstruction, bleeding,
and shock are killers because without treatment they
will lead to death. The first priority of medical
operations is to attend to those potential killers by:
Display Slide 3-7
Opening the airway
Controlling excessive bleeding
Treating for shock
Explain that this section will train the group to

recognize the killers by recognizing their symptoms
and their effects on the body.
Approaching the Victim

Discuss some general guidelines on how to approach
a victim.
Emphasize that rescuers must first ensure that they
are wearing safety equipment:
Helmet
Goggles
Gloves
N95 mask
Sturdy shoes or boots
Non-latex exam gloves
JANUARY 2011
PAGE 3-13

INSTRUCTOR GUIDANCE
CONTENT
Tell them that a time-saving technique is to wear nonlatex exam gloves under their work gloves. Then,
when they find a victim, they can remove their work
gloves and are ready to work with the victim.
Remind participants to use non-latex exam gloves to
prevent potential reaction by individuals who are
allergic to latex.
Explain to the group that there are several steps to
take when approaching a victim. When ready to
approach a victim:
1.
If the victim is conscious, be sure he or she can

see you.
2.
Identify yourself by giving your name and

indicating the organization with which you are
affiliated.
3.
ALWAYS request permission to treat an

individual. If the individual is unconscious, he or
she is assumed to have given implied consent,
and you may treat him or her. Ask a parent or
guardian for permission to treat a child, if possible.
4.
Whenever possible, respect cultural

differences. For example, in some Muslim
traditions it is customary to address the male when
requesting permission to treat a female member of
his family.
5.
Remember, all medical patients are legally

entitled to confidentiality (HIPAA). When dealing
with victims, always be mindful and respectful of
the privacy of their medical condition.
Display Slide 3-8
PAGE 3-14
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Opening the Airway

Explain that the respiratory system includes the
following components:
Display Slide 3-9
Lung
Bronchus
Larynx
Pharynx
Nasal Cavity
Trachea
Does anyone know what the most common airway

obstruction is?
If not mentioned, tell the group that the most common
airway obstruction is the tongue.
Display Slide 3-10
PM, P. 3-6
Explain that, in an unconscious or semiconscious

victim, especially one positioned on his or her back,
the most common airway obstruction is the tongue.
The tongue which is a muscle may relax and
block the airway. A victim with a suspected airway
obstruction must be checked immediately for
breathing and, if necessary, the airway must be
opened.
Refer the participants to the illustration titled Airway

Obstructed by the Tongue in the Participant Manual.
JANUARY 2011
PAGE 3-15

INSTRUCTOR GUIDANCE
PAGE 3-16
CONTENT
JANUARY 2011

PM, P. 3-6
Airway Obstructed by the Tongue
JANUARY 2011
PAGE 3-17

INSTRUCTOR GUIDANCE
CONTENT
The Head-Tilt/Chin-Lift Method
Explain that, when an airway obstruction is suspected,
because a victim is unconscious or semiconscious,
CERT members should clear the airway using the
Head-Tilt/Chin-Lift method.
Display Slide 3-11

PM, P. 3-7
Refer the participants to the table titled Head-Tilt/ChinLift Method for Opening an Airway in the Participant
Manual.
Explain that in addition to opening the airway, this
method causes little or no cervical-spine manipulation
because only the head is manipulated.
Mention that the proper technique is important in
opening an airway, but so is speed if there are multiple
victims.
Demonstrate each step slowly

using an instructor or
participant as the victim. Be
sure to wear gloves to
reinforce the need for
protective equipment.
PAGE 3-18
This method involves the following 7 steps:
Step 1: Positioning oneself at an arms distance,

make contact with the victim and ask, Can you
hear me? Speak loudly but do not yell.
Step 2: If the victim does not or cannot respond,

place the palm of one hand on the victims
forehead.
Step 3: Place two fingers of the other hand under

the chin and tilt the jaw upward while tilting the
head backward slightly.
Step 4: Place your ear close to the victims mouth,

looking toward the victims feet, and place a hand
on the victims abdomen.
Step 5: Look for chest rise.
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Step 6: Listen for air exchange.
If possible, demonstrate
abnormal lung sounds.
Indicate that when listening for air exchange, a

CERT member should document abnormal lung
sounds (wheezing, gasping, gurgling, etc).
Appearance of any sound that is not normal
raises the victims status to I. Remind the
participants that it is NOT their duty to diagnose
based on those signs.
Step 7: Feel for abdominal movement.
Step 8: If breathing has been restored, the clear

airway must be maintained by keeping the head
tilted back. If breathing has not been restored,
repeat steps 2-7.
JANUARY 2011
PAGE 3-19

PM, P. 3-7
Head-Tilt/Chin-Lift Method for Opening an Airway
Step
PAGE 3-20
Action
At an arms distance, make contact with the victim by touching

the shoulder and asking, Can you hear me? Speak loudly, but
do not yell.
If the victim does not or cannot respond, place the palm of one
hand on the forehead.
Place two fingers of the other hand under the chin and tilt the jaw
upward while tilting the head back slightly.
Place your ear close to the victims mouth, looking toward the
victims feet, and place a hand on the victims abdomen.
Look for chest rise.
Listen for air exchange.

Document abnormal lung sounds (wheezing, gasping,
gurgling, etc.).
Feel for abdominal movement.
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Exercise: Opening the Airway
Teach this skill in accordance

with your local protocols.
It is important to have other
instructors who can help
observe. Make sure that you
all agree on the proper
procedure.
Procedure: Explain that this exercise allows the

participants in pairs to practice using the Head-Tilt/ChinLift method on each other.
After all of the participants have had the opportunity to
be the rescuer, discuss any problems or incorrect
techniques that were observed. Explain how to avoid
these problems in the future.
Instructions: Follow the steps below to conduct this
exercise:
1. Assign the group to work in pairs.
2. Ask the person on the right to be the victim and the
person on the left to be the rescuer.
3. Ask the victims to lie on the floor on their backs and
close their eyes.
4. Ask the rescuer to use the Head-Tilt/Chin-Lift method
on the victim to open the airway.
5. After the rescuer has made two or three attempts at
using the Head-Tilt/Chin-Lift method, ask the victim
and the rescuer to change roles.
6. Allow each rescuer two or three observed attempts to
use the Head-Tilt/Chin-Lift method.
Observe each pair and correct improper technique.
After all of the participants have had the opportunity to
be the rescuer, discuss any problems or incorrect
techniques that were observed. Explain how to avoid
these problems in the future.
JANUARY 2011
PAGE 3-21

INSTRUCTOR GUIDANCE
CONTENT
Maintaining the Airway
Demonstrate both techniques.
Tell the group that, if breathing has been restored, the

clear airway still must be maintained. One option is to
ask another person to hold the head in place; even
another victim with minor injuries could do this. The
airway also can be maintained by placing soft objects
under the victims shoulders to elevate the shoulders
slightly and keep the airway open.
Remind the participants that part of their mission is to do
the greatest good for the greatest number of people. For
that reason, if breathing is not restored on the first try
using the Head-Tilt/Chin-Lift method, CERT members
should try again using the same method. If breathing
cannot be restored on the second try, CERT members
must move on to the next victim.
Explain that head injury

refers to concussion, not head
or facial cuts, although these
may be indicators of head
injury.
Tell the group that they should always be concerned with

head, neck, or spinal injuries (all of which are common in
structural collapses). Used properly, the Head-Tilt/ChinLift method for opening an airway causes little spinal
manipulation because the head pivots on the spine.
Remind the group of the importance of opening the
airway as quickly as possible. Emphasize that, in
treating the three killers, checking for airway obstruction
is always first.
Does anyone have any questions about recognizing
and clearing airway obstructions?
Tell the participants that in the next section, they will
learn to recognize and treat uncontrolled bleeding.
PAGE 3-22
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Controlling Bleeding
Show the class a 1-liter bottle

to illustrate this learning point.
Introduce this section by telling the group that

uncontrolled bleeding initially causes weakness. If
bleeding is not controlled, the victim will go into shock
within a short period of time and finally will die. An adult
has about 5 liters of blood. Losing 1 liter can result in
death.
Explain to the group that there are three types of
bleeding and the type can usually be identified by how
fast the blood flows:
Arterial bleeding. Arteries transport blood under high

pressure. Blood coming from an artery will spurt.
Venous bleeding. Veins transport blood under low

pressure. Blood coming from a vein will flow.
Capillary bleeding. Capillaries also carry blood under

low pressure. Blood coming from capillaries will
ooze.
Display Slides 3-12 and 3-13
JANUARY 2011
PAGE 3-23

INSTRUCTOR GUIDANCE
CONTENT
Tell the group that there are three main methods for
controlling bleeding:
Direct pressure
Elevation
Pressure points
Explain that direct pressure and elevation will control

bleeding in 95% of cases.
Display Slide 3-14
PM, P. 3-10
PAGE 3-24
Refer the participants to the table titled Procedures for

Controlling Bleeding in the Participant Manual.
JANUARY 2011

PM, P. 3-10
Procedures for Controlling Bleeding
Method
Direct Pressure
Procedures
Place direct pressure over the wound by putting a clean

dressing over the wound and pressing firmly.
Maintain pressure on the dressing over the wound by

wrapping the wound firmly with a pressure bandage and
tying with a bow.
Elevation
Elevate the wound above the level of the heart.
Pressure Points
Put pressure on the nearest pressure point to slow the flow

of blood to the wound. Use the:
Brachial point for bleeding in the arm
Femoral point for bleeding in the leg
Popliteal point for bleeding in the lower leg
JANUARY 2011
PAGE 3-25

INSTRUCTOR GUIDANCE
CONTENT
Direct Pressure
Demonstrate each procedure

on the mannequin or on
another instructor.
Demonstrate the procedure for controlling bleeding

through direct pressure:
Step 1: Place direct pressure over the wound by

putting a clean dressing over it and pressing firmly.
Step 2: Maintain pressure on the dressing over the

wound by wrapping it firmly with a bandage.
Stress that direct pressure and elevation can take 5 to

7 minutes to stop the bleeding completely. The use of
a dressing and pressure bandage allows the rescuer
to move on to the next victim.
Explain that a pressure bandage should be tied with a
bow, so that it can be loosened rather than cut to
examine the wound, and then retied. This procedure
helps to conserve supplies and saves time.
Explain that the bandage maintains the direct pressure
needed to stop the bleeding. CERT members
continue to assess the victims status. If the victims
limb is turning blue or becoming numb below the
bandage, then it should be loosened.
Demonstrate the procedure for
controlling bleeding through
elevation.
Elevation
Explain that elevation can be used in combination with
direct pressure.
Elevate the wound above the level of the heart.
PAGE 3-26
JANUARY 2011

INSTRUCTOR GUIDANCE
Demonstrate why elevation
works by asking the
participants to put their arms
straight up in the air over their
heads. Have them hold this
position for 20-30 seconds.
CONTENT
Emphasize that the body has great difficulty pumping
blood against gravity; therefore, elevating a wound
above the heart will decrease blood flow and loss of
blood through the wound.
Ask them how their fingers,

hands and arms feel. They
should feel cold, tingly, numb,
etc.
Pressure Points
Tell the participants that there are also pressure points
that can be used to stem the flow of bleeding.
Display Slide 3-15

Demonstrate use of the
brachial pressure point by
applying pressure to your own
arm. Explain that this
technique requires the
application of strong pressure.
Then, have the participants
apply pressure to their own
arms so that they can feel the
effect of this method.
Demonstrate where to find the pressure points. The

pressure points most often used are the:
Brachial point in the arm
Femoral point in the leg
Pressure point behind the knee
Explain that the pressure point to be used depends on

the location of the wound. The correct pressure point
will be between the wound and the heart.
JANUARY 2011
PAGE 3-27

INSTRUCTOR GUIDANCE
PM, P. 3-12
CONTENT
Refer the participants to the illustrations of these
pressure points and the figure titled Methods for
Controlling Bleeding in the Participant Manual.
Encourage the participants to get victims to help
themselves whenever possible by using any of these
methods to control bleeding.
Does anyone have any questions about controlling
bleeding?
PAGE 3-28
JANUARY 2011

PM, P. 3-12
Methods for Controlling Bleeding
JANUARY 2011
PAGE 3-29

INSTRUCTOR GUIDANCE
CONTENT
Exercise: Controlling Bleeding
participants to practice the techniques for controlling
bleeding on each other.
The participants will be divided into pairs. Each member
of the pair will practice applying a pressure bandage and
elevation.
exercise:
1. Assign the group to pairs.
2. Identify one person to be the victim and one person
to be the rescuer.
3. Ask the victims to lie on the floor on their backs and
close their eyes.
4. Ask the rescuer to use direct pressure to control
bleeding from a simulated wound on the right forearm
just below the elbow. Have the rescuer:
Apply a pressure bandage

Elevate the arm
Repeat these two steps
Repeat the two steps for speed
5. After the rescuer has made at least three attempts at

using each technique, ask the victim and the rescuer
to change roles. (Note: The three attempts should
emphasize a progression of slow to fast in applying
the skill.)
6. Observe each group and correct any improper
techniques. Common errors include bandages that
are too loose, tying a knot instead of a bow, or
elevation that cannot be maintained with comfort.
Allow each rescuer at least one observed attempt to use
each technique.
PAGE 3-30
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Tourniquets (Optional)
Note: This section on

tourniquets is optional and can
be added at the instructors
discretion.
Explain that CERTs will use direct pressure on pressure

points and elevation to manage most bleeding.
However, if bleeding cannot be stopped using these
methods and professionals are delayed in responding, a
tourniquet may be a viable option to save a person from
bleeding to death. However, a tourniquet is absolutely a
last resort (life or limb) when other preferred means have
failed to control bleeding in an arm or a leg.
While the use of a tourniquet is extremely rare, it may
have a use when part of an extremity is amputated or
crushed and bleeding cannot be stopped by any other
preferred means.
Explain the proper use of a tourniquet and demonstrate
its application, making the following points.
A tourniquet is a bandage which, when placed around

a limb and tightened, cuts off the blood supply to the
part of the limb beyond it.
A tourniquet can do harm to the limb, but it can halt

severe blood loss when all other means have failed
and professional help will not arrive in time to help
stop the bleeding before the person dies.
Use any long, flat, soft material (bandage, neck tie,

belt, or stocking). Do not use materials like rope,
wire, or string that can cut into the patients flesh.
JANUARY 2011
PAGE 3-31

INSTRUCTOR GUIDANCE
CONTENT
To tie a tourniquet:
1. Place the tourniquet between the wound and the
heart (for example, if the wound is on the wrist,
you would tie the tourniquet around the forearm).
2. Tie the piece of material around the limb.
3. Place a stick, pen, ruler, or other sturdy item
against the material and tie a knot around the
item, so that the item is knotted against the limb.
4. Use the stick or other item as a lever to twist the
knot more tightly against the limb, tightening the
bandage until the bleeding stops.
5. Tie one or both ends of the lever against the limb
to secure it and maintain pressure.
6. Mark the patient in an obvious way that indicates
that a tourniquet was used and include the time it
was applied.
7. Do not loosen a tourniquet once it has been
applied.
8. Only proper medical authorities should remove a
tourniquet.
Review
Reiterate the three main ways to control excessive
bleeding:
Direct pressure
Elevation
Pressure points
Stress that bleeding must be controlled as quickly as

possible so as not to endanger the victims life from
blood loss. Remind the group that they should always
wear their non-latex exam gloves, goggles, and an N95
mask as a protection against blood-borne pathogens,
such as hepatitis and HIV.
PAGE 3-32
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Does anyone have any questions about controlling
excessive bleeding?
Tell the group that the next section will deal with
recognizing and treating shock.
Recognizing and Treating Shock
Introduce this section by explaining that shock is a
condition that occurs when the body is not getting
enough blood flow. When blood doesnt circulate,
oxygen and other nutrients are not carried to tissues and
organs. Blood vessels begin to close and organs are
damaged and, if left untreated, will shut down completely.
Shock can worsen very rapidly.
Remaining in shock will lead to the death of:
Display Slide 3-16
Cells
Tissues
Entire organs
Tell the group that the main signs of shock that CERT
members should look for are:
Rapid and shallow breathing
Capillary refill of greater than 2 seconds
Failure to follow simple commands, such as

Squeeze my hand
Display Slide 3-17
JANUARY 2011
PAGE 3-33

INSTRUCTOR GUIDANCE
CONTENT
To demonstrate rapid, shallow Evaluate Breathing

breathing, ask two participants
Demonstrate rapid, shallow breathing.
to come to the front of the
room. Tell one to breathe
normally. Tell the other to
pant (i.e., 30 or more breaths
per minute). Point out the
audible difference to the class.
Make sure that the participant
who is panting is sitting during
the demonstration.
Evaluate Circulation
Ask the participants to check
their own capillary refill by
pushing down on the palm of
their hand and then releasing.
Tell them to watch what
happens. Ask one of the
participants to explain.
Emphasize that capillary refill
should occur within 2 seconds.
Ask participants to perform a
radial pulse test by placing
middle and ring finger over the
interior of their wrist where the
thumb meets the arm
Note that a normal pulse rate
is 60-100 beats per minute.
PAGE 3-34
Demonstrate capillary refill. Tell the group that this is

referred to as the blanch test. A good place to do this is
on the palm of the hand. The nail beds are sometimes
used.
Explain that the blanch test is not valid in children, and
that mental status should be used instead as the main
indicator.
Explain that another way to check for circulation is the

radial pulse test. Explain that this is an alternative to the
blanch test and can be used in the dark or where it is
cold.
Demonstrate how to find a radial pulse.
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Evaluate Mental Status
Explain that there are several ways to evaluate mental
status.
Ask, Are you okay?
Give a simple command such as Squeeze my hand.
If you are concerned that there might be a language

barrier or hearing impairment, reach out with both
hands and squeeze one of the victims hands. The
person will squeeze back if they can.
Treating for Shock

Remind the group that the body will initially compensate
for blood loss and mask the symptoms of shock;
therefore, shock is often difficult to diagnose. It is
possible and, in fact, common for an individual
suffering from shock to be fully coherent and not
complaining of pain. Pay attention to subtle clues, as
failure to recognize shock will have serious
consequences.
PM P. 3-17
Discuss the procedure for treating victims of shock.

Refer the participants to the chart titled Procedures for
Controlling Shock in the Participant Manual.
Step 1: Maintain an open airway.
Step 2: Control excessive bleeding.
Step 3: Maintain body temperature.
JANUARY 2011
PAGE 3-35

INSTRUCTOR GUIDANCE
CONTENT
Remind participants to avoid rough or excessive
handling. Stress the importance of maintaining the
victims body temperature. If necessary, place a blanket
or other material under and/or over the victim to provide
protection from extreme ground temperatures (hot or
cold). Position the victim on his or her back and elevate
the feet 6 to 10 inches above the level of the heart to
assist in bringing blood to the vital organs.
Emphasize that, although victims who are suffering from
shock may be thirsty, they should not eat or drink
anything initially because they may also be nauseated.
Does anyone have a question about the signs or
treatment of shock?
PM, P. 3-17
Procedures for Controlling Shock
Step
PAGE 3-36
Action
Maintain an open airway.
Control obvious bleeding.
Maintain body temperature

(e.g., cover the ground and the
victim with a blanket if
necessary).
Notes
Avoid rough or excessive

handling.
Do not provide food or drink.
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Exercise: Treating Shock
participants in pairs to practice the steps for treating
shock on each other.
Reiterate the key points about recognizing and
treating shock:
A victim may display one or more signs of shock.
If there is any reason to suspect shock, apply

immediate treatment.

exercise:
1. Assign the group to the same pairs as in the
previous exercises.
2. Ask those who were the rescuers first in the last
exercise to be the victims first.
3. Ask the victims to lie on the floor on their backs
and close their eyes.
4. Explain the following scenario to the rescuers:
You have come upon an unconscious victim

who has been bleeding profusely from a wound
of the upper arm for an undetermined period of
time. You have controlled the bleeding.
What do you need to do next?
5. Ask the rescuer to treat the victim.

6. Observe each rescuer as he or she treats for
shock. Do not let the students put a blanket under
the victims feet. Blankets are scarce during a
disaster response and should not be used for
nonessential purposes.
JANUARY 2011
PAGE 3-37

INSTRUCTOR GUIDANCE
CONTENT
When each rescuer has been observed treating for
shock, ask the victim and the rescuer to switch roles.
When all of the rescuers have had the opportunity to
treat their victims, lead a discussion about any
incorrect techniques observed and how to correct
them in the future.
Does anyone have a question about the signs of
shock or its treatment?
Tell the group that, in a disaster scenario, they may
have many victims requiring attention and few
resources to use. The next section will use the skills
just learned for prioritizing victim treatment. This is
called triage.
PAGE 3-38
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
Triage
Introduce this topic by getting participants thinking
about a mass casualty event and how medical
personnel handle it.
Display Slide 3-18

Examples might be from a
recent news story or imagining
what the emergency room
would be like after an
explosion at a shopping mall
or sports event.
Emphasize the importance of sizeup by reviewing the
9 steps to properly size up a situation. Remind the
participants that sizeup is a continual process; it never
stops.
Display Slide 3-19
JANUARY 2011
PAGE 3-39

INSTRUCTOR GUIDANCE
CONTENT
In mass casualty events, medical personnel:
The point of this discussion is

to get the participants thinking
about multiple casualties.
Identify the dead and those who are too severely

injured to be saved
Send those with relatively minor injuries and

wounds to a holding area to await treatment
Identify those who would die from life-threatening

injuries and treat them immediately
Tell the participants that these scenes showed medical

personnel conducting triage a French term meaning
to sort.
What Is Triage?
Explain that during medical triage, victims are
evaluated, sorted by the urgency of the treatment
needed, and set up for immediate or delayed
treatment.
Explain further that triage was, in fact, initiated by the
military and that experience has shown that triage is
an effective strategy in situations where:
Display Slide 3-20
There are many more victims than rescuers
There are limited resources
Time is critical
Point out that triage occurs as quickly as possible after

victims are located or rescued.
PAGE 3-40
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
During medical triage, victims conditions are
evaluated and the victims are prioritized into four
categories:
Immediate (I): The victim has life-threatening

injuries (airway, bleeding, or shock) that demand
immediate attention to save his or her life; rapid,
lifesaving treatment is urgent. These victims are
marked with a red tag or labeled I.
Delayed (D): Injuries do not jeopardize the victims

life. The victim may require professional care, but
treatment can be delayed. These victims are
marked with a yellow tag or labeled D.
Minor (M): Walking wounded and generally

ambulatory. These victims are marked with a
green tag or labeled M.
Dead (DEAD): No respiration after two attempts to

open the airway. Because CPR is one-on-one
care and is labor intensive, CPR is not performed
when there are many more victims than rescuers.
These victims are marked with a black tag or
labeled DEAD.
Display Slide 3-21

When discussing triage, be
sure to highlight how triage is
organized and conducted in
your area. Specify what
materials the CERTs use to
mark triaged victims, e.g.,
tags, tape, etc.
Some participants may
respond negatively to not
performing CPR. CPR is a
maintenance therapy that
requires time and rescuers
that may not be available
when dealing with multiple
casualties. In a situation
without multiple casualties,
CPR may be administered by
available trained personnel.
Remind the group that the CERT goal is to do the

greatest good for the greatest number.
JANUARY 2011
PAGE 3-41

INSTRUCTOR GUIDANCE
CONTENT
Explain that, from triage, victims are taken to the
designated medical treatment area (immediate care,
delayed care, or the morgue).
Explain any State laws about

moving the dead that may
apply to CERTs.
Remind the participants that CERT members do not

rescue those tagged DEAD. If the scene is deemed
safe and it is appropriate to do so, CERT members
may move the DEAD to the morgue.
It is crucial to the physical and mental well-being of
disaster survivors that the morgue be placed away
from the other groups. Traditionally, blue tarps are
used to identify and conceal the morgue area.
Note that the setup of medical treatment areas will be
covered in the next unit.
Rescuer Safety During Triage
Remind the group that, if hazardous materials are
present, rescuer safety is paramount. CERT members
should leave the scene to avoid harm to themselves
and to reduce the risk of spreading the contamination.
Display Slide 3-22

Emphasize these points.
Demonstrate the methods for
changing non-latex exam
gloves without contaminating
oneself by pinching the glove
at the top and rolling it off while
turning it inside out as it comes
off. To remove the second
glove, tuck two fingers inside
PAGE 3-42
Emphasize the need for rescuer safety during triage.

Rescuers must wear all safety equipment, including
non-latex exam gloves, goggles, a helmet, and an N95
mask when examining victims and should try to
change gloves between victims. Because of limited
supplies, it may not be possible to use a new pair of
gloves for every victim. If this is the case, gloves may
be sterilized between treating victims using 1 part
JANUARY 2011

INSTRUCTOR GUIDANCE
the glove and roll the glove off,
being careful not to touch the
outside.
CONTENT
bleach to 10 parts water. Tell the group that their
disaster kits should have a box of non-latex exam
gloves. Bleach and potable water should also be
available at the CERTs medical treatment area.
Exercise: Removing Exam Gloves

participants to practice the proper technique for
removing soiled exam gloves without spreading
contaminants.
exercise:
1. Ask the participants to put on a pair of non-latex
exam gloves.
2. Walk around the room and give each participant a
small dollop of shaving cream and ask them to rub
their hands together as if washing.
3. Demonstrate the procedure for removing gloves
again with shaving cream on your gloves.
4. Ask the participants to remove their gloves without
touching or splattering any shaving cream.
Repeat until all participants are able to complete the
technique quickly and comfortably.
JANUARY 2011
PAGE 3-43

INSTRUCTOR GUIDANCE
CONTENT
Triage in a Disaster Environment

Introduce this section by explaining the general
procedure for CERTs to conduct triage:
Step 1: Stop, Look, Listen, and Think. Before your

team starts, stop and size up the situation by
looking around and listening. Think about your
safety, capability, and limitations, and decide if you
will approach the situation. If you decide to
proceed, quickly make a plan about your approach
that all members understand.
Step 2: Conduct voice triage. Begin by calling out,

Community Emergency Response Team. If you
can walk, come to the sound of my voice. Speak
loudly and firmly. If there are survivors who are
ambulatory, tag them M and direct them to a
designated location. If rescuers need assistance
and there are ambulatory survivors, then these
survivors should be asked to provide assistance.
These persons may also provide useful information
about the location of the victims. Note that, during
triage, these individuals must be tagged M.
Step 3: Start where you stand, and follow a

systematic route. Start with the closest victims and
Display Slide 3-23

Emphasize this first step.
Discuss questions you should
ask to gather facts about the
situation.
PAGE 3-44
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
work outward in a systematic fashion.
Step 4: Evaluate each victim and tag them I

(immediate), D (delayed), M (minor), or DEAD.
Remember to evaluate the walking wounded.
Remember to ASK for permission to treat if the
individual is conscious.
Say that you will explain more about how to do a
triage evaluation in a minute.
Step 5: Treat I victims immediately. Initiate airway

management, bleeding control, and/or treatment
for shock for Category I victims.
Step 6: Document triage results for:
Effective deployment of resources
Information on the victims locations
A quick record of the number of casualties by

degree of severity
Emphasize that the rescuers safety is paramount

during triage. Stress the importance of wearing proper
protective equipment to avoid endangering personal
health.
JANUARY 2011
PAGE 3-45

INSTRUCTOR GUIDANCE
PAGE 3-46
CONTENT
JANUARY 2011

INSTRUCTOR GUIDANCE
This section puts together the
pieces that have been covered
so far in the unit.
CONTENT
Evaluating a Victim During Triage
Remind participants that the goal of triage is to identify

and treat victims who need immediate care as rapidly
as possible. As an expansion of Step 4 on the
previous page, explain that there is a certain order for
doing a triage evaluation. Every evaluation should be
done in this order.
Display Slide 3-24

PM, P. 3-22
Refer the participants to the table titled Evaluating a

Victim During Triage in the Participant Manual.
Demonstrate as you explain the Explain that when conducting a triage evaluation they
should:
steps.
Start with the airway. At an arms distance, make
contact with the victim and speak loudly. If the
victim does not respond, then:
Position the airway.
Look, listen, and feel.
Check breathing rate. Abnormally rapid

respiration (above 30 per minute) indicates
shock. Maintain the airway and treat for shock
and tag I.
If the victim is not breathing after two attempts

to open the airway, then tag the victim DEAD.
JANUARY 2011
PAGE 3-47

INSTRUCTOR GUIDANCE
CONTENT
Second, check for bleeding.
Stop uncontrolled bleeding.
Perform blanch test for capillary refill (greater

than 2 seconds should be marked I).
Or perform a radial pulse test.
If pulse present, continue to assessment of

mental status. Note abnormal pulse.
If pulse absent or abnormal, elevate status

to I and treat for bleeding and shock.
Third, check mental status. If no response, the

victims status is I.
If the victim passes all tests, his or her status is D. If

the victim fails one test, status is I. Remember that
everyone gets a tag.
PAGE 3-48
JANUARY 2011

PM, P. 3-22
Evaluating a Victim During Triage
Step
Procedures
Check airway/breathing. At an arms distance, make contact with the victim

and speak loudly. If the victim does not respond:
Position the airway.
Look, listen, and feel.
Check breathing rate. Abnormally rapid respiration (above 30 per

minute) indicates shock. Maintain the airway and treat for shock and
tag I.
If below 30 per minute, then move to Step 2.
If the victim is not breathing after two attempts to open airway, then tag
DEAD.
Check circulation/bleeding.
Take immediate action to control severe bleeding.
Check circulation using the blanch test (for capillary refill) or a radial
pulse test.
Press on an area of skin until normal skin color is gone. Time how
long it takes for normal color to return. Treat for shock if normal
color takes longer than 2 seconds to return, and tag I.
Or check the radial pulse.
If present, continue to step 3.
Note if the pulse is abnormal (rapid, thready, weak, etc.)
If absent, tag I and treat for bleeding and shock.
Check mental status. Inability to respond indicates that immediate

treatment for shock is necessary. Treat for shock and tag I.
JANUARY 2011
PAGE 3-49

INSTRUCTOR GUIDANCE
Ask participants to work
individually to learn the steps:
CONTENT
Tell participants that they need to get very good at doing
a triage evaluation rapidly. The goal should be to do it
within 15-30 seconds.
1. Read through the first

step.
2. Perform the motions of
the step.
3. Repeat the process for
steps 2 and 3.
4. Finally, perform the
motions of the entire
triage evaluation
without looking at the
chart.
Suggest that participants do
mental and physical walkthroughs of the triage
evaluations at least three times
a day until the next session.
Documenting Triage
PM, P. 3-23
Refer the participants to the Sample Triage

Documentation figure in the Participant Manual.
Explain how to document victims during triage (the
number of people tagged Immediate, Delayed,
Minor, and Dead) and their location. Also explain to
the group how useful such information can be to
professional responders.
PAGE 3-50
JANUARY 2011

PM, P. 3-23
Sample Triage Documentation

Location
Status
A
10
11
15
Dead
JANUARY 2011
PAGE 3-51

INSTRUCTOR GUIDANCE
CONTENT
Triage Pitfalls
PM, P. 3-25
Refer the participants to the flowchart titled Triage

Decision Flowchart in the Participant Manual and
recommend that they study the flowchart outside of this
session until they are very familiar with triage
procedures. (Point out that 2 seconds refers to the
results of the capillary refill test.)
Stress that time will be critical in a disaster. The
participants will not be able to spend very much time with
any single victim. Remind them that they want to do the
greatest good for the greatest number of victims.
Tell participants that in order to respond effectively in a
mass casualty event, CERT members must:
Have a plan based on a thorough sizeup
Follow that plan
Document actions throughout
Stress also that the participants should take advantage

of local exercises as a means of maintaining their triage
skills and to help them avoid the triage pitfalls.
Triage pitfalls include:
Display Slide 3-25
No team plan, organization, or goal
Indecisive leadership
Too much focus on one injury
Treatment (rather than triage) performed
Does anyone have questions on how to perform

triage?
PAGE 3-52
JANUARY 2011

PM, P. 3-25
Triage Decision Flowchart
JANUARY 2011
PAGE 3-53

INSTRUCTOR GUIDANCE
CONTENT
Exercise: Conducting Triage
Before the session, prepare

victim status cards, each
documenting the status of one
disaster victim. See
Preparation at the beginning
of this unit for instructions on
how to complete the victim
status cards.
Purpose: Explain that this exercise will allow the

participants to practice conducting triage in a highpressure situation.
Participants will divide into three groups. Each
participant will be given a card describing their medical
status to tape to their shirt. The members of the group
will take turns triaging.
Explain to the participants that there will be three rounds
of the exercise to give each person a chance to practice
triage. In each round, one group will be the rescuers and
the other groups will be victims. Each participant has a
chance to be a rescuer once. The rescuers will have a
limited amount of time to:
Size up the situation and develop a plan of action
Conduct triage and tag each victim for treatment
Document the number of victims in each category of

triage (Immediate, Delayed, Minor, Dead)
Remind the participants to bring their blankets to the

disaster area.
exercise:
1. In the classroom, divide the participants into three
groups. Provide one set of the victim status cards to
each group. Each participant will get one card.
2. In Round 1, Groups 2 and 3 are victims and remain in
the classroom. Each person should tape his or her
victim status card to their shirt. One instructor
remains in the classroom to work with the victims to
arrange themselves.
PAGE 3-54
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
3. In Round 1, Group 1 will be the rescuers. While
Groups 2 and 3 set up the scene in the classroom,
Group 1 goes outside the room to quickly develop a
plan of action. A second instructor should observe
the rescuers brief planning session.
4. After no more than 2 minutes, Group 1 enters the
classroom to triage the victims. (They will tag each
by writing I, D, M, or Dead on the victim status
card.)
5. Allow the rescuers 5 minutes to complete their triage.
Observe the rescuers as they conduct triage.
6. In Round 2, Group 2 will be the rescuers.
7. In Round 3, Group 3 will be the rescuers.
Debrief: After all three groups have had a chance to
practice triage, call the groups together and conduct a
discussion on the results of the triage exercise:
Problems that the rescuers encountered during triage
How it felt to be under pressure to conduct triage

within such a short period of time
Relate the rescuers feelings about their time constraints

to the pressure they will feel under actual conditions.
Explain that they will learn ways to control some of their
stresses in a later session.
Does anyone have questions about triage?
Be sensitive to the participants Emphasize that planning and organization are necessary
and the difficulty of these
to do the greatest good for the greatest number of
decisions during a catastrophic victims.
event.
JANUARY 2011
PAGE 3-55

INSTRUCTOR GUIDANCE
CONTENT
Unit Summary
Summarize the key points from this unit:
Display Slide 3-26
CERT members ability to open airways, control

bleeding, and treat shock is critical to saving lives.
Use the Head-Tilt/Chin-Lift method for opening

airways.
Control bleeding using direct pressure, elevation,

and/or pressure points.
If there is a question about whether a victim is in

shock, treat for shock as a precaution.
Triage is a system for rapidly evaluating victims

injuries and prioritizing them for treatment.
There are four triage categories:

1. Immediate
2. Delayed
3. Minor
4. Dead
Triage in a disaster environment consists of 6

important steps:
1. Stop, Look, Listen and Think, and make a
quick plan.
2. Conduct voice triage.

3. Begin where you stand, and work
systematically.
4. Evaluate and tag all victims.

5. Treat those tagged I immediately.
PAGE 3-56
JANUARY 2011

INSTRUCTOR GUIDANCE
CONTENT
6. Document your findings.
INSTRUCTOR GUIDANCE
CONTENT
The procedure for conducting triage evaluations

involves checking:
The airway and breathing rate
Circulation and bleeding
Mental status
Remind the participants that disaster medical operations

require careful planning, teamwork, and practice. Urge
them to take advantage of community-wide disaster
exercises whenever they are scheduled.
Homework Assignment
Ask the participants to read and become familiar with
Unit 4: Disaster Medical Operations Part 2 before the
next session.
Remind the participants to bring a blanket, roller gauze,
adhesive tape, duct tape, and cardboard to the next
session.
Thank everyone for attending this session.
Display Slide 3-27
JANUARY 2011
PAGE 3-57

INSTRUCTOR GUIDANCE
CONTENT
PAGE 3-58
JANUARY 2011

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UNIT 3: DISASTER MEDICAL

In this unit you will learn about:

Life-Threatening Conditions: How to recognize and treat an airway

Triage: Principles of triage and how to conduct triage evaluations.

[This page intentionally left blank]

COMMUNITY EMERGENCY RESPONSE TEAM

At the conclusion of this unit, the participants should be able to:

Identify the killers.

The scope of this unit will include:

Introduction and Unit Overview

CERT BASIC TRAINING: INSTRUCTOR GUIDE

COMMUNITY EMERGENCY RESPONSE TEAM

The lead instructor will begin this session by welcoming the

Finally, the participants will practice triage evaluation and immediate

Community Emergency Response Team Instructor Guide

If time permits, the 23-minute video, CERT Triage: Handling Mass

CERT BASIC TRAINING: INSTRUCTOR GUIDE

COMMUNITY EMERGENCY RESPONSE TEAM

In addition to the equipment listed at the front of this instructor Guide,

A computer with PowerPoint software

CERT BASIC TRAINING: INSTRUCTOR GUIDE

COMMUNITY EMERGENCY RESPONSE TEAM

Sample victim status descriptions

Ambulatory responds to voice triage

Standing, but does not respond to voice

Culturally Sensitive Topics

CERT BASIC TRAINING: INSTRUCTOR GUIDE

COMMUNITY EMERGENCY RESPONSE TEAM

A suggested time plan for this unit is as follows:

Be sure to emphasize throughout the session the importance of

CERT BASIC TRAINING: INSTRUCTOR GUIDE

COMMUNITY EMERGENCY RESPONSE TEAM

Unit 3: Disaster Medical Operations

Introduction and Overview

Display Slide 3-0

Class A Fires: Ordinary

Class B Fires: Flammable

Class C Fires: Energized

CERT BASIC TRAINING: INSTRUCTOR GUIDE

COMMUNITY EMERGENCY RESPONSE TEAM

Class K Fires: Cooking oils

Remind participants that the method used to

CERT BASIC TRAINING: INSTRUCTOR GUIDE

COMMUNITY EMERGENCY RESPONSE TEAM

Can I escape quickly and

Do I have the right type of

Is the extinguisher large

Is the area free from other

Is the fire extinguished in 5

CERT BASIC TRAINING: INSTRUCTOR GUIDE

COMMUNITY EMERGENCY RESPONSE TEAM

The number of victims could exceed the local

Survivors will attempt to assist others. CERT

Display Slide 3-1

Display Slide 3-2

Explain that these phases underlie why disaster

CERT BASIC TRAINING: INSTRUCTOR GUIDE

COMMUNITY EMERGENCY RESPONSE TEAM

Display Slide 3-3