Making Water Safe in an Emergency

cdc.gov/healthywater/emergency/drinking/making-water-safe.html

If you don't have safe bottled water and if boiling is not possible, you often can make small quantities of filtered and settled water safer to drink by using a chemical disinfectant such as unscented household chlorine bleach. Disinfectants can kill most harmful or disease-causing viruses and bacteria, but are not as effective in controlling more resistant organisms, such as the parasites Cryptosporidium and Giardia.(https://www.cdc.gov/parasites/giardia/index.html) Chlorine dioxide tablets can be effective against Cryptosporidium if the manufacturer’s instructions are followed correctly.

To disinfect water with unscented household liquid chlorine bleach:

If the water is cloudy,

1. Filter it through a clean cloth, paper towel, or coffee filter OR allow it to settle. 2. Draw off the clear water. 3. Follow the instructions for disinfecting drinking water that are written on the label of the bleach. 4. If the necessary instructions are not given, check the "Active Ingredient" part of the label to find the sodium hypochlorite percentage, and use the information in the following table as a guide. Typically, unscented household liquid chlorine bleach will be 8.25% sodium hypochlorite, though concentrations can be different. Using the table below, add the appropriate amount of bleach using a medicine dropper, teaspoon, or metric measure (milliliters). 5. Stir the mixture well. 6. Let it stand for at least 30 minutes before you use it. 7. Store the disinfected water in clean, sanitized containers(https://www.cdc.gov/healthywater/emergency/drinking/cleaning-preparing-storage- containers.html) with tight covers.

If the water is clear,

1. Follow the instructions for disinfecting drinking water that are written on the label of the bleach. 2. If the necessary instructions are not given, check the "Active Ingredient" part of the label to ﬁnd the sodium hypochlorite percentage, and use the information in the following table as a guide. Typically, unscented household liquid chlorine bleach will be 8.25% sodium hypochlorite, though concentrations can be diﬀerent. Using the table below, add the appropriate amount of bleach using a medicine dropper, teaspoon, or metric measure (milliliters). 3. Stir the mixture well. 4. Let it stand for at least 30 minutes before you use it. 5. Store the disinfected water in clean, sanitized containers(https://www.cdc.gov/healthywater/emergency/drinking/cleaning-preparing-storage- containers.html) with tight covers.

1/3 Making water safe to use with bleach having a 1% concentration of sodium hypochlorite * If the water is cloudy, murky, colored, or very cold, add double the amount of bleach listed below

1 quart/liter water 1 gallon water 5 gallons water

If you have a dropper: If you have a dropper: If you have a dropper: Add 10 drops of bleach Add 40 drops of bleach Add 200 drops of bleach

If you have something that If you have something that If you have something that measures milliliters (ml): measures milliliters (ml): measures milliliters (ml): Add ½ ml of bleach Add 2½ ml of bleach Add 12½ ml of bleach

If you have a measuring spoon: If you have a measuring spoon: If you have a measuring spoon: Add ⅛ teaspoon of bleach Add ½ teaspoon of bleach Add 2½ teaspoons of bleach

Making water safe to use with bleach having a 4-6% concentration of sodium hypochlorite * If the water is cloudy, murky, colored, or very cold, add double the amount of bleach listed below

1 quart/liter water 1 gallon water 5 gallons water

If you have a dropper: If you have a dropper: If you have a dropper: Add 2 drops of bleach Add 8 drops of bleach Add 40 drops of bleach

If you have something that If you have something that If you have something that measures milliliters (ml): measures milliliters (ml): measures milliliters (ml): Add 0.1 ml of bleach Add ½ ml of bleach Add 2½ ml of bleach

If you have a measuring spoon: If you have a measuring spoon: If you have a measuring spoon: Amount too small to measure Amount too small to measure Add ½ teaspoon of bleach

Making water safe to use with bleach having an 8.25% concentration of sodium hypochlorite** * If the water is cloudy, murky, colored, or very cold, add double the amount of bleach listed below

1 quart/liter water 1 gallon water 5 gallons water

If you have a dropper: If you have a dropper: If you have a dropper: Add 2 drops of bleach Add 6 drops of bleach Add 30 drops of bleach

If you have something that If you have something that If you have something that measures milliliters (ml): measures milliliters (ml): measures milliliters (ml): Amount too small to measure Add ½ ml of bleach Add 2 ml of bleach

2/3 1 quart/liter water 1 gallon water 5 gallons water

If you have a measuring spoon: If you have a measuring spoon: If you have a measuring spoon: Amount too small to measure Amount too small to measure Add ⅓ teaspoons of bleach

**8.25% is the most common household bleach concentration available

Making water safe to use with bleach having an unknown concentration of sodium hypochlorite * If the water is cloudy, murky, colored, or very cold, add double the amount of bleach listed below

1 quart/liter water 1 gallon water 5 gallons water

If you have a dropper: If you have a dropper: If you have a dropper: Add 10 drops of bleach Add 40 drops of bleach Add 200 drops of bleach

If you have a measuring spoon: If you have a measuring spoon: If you have a measuring spoon: Add ⅛ teaspoon of bleach Add ½ teaspoon of bleach Add 2½ teaspoons of bleach

To disinfect water with tablets that contain chlorine or iodine:

Follow the manufacturer’s instructions on the label or in the package.

Chlorine dioxide tablets can be eﬀective against Cryptosporidium if the manufacturer’s instructions are followed correctly. Iodine and iodine-containing tablets (tetraglycine hydroperiodide) or chlorine tablets are not eﬀective against Cryptosporidium.

3/3 EMERGENCY DISINFECTION OF DRINKING WATER

In an emergency situation where regular water service has been interrupted – like a hurricane, flood, or water pipe breakage – local authorities may recommend using only bottled water, boiled water, or disinfected water until regular water service is restored. The instructions below show you how to boil and disinfect water to kill most disease-causing microorganisms that may be present in the water. However, boiling or disinfection will not destroy other contaminants, such as heavy metals, salts, and most other chemicals.

ONLY USE WATER THAT HAS BEEN PROPERLY DISINFECTED FOR DRINKING, COOKING, MAKING ANY PREPARED DRINK, WASHING DISHES, AND FOR BRUSHING TEETH.

Use bottled water or water you have properly prepared and stored as an emergency water supply. Boil water, if you do not have bottled water. Boiling is sufficient to kill pathogenic bacteria, viruses and protozoa (WHO, 2015). − If water is cloudy, let it settle and filter it through a clean cloth, paper towel, or coffee filter. − Bring water to a rolling boil for at least one minute. At altitudes above 5,000 feet (1,000 meters), boil water for three minutes. − Let water cool naturally and store it in clean containers with covers. − To improve the flat taste of boiled water, add one pinch of salt to each quart or liter of water, or pour the water from one clean container to another several times. Disinfect water using household bleach, if you can’t boil water. Only use regular, unscented chlorine bleach products that are suitable for disinfection and sanitation as indicated on the label. Do not use scented, color safe, or bleaches with added cleaners. − If water is cloudy, let it settle and filter it through a clean cloth, paper towel, or coffee filter. − Locate a clean dropper from your medicine cabinet or emergency supply kit. − Locate a fresh liquid chlorine bleach or liquid chlorine bleach that is stored at room temperatures for less than one year. The label should say that it contains 8.25% of sodium hypochlorite. − Use the table on the next page as a guide to decide should add to the water, for example, add 6 drops of bleach to each gallon of water. Double the amount of bleach if the water is cloudy, colored, or very cold. − Stir and let stand for 30 minutes. The water should have a slight chlorine odor. If it doesn’t, repeat the dosage and let stand for another 15 minutes before use. − If the chlorine taste is too strong, pour the water from one clean container to another and let it stand for a few hours before use. Table 1: Bleach to Water Dose Guidance OTHER DISINFECTION METHODS Amount of Liquid Bleach If you don’t have liquid bleach, you can use one of the Volume of Water to Add† other disinfection methods described below. 1 quart/liter 2 drops • Granular calcium hypochlorite. The first step is to 1 gallon 6 drops make a chlorine solution that you will use to 2 gallons 12 drops (1/8 teaspoon) disinfect your water. For your safety, do it in a 4 gallons 1/4 teaspoon ventilated area and wear eye protection. Add one 8 gallons 1/2 teaspoon heaping teaspoon (approximately ¼ ounce) of † Bleach contains 8.25% sodium hypochlorite. high-test granular calcium hypochlorite (HTH) to ADDITIONAL WATER GUIDANCE FOR EMERGENCIES two gallons of water and stir until the particles have dissolved. The mixture will produce a Prepare and store an emergency water supply. Visit chlorine solution of approximately 500 milligrams the Federal Emergency Management Agency (FEMA) per liter. To disinfect water, add one part of the website www.ready.gov/managing-water for chlorine solution to each 100 parts of water you additional guidance on preparing and storing an are treating. This is about the same as adding 1 emergency water supply. pint (16 ounces) of the chlorine solution to 12.5 gallons of water. If the chlorine taste is too strong, Look for other sources of water in and around your pour the water from one clean container to home. Although bottled water is your best choice, you another and let it stand for a few hours before may be able to find other sources of water by melting use. CAUTION: HTH is a very powerful oxidant. ice cubes or draining your hot water tank or pipes. Follow the instructions on the label for safe You should not use water from toilet flush tanks or handling and storage of this chemical. bowls, radiators, waterbeds, swimming pools, or spas. • You can also use river or lake water. It is generally Common household iodine (or “tincture of better to use flowing water than still, stagnant water. iodine”). You may have iodine in your medicine However, do not use water with floating material in it cabinet or first aid kit. Add five drops of 2% or water that has a dark color or questionable odor. tincture of iodine to each quart or liter of water that you are disinfecting. If the water is cloudy or Regardless of the source, treat the water by following colored, add 10 drops of iodine. Stir and let the the instructions on the previous page. water stand for at least 30 minutes before use. If you have a well on your property that has been • Water disinfection tablets. You can disinfect flooded, make sure to disinfect and test the well water with tablets that contain chlorine, iodine, water after the flood. Contact your state or local chlorine dioxide, or other disinfecting agents. health department for advice or go to These tablets are available online or at water.epa.gov/drink/info/well/whatdo.cfm. pharmacies and sporting goods stores. Follow the Consider how the water looks and how to filter it if instructions on the product label as each product needed. Disinfection does not work as well when may have a different strength. water is cloudy or colored. If water is cloudy, let it settle. MORE INFORMATION Then filter the water through a clean cloth, paper towel, or World Health Organization (WHO), 2015. Technical coffee filter. Store the Briefing on Boil Water. settled and filtered water in Safe Drinking Water Hotline 1-800-426-4791 clean containers with covers. water.epa.gov/drink/hotline

OFFICE OF WATER 4606-M EPA 816-F-15-003 JUNE 2015 Water

ready.gov/water

Storing Water in Plastic Soda Bottles

It is recommended you purchase food grade water storage containers from surplus or camping supplies stores to use for water storage.

Before ﬁlling with water, thoroughly clean the containers with dishwashing soap and water and rinse completely so there is no residual soap.

If you chose to use your own storage containers, choose two-liter plastic soft drink bottles – not plastic jugs or cardboard containers that have had milk or fruit juice in them. Milk protein and fruit sugars cannot be adequately removed from these containers and provide an environment for bacterial growth when water is stored in them. Cardboard containers also leak easily and are not designed for long-term storage of liquids. Also, do not use glass containers, because they can break and are heavy.

Follow these steps for storing water in plastic soda bottles.

Thoroughly clean the bottles with dishwashing soap and water, and rinse completely so there is no residual soap.

Sanitize the bottles by adding a solution of 1 teaspoon of non-scented liquid household chlorine bleach to a quart of water. Mix the sanitizing solution in the bottle so that it touches all surfaces. After sanitizing the bottle, thoroughly rinse out the sanitizing solution with clean water.

Fill the bottle to the top with regular tap water. If the tap water has been commercially treated from a water utility with chlorine, you do not need to add anything else to the water to keep it clean. If the water you are using comes from a well or water source that is not treated with chlorine, add two drops of non-scented liquid household chlorine bleach to the water. Let the water stand for 30 minutes before using.

A slight chlorine odor should be noticeable in the water, if not, add another dose of bleach and allow the water to stand another 15 minutes.

Tightly close the container using the original cap. Be careful not to contaminate the cap by touching the inside of it with your ﬁnger. Place a date on the outside of the container so you can know when you ﬁlled it. Store in cool, dark place.

Water can also be treated with water puriﬁcation tablets that can be purchased at most sporting goods stores.

Water that has not been commercially bottled should be replaced every six months.

More information on water treatment is available at RedCross.org.

1/1 Walnut Creek CERT 8 8 2013 Head – to – Toe Assessment Checklist

The objectives of the head-to-toe assessment are to: • quickly and as clearly as possible determine the extent of the victim’s injuries • determine what type of treatment is needed • document injuries you find

Before You Start Check scene for safety Identify yourself to the victim Put on appropriate sized gloves (no latex), goggles and face mask Check for medical emblems, bracelets, or neck chains Ask the patient how he/she was injured (determine the mechanism of injury) Ask the patient for permission to conduct a head-to-toe assessment Ask patient about - pain - bleeding - other symptoms Things to Look For Look, listen and feel for anything unusual Use the acronym DCAP-BTLS on each body part you check - Deformities - Burns - Contusions (bruising) - Tenderness - Abrasions - Lacerations - Punctures - Swelling Check all extremities for - pulse - movement - sensation What to Check Head - check scalp - check skin for color/temperature/moisture - assess eyes/pupils - check ears for fluid - inspect mouth (inside & out), nose, facial area Neck - check trachea for midline alignment Shoulders Chest Abdomen Pelvis Legs Arms Back Check for Signs of a Closed-Head, Neck or Spinal Injury Change in level of consciousness/watch for seizures Inability to move one or more body parts Severe pain or pressure in head, neck or back Tingling or numbness in extremities Difficulty breathing or seeing Heavy bleeding, bruising, or deformity of head or spine Blood or straw colored fluid coming from or in nose or ears Bruising behind the ear or around the eyes Raccoon eyes (bruising around the eyes) Uneven pupils Seizures Nausea or vomiting Victims found under collapsed building material or heavy debris

WC CERT MED OPS Documentation Form Date: Name: Page # ______of ______ID#: Age: Gender: Notes: (Include other medical problems) Allergies: Address: Family( ICE):

On Arrival: Time: Time: Time: Respirations: 0 >30 <30 Respirations: 0 >30 <30 Respirations: 0 >30 <30 Respirations: 0 >30 <30

Perfusion: > 2 secs < 2 secs Perfusion: > 2 secs < 2 secs Perfusion: > 2 secs < 2 secs Perfusion: > 2 secs < 2 secs

Mental Status: Mental Status Mental Status Mental Status

Head/Neck Head/Neck Head/Neck Head/Neck

Chest/ Abdomen Chest/ Abdomen Chest/ Abdomen Chest/ Abdomen

Shoulders/Back Shoulders/Back Shoulders/Back Shoulders/Back

Arms Arms Arms Arms

Legs Legs Legs Legs

Care Given? Care Given? Care Given? Care Given?

Status Status Status Status Red Yell Grn Blk Red Yell Grn Blk Red Yell Grn Blk Red Yell Grn Blk

Initials Initials Initials Initials

MED OPS TREATMENT FORM ‐ WC CERT April 2 2013 doc