Youth & First Aid

[KC9DDI]

Has anyone had any experience with youth serving as the primary "first aid officers" at a summer camp/day camp/etc? I've seen this occur in some situations, and I'm not convinced its the best idea. Granted, some youth do have the maturity to handle that responsibility (some states will certify 16 year olds as EMT-B's, and 18 year olds as EMT-P's). I don't think there's a problem with youth handling basic band-aids, ice packs, etc (after all, that's what we teach them to do!) But, there seems to be a greater problem when it comes to medications, health history, etc - stuff thats pretty confidential. So, I'm wondering if anyone has any thoughts on this matter - at this point, I'm not referring to any specific instance, just trying to get a feel for what others think.

[Beavah]

Yah, it's like anything, eh? Depends on the person.

 

Disadvantage of youth is lack of experience, and so a tendency to overreact a bit until they've built up some of that experience. You can know all about how to treat a deep laceration, but until you've done it a few times it's tough to handle the technical skill at the same time you're carin' for the emotional needs of the patient, eh? Yah, and a hurt kid is usually goin' to want an adult to care for him. If a parent is present, the youth first aider might make them nervous.

 

Youth and adults at camp tend to be an ongoin' sleep deprivation experiment, so that's a factor, too. Adults are often a bit better at performin' with lack of sleep, especially the college-aged crowd .

 

I've never found youth to be less trustworthy than adults when it comes to confidentiality. Often times they're more trustworthy. A lot of bright lads who take ownership of an area get ridiculously efficient, workin' harder at it than many adults. Youth tend to run kids who missed meds down with gusto; few adults do. I'd think youth handlin' meds and paperwork would be fine, dependin' on what your state says. Get a RN to train 'em and pop in randomly once a week or two and you'll have a great system.

 

So I think it mostly depends on bein' smart about your hiring process; a great youth will beat a mediocre adult. But with anything, be mindful of the strengths and weaknesses. Taskin' out an on-call adult for more "serious" cases to handle comfort/crowd/parent control seems prudent if a youth is giving primary care.

 

[CalicoPenn]

If you have an EMT-B on staff, and they are the highest certified emergency care provider, they may automatically become the "primary first aid officer" at camp. In most states, the highest state certified emergency care provider on scene of an injury is in charge - a 16-year old EMT-B wouldn't be an exception - they're certified by the state and are required to act according to state mandated protocols (which, btw, also makes them a mandatory reporter of suspected child abuse). The only people that can prevent that EMT-B from giving proper care would be the patient (and 12 year olds can't legally consent to turn down care) or the patients parent. The age of the EMT-B doesn't matter, as long as they are certified by the state, or, in case of working at a camp that is not in the same state as their license, are covered by reciprocal agreements.

 

That doesn't mean your 16-year old EMT-B should also be your camp Health Officer - the camp Health Officer would take charge of health records, and in most cases, Scoutmasters of units should be the ones handling routine medications for their units, acting in "loco parenti". In the case of certain asthma inhalers and epinephrine auto-injectors, EMT-B's are trained in the proper use and you might want that person to be there, especially if dealing with it on an emergency basis (a trained EMT-B can prevent a patient who is panicking from overusing their inhaler, or the epi-injector).

 

Calico

[KC9DDI]

Calico - I agree with most of what you said, though its important to note that the regulations of EMT's vary from state to state, and even between hospital affiliations within states. In some states, a 16 year old EMT can only practice under the direct supervision of an adult EMT or other health care provider. Additionally, an EMT working or volunteering at a camp will probably not have oversight from an MD, or the liability protection provided by an EMS agency, which would limit the care they're able to provide.

 

But that's not so much the point - I guess I'm wondering whether youth (whether certified EMT's, FR's, or otherwise) should be allowed (or are legally allowed) to manage medical forms and medications. I think there's two issues here: 1) is it legal (probably a simple yes/no question) and 2) does it make sense? Do youth have the maturity necessary to handle this responsibility. Take, for instance, somewhat embarrassing medical problems including bed wetting, depression, OCD, ADHD, etc - should a youth be entrusted with knowing and safeguarding this information?

[Beavah]

1) is it legal (probably a simple yes/no question)

 

Nuthin' is ever a simple yes or no question . To get a real answer to your question, yeh need somebody who knows your state's laws on camp licensing and health care.

 

2) does it make sense? Do youth have the maturity necessary to handle this responsibility. Take, for instance, somewhat embarrassing medical problems including bed wetting, depression, OCD, ADHD, etc - should a youth be entrusted with knowing and safeguarding this information?

 

Yah, yeh know, within a troop we're expecting youth to take leadership responsibilities. Manage a patrol, watch out for their friends and charges.

 

Seems to me what doesn't make sense is not telling them about such issues, and how to handle it. If a PL knows about a bed-wetter, he can be alert for the problem and handle it quietly, or tip off an adult. If a PL knows about depression or OCD, he can become part of the help and support, rather than add to the problem. Far better to provide knowledge up front than deal with teasing and damage control after the fact.

 

Personally, I think goin' through adolescence and teenage years is a tough task. No reason we should make it tougher by failin' to keep all of a child's caregivers well informed, so that they can offer support. Includin' their peers, who in many ways are as important a support as a boy's parents, eh?

 

In a camp setting, with a 16 or 17 year old who was (presumably) hired for the position of first aider because of his knowledge and capability, I'd have no problem with it myself. Da kids I know at our camp are top-notch.

 

[ASM915]

KC,

I agree with Beav. on most of his post.

Have the scout be the First Aid Officer under the supervision of an adult. This gives the scout a safety valve. He has someone he can go to with concerns and questions.

As to medications, our camp has a 2 logbooks at each site. One for Medications. By the way which are kept in a lock-box, except for Inhaler, Epi-pens and Insulin. Every time a scout takes his med's, it is documented in the book (Camp CYO). The second book is for FIRST AID RENDERED from CPR to a band-aid. Have the you FAO in charge of reminding the scout to take his med.'s and documenting it in the book after the med is taken, but have an adult dispense the med. Believe me the boy will be after the scout as well as the adult.

AS for rendering aid: Adults get lazy and the Alzheimer's, WOW. Ive seen adults want to jump in there forgetting everything they were taught, wanting to move the injured or making lite of situations that are serious.

As for the scouts, especially the young ones, you have to remember that they are sponges and don't forget a damned thing, particularly if blood and guts are involved. I've seen boys get right up in the adults face citing verse and scripture out of the handbook or MB book telling the adult "Your not suppose to do that" or "Stop!! Your doing it wrong." The boys remember, the adults forget. Usually the boy is right. The problem is the adult doesn't like being wrong and will argue with the boy.

 

Here's some guidelines for a youth Troop First Aid Officer

 

1) Appoint to the JASM, Troop Guide or Instructor, ASPL (as last resort). The SPL and ASPL will probably be to busy with meetings, and keeping the campsite running smoothly.

 

2)The youth has to be very mature mentally. He can't be a gossip. HIIPA. He has to know when to go to an adult for advice or help, so not to get in over his head.

 

3) He has to keep track of the records in the books.

 

4) The youth answers to the SM, ASM and other designated adult(s). He has to have the trust of the boys and the adults and keep the trust. If an adult comes over and asks "Whats Johnie's issue " or "What med is that there that Johnie takes?" " Is Johnie a bed-wetter? You an tell me", the youth needs to know to direct the adult to the SM or ASM. Some adults are worse then kids when it comes to gossiping and cruel pranks and the info is none of their business.

 

5) Have the FAO and the SM or ASM pull the scouts with special considerations aside and let them know that he is here for them to come to if they need assistance and he wont tell other scouts about their problems, they can trust him.

 

6) Definitely First Aid trained. WFA, WFR the highest level possible, and CPR. Not the camp's 1 hour "Heres how you do it, now show me" series, but the real thing.

 

Troop Suggestions

 

1) The whole troop, boys and especially adult are AHA or ARC CPR trained (makes for a nice indoor winter activity). Who knows, the boys might have to perform CPR on one of us OLD GEEZERS while out hiking.

 

2)All adults that attend camping trips are First Aid trained ( ARC, WFA, WFR, etc.)

 

3) 4 Adults on the trip. If something happens and a boy needs the ED, 2 adults need to go and 2 need to stay. The 2 staying better know what to do if something else happens.

4) Make use of the buddy system with the boys. The buddies can act as the reminder also. They can also act as a spare set of eyes keeping close watch on their buddy if he has a condition. Educate the partner on what he might want to be watching for if his buddy starts to have problems and what to do.

5) I like the double buddy system, 4 boys. If something happens to one boy, he still has a partner with him while the other 2 go for help.(This message has been edited by ASM915)

[LongHaul]

If you are the person in charge of organizing this Camp/ Day Camp then as Beavah says find some one that knows the state laws on camp licensing and heath care. If youre a leader that is attending this Camp/ Day Camp with your boys ask yourself if your concerns are real or imagined. We trust them to see that the kids dont drown, we trust them to see that the kids dont skewer each other with knives and axes in Campcraft, we trust them to take kids out in the woods for 5 mile hikes, is seeing a med form really an issue?

We do a lot of things in Scouts that push the envelope and meds usually top the list. In Illinois it is illegal to be in possession of a controlled substance without a valid prescription IN YOUR NAME. So technically you can get busted transporting your childs meds home from the Walgreen. I know this sounds crazy but it's the law. My sons are ADHD and are on Ritalin. My wife was in an accident and the contents of her purse ended up all over the front seat of the vehicle. When the State Police saw the bottle of Ritalin she carries for when the kids are not at home when meds are needed, he made a big deal over it. The States Attorney agreed. The judge finally dismissed the charges and told my wife she can only carry enough meds for the length of time the boys are away from home and that each set of pills must be in bottles with current prescription info for each child and the child must be present. You dont need meds for children that arent there. Getting the charges expunged was more important that arguing the stupidity of the situation.

At camp all the meds are locked up in a leaders tent and we use a meds check list. The problem is we are not licensed by the state to dispense controlled substances. A minor in possession of a controlled substance even with a prescription needs to have adult supervision. It all goes to the concept Beavah addressed in his "Fear" thread. How afraid should we be that doing something right for the boys will land us in court or even jail?

As for having youth serve as chief medical officer for Day Camp why would you even think of doing it if you didnt feel the youth was capable of handling the responsibility? If you feel that the person in charge can handle the responsibility then age should not be a factor beyond statue and BSA Policy. Health History was mentioned, is this the Med Check where the med forms are gone over at camp? The question is can you trust the youth staff to accept the responsibility of the position, back where we started. As for a child being comforted better by an adult Id have to ask who brought the child to the Health station in the first place? Our boys usually arrive with an adult and with the YP rules usually three other scouts. How far away time wise is emergency assistance? Just what level of First Aid needs to be maintained?

LongHaul