Camp Health Officer

[dScouter15]

I've been asked to serve as the health and safety officer for a council-wide week-long youth training event this summer. I have experience working as a paramedic in the EMS industry, but never volunteering in this kind of capacity in the BSA. I understand my job to basically cover three general categories:

 

1) Work with the staff to ensure that the program itself is carried out with health and safety in mind. Preventing illness/injury is preferable to treating illness and injury.

 

2) Ensure that scouts are taking their prescribed medication appropriately.

 

3) Be available 24/7 to treat illness and injury situations as they arise. Disposition patients appropriately.

 

Obviously #1 is pretty easy. My questions involve #2 and #3.

 

Has anyone with any EMS certification volunteered in this capacity before? Did you have any type of medication direction provided, or protocols for while you were volunteering at camp? Particularly, how did you handle distributing scout's prescription meds? Were there any provisions for providing OTC meds?

 

I'm basically thinking that, in terms of treatment, it will just be BLS care. I'm concerned that, because I have a license, I may be opening myself up to liability, both in terms of care rendered, and the medication issue.

 

Any advice?

 

If anyone has any advice, I'd like to hear it. Thanks.

[mdutch]

I have no expirience in this feild, however, National puts out a power-point training for camp health officers that might be of some help.

www.scouting.org/pubs/19-141.ppt

[Bob White]

As an EMS it is doubtful that you have the legal standing to store or distribute prescription pharmaceuticals. Unless there is a licensed medical professional on staff with you, I would caution you against accepting that responsibility. the BSA Guide to Safe Scouting basically says that it strongly recommends that no volunteer accept this responsibility and that either the scout be responsible for his own medication or a parent or guardian must be present to manage it.

 

Should you accept this responsibility you also accept the legal liability issues that go with it, and since the BSA has already suggested you not do it, to take that responsibility on you do so at your own risk.

 

BW

[ASM416]

Hi,

 

I am also a paramedic and have served as Health and Safety Officer for many BSA events. I have never had or been asked to distribute medication to any youth and am not quite sure how I would handle it. I have seen a very green EMT acting as the Health Officer at summer camp. I think the important difference here is that he was paid staff and I believe the camp had a doctor giving medical direction.

 

I agree with BW that this would be a very risky responsibility for you to take by yourself. You might want to talk with you council's summer camp staff, either the Director or the Health Officer, and see how they handle things. I would also be careful with advise from the Internet as the laws can very significantly between counties and states.

 

As far as #3 goes, you seem to have a good idea there. Only provide BLS care and if anything else is needed call and ambulance or take them to the local ED. Depending on the size of the event you may want to notify the local hospital and ambulance service so no one is surprised. Always err on the side of caution and let whoever is responsible for the child make the decision for them not to be seen in an ED. If there is no one willing to take that responsibility then they need to be seen by a doctor.

 

Lastly, If you don't already, I would take out some personal liability or malpractice insurance. Since you will be volunteering it will be your butt if anything goes wrong. Remember, everyone sues for everything these days and insurance isn't that expensive.

 

Tim

[Eamonn]

Hi,

I have never served as a Camp Health Officer.

In fact I'm a little unsure what is really expected?

I think I would have a chat with the organizer of the event and ask for a clear job description.

My reason for this is that I see the role of Camp First Aider or Camp Medic as being very different as Camp Safety Officer.

Much of what I see as the job of a Camp Safety Officer will need to be done before the event and will require a lot inspections and ensuring that emergency procedures are in place and have been distributed.

I'm thinking along the lines of what to do in the event of sever weather, lost scout, fire,. What will the alarm be? How are people supposed to respond to it?

Before the Scouts arrive there will need to be an inspection of the sites that they will be using, looking for any hazards. Things like dead limbs on trees, over-head or underground power lines.

Going over equipment that the Scouts will be using? Ensuring that everyone knows the correct and proper way to use it.

Ensuring that the water supply is safe and other essential services are in order (Garbage removal, waste water disposal)

Making sure that the people assigned to work in areas have the needed training and if need be certifications.

This sounds like a lot of work for one person and is very different from just being the Camp First Aider.

As this is a Council event, you might want to have a talk with the SE about what Safety committees the Council has in place that could help.

A quick read of the G2SS might also be a good idea.

Ea.

[scoutldr]

"strongly recommends that no volunteer accept this responsibility and that either the scout be responsible for his own medication or a parent or guardian must be present to manage it."

 

Apparently the camp staffs never got the word. As a 53 year old adult, I am still "required" to turn over all prescription meds to the camp staff on check in and report to the health lodge for ever dose. We're not even "allowed" to have Tylenol in our possession in the campsite. Needless to say, most of us ignore it, since we're capable of taking our own medications without killing ourselves.

 

And as of last year, the parent had to fill out a "authorization form" for EVERY dose that the scout was to take. Three times a day for 6 days = 18 separate forms.

 

[John-in-KC]

dScouter15,

 

I'm not a medical person, but have friends who are Scout Reservation physicians and nurse in my Council.

 

I would contact the Council Surgeon (many Councils have a volunteer physician on the health and safety committee), and ask to spend some time with him, walking through the Council's medical protocols.

 

I would also ask the Reservation Ranger or the Reservation Director for a copy of the National Camp Standards as they pertain to medical lodge operations.

 

You have to know and accept...

- What the National Camp Standards are.

- What implementing protocols your Council has.

- How the protocols define your job as a health officer.

 

BTW, welcome to the Forums. Let us know how you decide.

[Bob White]

Scoutldr,

What you fail to mention is...is there a licensed medical professional on staff who can legally store and distribute pharmeceuticals?

 

Id so, then it is their property and event they can require they choose.

 

If not...they are likely in violation of a number of state and feeral laws, as well as putting their "medical" staff in a very precarious legal and financial risk situation.

 

So do they have a licensed medical professional on staff who can legally distribute pharmaceuticals?

[scoutldr]

The camp medic is an EMT...if we're lucky. Sometimes it's an E-2 medic from a local military base. The one we had 2 years ago had never seen an ear thermometer before and tried to point it down my throat. I don't believe it requires any special medical license to take Johnny Scout's pill bottle off the shelf and hand it to him. That's neither prescribing nor "distributing". That's just "storing" and "documenting" that he got his dose. Of course, laws vary by state. My wife, a school nurse, cannot even give a child an aspirin unless there's a written Dr's order on file...doesn't matter what the parents say.

[Bob White]

If he is storing and handing it he is distributing it.

 

Many prescription medications common among youth today are controlled subtances that to even have them in your possession if you are not the person they are prescribed to their leagl care giver, is illegal, unless you are a licensed medical professional.

 

Ask your wife.

 

The G2SS is very strong in its recommendation that volunteers not take this responsibility on themselves.

 

PS

I do not know what ages of students you wife works with but she will know that children under the age of 13 that should not be taking aspirin regardless of a note or not.

[scoutldr]

Elementary age. Yes, I know about Reyes' syndrome. I think you know what I meant.

[infoscouter]

Council managed camps (day camps and resident camps of all levels) operate under the BSA national camping standards. One of the mandatory standards for all camps is that the council appoint a physician to serve as the supervising camp physician.

 

"The council will appoint a physician, licensed by the state to practice medicine, to be in charge of medical care and health supervision for the camp.

This supervisory physician will be responsible for providing written instruction (standing orders) for the camp health officer to follow.

The physician must approve the employment of the health officer and be available to support the needs or concerns of the health officer throughout the camp season" (from the Camp Health Officer training)

 

This individual does not have to be present at camp. However, s/he writes the medication orders and procedures under which medical (including the administration of medications) is handled in your council camps. These are the rules that are followed at camps - in general the Guide to safe Scouting procedures apply to *unit* operations, not council level activities. Remember that districts don't operate independantly of the council - district level camps such as Cub Day Camp are extensions of council functions, in this case the Council Camping Committee.

 

In dScouter's case the NYLT event is a function of the Council training committee. I don't know if the National Camping standards would apply to this event. However, that doesn't mean that the Standing Orders provided by the council physician couldn't be applied to this event. The professional advisor to the camping committee will likely be able to provide the contact info for the council physician, and may have a copy of the current standing orders.

 

In my council this event is multiple (5 one week sessions) long. We have documented procedures for all aspects of this event, including Health and Safety. I don't know for sure, but imagine that standing orders have been produced for this event. This event has a national syllabus and operating manual. While I haven't seen those documents, they well may address this question. Again, the professional advisor to the training committee may know these answers.

 

This course operates in much the same way as a Wood Badge course - any course directors out there? I would bet the issue is addressed in the WB Course Director's materials.

[Beavah]

Yah, hi dScouter!

 

Yeh ask some good questions.

 

As others have mentioned, the normal setup is that da council has a licensed physician as camp physician. For all practical purposes, that person is your "medical control" for care at camp until you have need to access the county EMS system, in which case you naturally fall under county medical control. In quite a few state codes or regulations, this kind of setup is mandated, so the arrangement has statutory effect.

 

An interestin' question comes up in terms of medical malpractice coverage. This is a paid position, right? Or are you actin' as a volunteer?

 

I can't give yeh specific legal advice, eh? But I'd say yeh need to confirm that BSA liability coverage is goin' to apply for medical malpractice in your role (if you're paid), or that volunteer immunity and good sam provisions in your state are goin' to protect you (if you're not paid). And of course by "paid" I mean "compensated in any way" as you know. Find some local folks to give yeh a definitive answer you can be comfortable with; don't settle with anybody bein' "flip." Hopefully, your council has dealt with this before and has all the information in a file somewhere.

 

The way states handle this stuff is all over da place, so yeh really need a competent local to advise you.

 

Beavah

 

[dScouter15]

Thanks everyone for the advice.

 

To clear up a few issues -

 

Firstly, Bob, I am a "licensed medical professional," and am very well aware of the actions my license permits, and those which it does not. However, if a physicians provides me with a protocol, or standing order allowing me to manage prescription or OTC meds, I may act in accordance with that protocol (whether a doc would actually do this is another story). What happens is, provided I act correctly, in accordance with the protocol, the doc takes responsibility for that action. I've heard of this type of situation occurring, and am wondering if anyone has any experience with it. I'd be perfectly content to allow scouts to handle their own medications; however, some scouts do need supervision in taking their meds. For instance, last year (I was involved with the program, but not as the "health officer", per se), several scouts were taking various kinds of psychiatric drugs. If you're not familiar with these drugs, the effects of withdrawal can be very serious, and dangerous. We also has cases of scouts not wishing take their medications. We've also had scouts taking psych meds, whose parents told them that they were allergy pills. Thus, the parents entrusted the staff with the responsibility of ensuring that the scout took these medications on schedule. Right or wrong, this is what occurred, and this is the situation I'm faced with.

 

Secondly, Eamonn - I understand my role to include both of those general areas. Fortunately, we have some general "camp safety" policies in place from previous years. Also, the camp ranger is very much on top of his facility, and works very closely with the staff to ensure that the camp itself is safe, and has emergency procedures. I don't see this part of the job being as complex at the medication issue.

 

Thirdly - As far as treating injuries goes, I do plan on giving a head's up to the local volunteer EMS department, and well as the local emergency department. We've only had to send scouts to the ED a few times in the time I've been involved, as that has always run very smoothly.

 

So, to synthesize the advice to this point - the council should have a physician who oversees health and safety operations, and I should get in contact with him/her to establish protocols and procedures? Seems easy enough - I'll have to see if my council has such a doctor.