Meds for those who choose to

[Beavah]

Yah, da parent thread is now debatin' the relative merits of carryin' OTC and other meds, eh? That's a good discussion, and worth followin'.

 

This thread is for units who do carry meds in first aid kits, or for units faced with the (many!) different kids with special needs where the availability and administration of meds is important to allowing a boy or girl to participate.

 

What are your "best practices" that yeh can share? What are your challenges?

 

I'll again ask that posters refrain from discussion of liability and law and such. Let's limit it to our area of expertise: how we help and provide for kids.

 

Beavah

 

[ozemu]

Paracetemol

asprin

antihistamine

ventalin inhaler and spacer

ibuprofen (more for me - never administered any, have yet to have a need that my training indicated it should be used)

codeine (for me in case back stops working - script is for me alone)

brand - travel calm, over the counter med, kit isn't at home so can't quote the drug

 

in a separate box with specific protocol laminated and folded inside; antihistamine, cortizone, adrenalin, sharps for same

 

Now Beavah this is my personal kit. I do not allow others to use it - not access drugs anyway. The Scout kit is in woeful state and I have never seen one I would trust. Ever. 15+ yrs in Scouting as an adult. Never used a unit kit even when they existed.

 

[Bob White]

Since you asked for their 'area' of expertise, how about asking for their 'level' of expertise?

 

It would be helpful to know what their level of medical training and authorization for carry and dispensing those drugs to others is as well would it not? Even if the answer is none, it would be helpful to know that.(This message has been edited by Bob White)

[Stosh]

As a former EMT-A I do not carry any OTC medications for any of my boys. I carry my own prescription drugs and that's it. When I took over SM of my current troop I went through their troop first aid kit and threw out all medications. The committee was upset but when I showed them that all the meds were at least 4 years beyond their expiration date, the discussion faded away. I may know what fresh drugs may do, but I don't have the foggiest idea what expired drugs do.

 

Stosh

[GernBlansten]

In my personal kit, I carry a plethora of OTC and prescription goodies. 4 types of analgesics (aspirin, Tylenol, Vitamin I, naproxen sodium), antidiuretics, nausea concoctions, cold remedies, benadryl. Those are available to other adults, not the kiddos unless the parents are there. Ran out of Vitamin I at Philmont.

 

On the prescription side, I carry some muscle relaxants I got when I threw my back out and some codeine from some previous dental work. Those are my private stash.

[Gold Winger]

The troop first aid kit has tylenol, benedryl, immodium and that's about it.

 

I carry everyday asprin, benedryl, psuedophed (sp?), and immodium along with a few band-aids. Since I carry a pouch with a meter and insulin, there's no problem carrying the other stuff.

 

During our training hikes for Philmont, the first aid guru added a tube of frosting for me in case I needed it.

[Gold Winger]

To be really prepared, your unit should include and make sure they accompany every outing, a nurse, EMT, two PAs, an internist, an orthopod, and a general surgeon. Along with those folks you'll take two pack mules who'll carry the field operating theater and diagnostic equipment.

 

 

[Beavah]

Aw, GW...

 

Yeh left off da attorney to consult on liability and legality of care! I think you're prejudiced.

 

He'll also need at least one intern for research, and an accountant with a stopwatch (preferably one dat runs fast) for billing purposes.

 

B

 

[GernBlansten]

Don't forget the reserve heli pilot just in the event the rescue heli pilot has exceeded his total air time for the day.

[Gold Winger]

"Yeh left off da attorney to consult on liability and legality of care! I think you're prejudiced."

 

I figured that the attorney that was along to consult and advise on risk management could do double duty with the medical side. Maybe not.

 

[Mike F]

Our troop first aid kit has all the standard OTC meds mentioned above.

To keep them current, two TC members (an RN and a Med Tech) go through it and update at least once a year. Whenever we use something, we let them know so they can check stock after we return.

We have BSA med form on each scout and adult - even if they do not regularly take meds for particular condition. The form is annotated to clearly state we have authority to administer these OTC meds as we deem necessary, except as noted by the parent.

At the end of the campout, we let the parents know we gave Johnny some Tylenol for a headache last night (along with a liter of gatorade) or Timmy some ibuprofin for a painful knee, etc.

 

Because we participate in a lot of backpacking, etc., we require all scouts and adults to have current BSA Class III physical on file. A medical notebook goes with the leader of every activity. In the front is a summary of all members with special needs: allergies (drug, food, other), routine med requirements, and known medical conditions (ADHD, etc.) and what these mean in terms of limitations and possible problems.

 

For scouts with special prescription drug needs, the parents send only enough for the trip along with written instructions. One of the attending adults is in charge of handling these. As the boys get older, we encourage the parents to work toward the time when boy can handle it himself, but never to send more than required for the trip.

 

Since you asked for lessons learned, we used to be more cavalier about it until scout on some pretty heavy-duty mood control meds had some major issues on a couple of campouts. Worst part of this was his parents chose to not disclose his condition and medications, so we had no idea what was going on when he forgot to take the meds. Now were very up-front when they join we need that Class III and full disclosure so we can best help every boy.

 

[Beavah]

Talked to one pretty active, savvy troop tonight. Adults are mostly WFA, some WFRs, the rest ARC FA. Committee includes a doc, a paramedic, and at least one mom who's a former nurse.

 

When a new boy joins and they get an initial health history, the doc and the medic review the information. They may make follow-up calls with da parents with questions, or even ask to speak to the child's physician. They prepare a short summary for the scouters on each kid, which goes in a notebook along with permission forms. If there's a really odd case (they had one boy some years ago who had recent open heart surgery), they develop trainin' for the scouters and PLs.

 

For boys with "must take" or "must be available" meds, they obtain Rx's so that spares are kept in the unit adults' first aid kit. For epi (they have 2 nut allergy kids and one adult sting allergy scouter), they carry that as well - and in the patrol first aid kits for that patrol. Older/mature PL's and all adults are trained in administration (yah, a video of symptoms, when/when not, scenarios and practice injections with saline. Kids take it seriously.) Epi kits include chewable benadryl.

 

The unit first aid kits also contain the typical OTC meds, but in small enough quantities that even if yeh took 'em all it wouldn't be a problem. Adult QM keeps track. Boys taught about OTC meds as part of First Aid MB within troop.

 

Permission slip contains meds permission.

 

B

 

[Knot Head]

Is there a written BSA policy on what should be in the Troop first aid kit or whether you are required to have a Troop kit? We have a giant troop kit but I bring my own stuff in a zip lock.

 

One medic I talked to at summer camp last year said he makes each boy bring his own first aid kit camping & hiking. When they come to him needing a band aid or something he tells them "get one from your kit" or if need be asks them "where is your kit?" I adopted that approach even though the troop has a first aid kit. I won't treat the typical camping injuries like blisters, scrapes & minor burns, I make them go find a scout that has the first aid MB and supervise them to treat the injury for the burned finger or sunburn or tick or scratch or whatever. If someone ever gets really hurt like a broken bone of course I'd treat them.

[ASM857]

In our kit we have cheable Benadryl Imdium & the generic pebto, we also have burn cream, bite aid & genral first aid cream. On first aid training, myself and the committee chair are First aid Cpr AED & oxygen certified first responders by our employers. I am planning on attending Wilderness first aid this summer. On prescription meds we have one leader assigned that keeps with him and hands to the scouts at the appropriate time. ON the older star & life scouts they take care of themselves.

 

YIS

Doug

[Beavah]

Ive been tryin to collect a bit of info from units around here. Heres what Ive got.

 

Troop A

One adult who did WFA to meet da Philmont requirement.

Troop uses those blue first aid kits yeh see in stores, and buys the restock kits.

Kit contains cortisone cream, iodine tincture, neosporin, antifungal cream, mylanta, benadryl, tylenol, advil, loperamide

 

Troop B

Experience unclear.

First Aid kit does not contain meds. However, youth have own small kits from 2nd class requirement that do contain meds. Sorta random.

 

Troop C

80% of leaders ARC First Aid or higher, 50% WFA.

All PLC members ARC First Aid or higher, some WFA.

First Aid kits contain OTC meds.

Several kids with chronic medical conditions.

First Aid kits contain Rx meds for kids with chronic conditions.

A couple adult leaders carry meds (EMT and higher)

 

Troop D

Most experienced adult is ARC Community CPR/First Aid

One troop first aid box, mostly topical meds, a few tylenol.

Youth meds not allowed; all meds collected, stored, and dispensed by adult.

 

Crew A

100% of leaders WFR or higher

100% of youth members WFA or higher (most WFR)

First Aid kits contain OTC meds

First Aid kits for longer expeditions may also contain Rx meds.

Adult first aid kits contain Rx meds

 

Crew B

Forgot to ask about training

First aid kits contain OTC meds (similar to Troop A above)

 

Yah, Im not sure what this says, eh? Units span quite a range. Laissez-faire seems to be most common, perhaps? Da units that actively carry meds seem pretty experienced/thoughtful about it. Maybe itd be good to develop several good practice guidelines for different levels?

 

B