How does your troop handle medication(s)?

[T2Eagle]

I should add to my previous posting that what I most want to do is work with the family to determine what's best for the individual scout. I would be more than willing to take responsibility for a medication if a parent, or even the scout, thinks that's what's best for that scout. Some scouts are more responsible than others, some medications are more critical than others.

[jhankins]

The rules for camp staff controlling medication changed last year. I can't find my folder with my notes, though. It was something about taking responsibility for medications isn't something camp staff should do, and that's the unit's responsibility.

 

I just moved, but I'll keep going through my rubbermaid bins of folders..

[IM_Kathy]

troop campouts the boys are responsible for their meds unless their parent comes to us and says "here are his meds make sure he takes them at X time" meaning their son doesn't want to take his meds so we have to make him.

 

at summer camp we follow the camp's rules - each medication is turned in and the troop is given a lock-box for them and unless they need refriderated they can bring the lock-box back to camp site - those needing refriderated have to go to director/nurse office to take their medication.

 

our permission sheet lists all the boys when we sign up and has a spot where a parent lists their son's meds so we have that on hand for medical emergencies.

 

as a person that is on medication and often has to get doses changed it is easier for me to keep a list in my wallet - and then on that sheet or any other sheet I write down "medication list in wallet" That way when I'm at a non-scout activity and have a medical emergency my medication info is right there with me (1 of them has reactions when mixed with other types of meds so it's important for those who need to know to know) And I always recommend this to all parents who have boys that are on daily medication(s)

[Engineer61]

After reading this statement in OldGrey's post....

 

"The COmmittee Chair of the troop is a Pediatrician who thinks that scouting is a fine outlet for the excess energy expened by ADD/ADHD youth."

 

I am convinced that the above mentioned Peds Doc has absolutely no clue as to what ADD/ADHD actually is. There is no "excess energy" involved in any aspect of ADD/ADHD. ADD/ADHD kids have no more or less energy to expend than other kids.

 

Wow...I'm lost my 2 cents!

[T2Eagle]

I won't put words in his mouth, but I given the rest of OGE's post I took his remark as mostly tongue in cheek and the Pediatrician's "prescription" as an urge to address the cognitive side of ADD/ADHD.

[DeanRx]

"Here is what works for our troop: We have a medicine permission slip for prescription/non prescription meds that they must list what med., amount, time and date to be given. All meds must be in original container with current dosage and only send amount that will be needed for the weekend in a ziplock. I am the one who safe keeps the meds on the trips (always there hubby SM). The scouts get their ziplock and open the bottles and take the meds. If there is a medical emergency I think it is important to know when that scout had whatever med."

 

Very good way of handling the meds.

 

1) Send only what is needed in original pharmacy containers, labelled from the pharmacy. Ask your pharmacy for a reprint labelled vial for school or camp use. They should be more than willing. If not, I'd change pahrmacies. Any kid who is on a long term med should have a "travel" bottle at the ready (this goes for adults as well). At least if he looses it, the parents aren't out big$$ in copays for a 30 to 90 day supply worth of med that the insurance won't pay for until next month.

 

2) Have a central control point / person. This person's job is not to administer the meds, but to keep track of them and give the correct kid the correct bottle. This should be done at the UNIT level.

 

Having all meds in a large camp with the first aid tent / cabin is unpracticle and runs the risk of potential for diversion and med-errors. If you have all the Ritalin together in the same place (and everyone knows it), then there's only one place someone has to go to steal it all. Also, most first-aid stations are manned by EMT's or LPN's at the camps (if even that level of training) and having 50+ kids to keep straight, especially when the individuals are not known to the staff, leads to medication administration errors. Johnny gets Joe's Methylphenidate 10mg SR, while Joe gets Johnny's Methylphenidate 20mg IR, etc... very easy to get things confused.

 

Keep the meds under ADULT supervision at the UNIT level in ORIGINAL PHARMACY CONTAINERS.

 

You can hash out whether or not the supervising adult wants to be responsible to remind the scout(s) that its time to take drug a or drug b, but I would side with that is the scout's responsibility unless the scout is unable (i.e. Down Syndrome / Austistic / or other special needs condition). In that case, I would guess that the scout is going to have a parent or some type of chaperone along on the campout, as few adults would be willing or prepared to meet the needs of such a scout and still provide adequate supervision to the rest of the unit.

 

My 2-cents FWIW.

 

[dScouter15]

I'm a paramedic, and for a few years now have volunteered as the "medical officer" for my council's week long NYLT program. The method I've used for medication handling is to instruct all participants to bring their medication to camp in the original bottle, and to bring only the amount needed for camp. At the start of the week, we do our "medical checks", where I briefly meet privately with the scout, his parent and one other member of the course adult staff. We review the medical form, and significant medical conditions/special needs/etc, as well as medications. I confirm that time of day that the scout needs to take each of his medications, and ensure that myself, the scout and his parents are all in common understanding of his expectations while camping with us. I then place the medication in a zip-loc bag clearly labelled with the scout's name. The bag is placed in a filing cabinet in the health lodge alphabetically by the scout's name. At the conclusion of check in, I make a master list for each day that lists each scout's expected medication needs. For instance, I'd have a "Monday" page, with columns for "morning," "dinner" and "bedtime" with the scout's name and needed medications listed under each column - eg "Joe Smith - Loratadine". The scouts are responsible for coming to the health lodge at the appropriate time. When they arrive, I pull out their bag of medication, confirm that I have the correct name on the bag, and the correct names on the medication bottles inside the bag. I then give it to the scout, and I instruct him to verify that its his name on the bag and the pill bottles. He then takes his medication, and I cross his name off my master list and initial it with the time he took the medication.

 

I think this setup works well for a number of reasons - first, all medication is stored in a temperature/humidity controlled environment, that only I and the course director have access to; so all medication is secure, and cannot easily get lost in a tent, damaged by rain, etc. Secondly, I'm not actually administering medication - I just verify that I'm giving the scout his own bag of medication, and its up to him to take them. Additionally, the list I keep allows me to make sure that each scout is taking his medication on time. I only need to look and see if there's any names not crossed off my list to see who I need to track down to take their meds. In the event of a medical emergency, I can notify EMS and hospital staff as to the what meds the scout took, and what time he took them.

 

I understand that this setup is for a council-wide event, but I would recommend modelling you're troop's procedures on it. Designate an adult who will confidentially determine the needs of each scout in attendance, and be responsible for ensuring that the scout takes his meds on time. The scout is still responsible for administering his own meds, but the adult leader still is able to remind the scout if necessary.

 

Disclaimer: This procedure has been approved for me by our council's professional staff and physician liaison, you're council's guidelines and state laws may differ.

[Sebastian a lady]

How about allergy medicine? We have a scout with quite a few allergies. I mentioned to his mom that he should probably carry his Epipen. Her concern was that if he was having a reaction that he wouldn't be in any condition to administer the medication. My concern was that the person with custody of the Epipen would be in some other part of camp.

 

 

[OldGreyEagle]

 

T2Eagle wins today's prize and is eligible to advance to the next round...(This message has been edited by OldGreyEagle)

[NE-IV-88-Beaver]

dScouter15, I have to take exception to your definition of "administering his own meds". I question legally if it would hold up that you are not the person administering the drugs since you are the person being placed in charge of them.

 

"The scout is still responsible for administering his own meds, but the adult leader still is able to remind the scout if necessary."

 

In your scenario, all the Scout is doing is taking his pills out of the bag that you are maintaining and giving them to himself. And this is for Scouts deemed mature enough by their leaders to be taking NYLT (13 to 17 year old Scouts)! What do you do if the parent says that they would rather have their son responsible completely for his own medication? He has been doing it for the last x years. What do you do for nebulizers, epipens, and allergy meds that should be close at hand, when needed? Do you tell them that it is course policy that they follow your procedure? If so, then you have taken over the responsibility for administering medication, and in some cases possibly placed these youth in unnecessary danger, whether you think so or not.

 

We all understand that there could be special circumstances that could warrant your procedure (such as meds needing refrigeration), but as the rule I find that it diminishes the whole intent behind youth leadership training. We are teaching responsibility and self-reliance.

 

I agree that is essential that a person be responsible for knowing what medications are in camp. This would be determined at medical check-in and parents would be made aware that their son will be completely responsible for his own medications. I think that it is also a good idea to periodically check to see if they are taking maintenance meds. But to subject them to lining up for a sick call to pick up their medications, I think, invades their privacy and demeans them.

 

I have been involved with youth leadership training (JLT, YLT, or whatever) at the district and council level for almost thirty years. I have found that most parents would rather see their child be responsible for his own medication. They do it at home and why shouldn't we give them the same opportunity!

[dScouter15]

NE-IV-88-Beaver - I've not been made aware of any legal issues with this setup - could you point me towards the resources that led you to suspect potential legal trouble so that I can review them with my council staff and physician medical director?

 

Of course, all "rescue" meds (epipens, inhalers, etc) would be kept on the scout's person at all times. I apologize for not clearly stating that. Again, I am a paramedic, and am quite familiar with why it is essential for these rescue meds to be immediately available to scouts with life-threatening allergies, asthma, etc - my apologies again for not making that clear in my post.

 

In regards to the NYLT program specifically, I always tell both parents and scouts what our "baseline" policy is, but that I'm always willing to work with each individual scout to address any special needs or concerns. I've never had anyone ask me to keep their regularly scheduled prescription meds out of the health lodge. More than once I've had parents emphasize that I needed to "stay on top" of making sure the scout takes his meds correctly.

 

Yes, at NYLT we do teach principles of leadership and personal responsibility. However, NYLT is intended to be a "safe haven" where scouts can make mistakes, and learn from them in a safe environment. I don't feel that we can safely allow 13 year old scouts to make mistakes with their medication. I think that using the word "demeaning" to refer to asking scouts to pick up their medication from the health lodge is a bit hyperbolic. I would disagree that "self reliance" is a trait we teach in NYLT. I agree that in an ideal world any scout selected to go to NYLT would have the maturity and responsibility to correctly handle their own medication. But, here in the real world, we have seen time and time again that this is not the case, and I am not willing to jeopardize a scout's safety to make a point.

 

There are also a few "unique" factors that apply to NYLT, that would not apply to unit-level camping, which I initially felt were off-topic for this thread, but seem have been called into question. At NYLT, we work with scouts from dozens of troops across the council, most of whom are not known personally to the course staff. At a unit level, the adult leaders typically have a fairly decent understanding and measurement of each scout's personal level of maturity and responsibility, and have a good idea of which scouts can be trusted to take their own meds, and which scouts might need to supervision or reminders. At NYLT, we don't have that kind of knowledge, so we've have to develop this one-size-fits-all approach. Furthermore, we have A LOT (last year roughly 30-40%) of scouts of mood stabilizers, anti-ADD drugs, antidepressants, etc. With some of these drugs, it is quite important that doses not be missed, and repeated missed doses could lead to serious problems. On more than one occasion, I've had scouts who seriously believed that their antidepressant drugs were for "allergies." In previous years, we have had some problems with scouts taking incorrect medication, missing doses, etc, when the meds were in their own care. On at least one occasion, this resulted in a moderate medical emergency.

 

Another factor we deal with is that scouts are tenting with another scout who they most likely do not know. This leads to concerns about a scout mistakenly or intentionally taking another scout's medication.

 

Sebastian - I've also heard the concern that a scout who needs the medication may not be able to self-administer it. My solution to that concern was to request that the scout keep the EpiPen in a designated place on their person - either in a pocket, in a "fanny pack," or whatever the scout feels comfortable with. That way, if the scout is unable to administer his own meds, me or another adult leader will know where to look for the epipen to assist him. (Of course, if anaphylactic shock has progressed to the point where a patient is not conscious enough to administer an epi-pen, the epi-pen probably won't do much good at that point - but that illustrates the necessity of keeping it close by, so that it can used ASAP after the onset of symptoms). I definitely think that the preferred situation should be for the scout to keep his epi-pen on hand at all times.

 

(This message has been edited by dScouter15)