Tips on Summer Camp ?

[WholeHam]

Hello. I'm going to be working at a summer camp as the on call EMT. Just wondering if anyone could help me with pointing out some things that I should brush up on. Also, what are some things I should make sure to bring with me or carry at all times? Any general advice/tips?

Thanks!

[Sullcofirenet]

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[Dustdevil]

Oh man, where to start! :?

First thing, hopefully you have either some military medic or ER tech experience behind you. No offence intended, but be aware that if EMT is your only medical training or experience, you probably don't know two percent of what you need to know to be a competent camp medic. You will probably get through a whole summer without seeing a single thing that was covered in EMT school. No fractures. No diabetics. No CPR's. No CVA's or MI's. Just a lot of minor cuts and scrapes, splinters, insect bites and stings, sunburns, poison ivy, ankle sprains, ear infections, sore throats, allergic rhinitis, tummy aches, headaches, nausea and vomiting, malaise, and homesickness. A good pædiatric practice handbook like "Current Pediatric Diagnosis and Treatment" would be helpful, but only if you are well schooled in anatomy and physiology and medical terminology (well beyond the EMT level). If not, you're better off with a family medical guide written for lay persons. Another book that would be extremely helpful would be a pædiatric phone triage handbook for nurses. Read it thoroughly. It will be your best resource for deciding what needs to go to the doctor and what can be treated in your clinic with supportive care. Quite invaluable. If you can find a good handbook on dermatology for recognising different rashes, that is good too. If you mistake chicken pox for mosquito bites, or an medication reaction rash with a detergent rash, it can be serious. Impetigo and a fungal rash are very similar in appearance, but are treated very, very differently. One requires a trip to the MD. The other does not. You need to know the difference. Learn to do a thorough, physician style (not EMT style) physical examination and history taking. Of course, if you'll have Internet access on-site, take advantage of it and study up on all this stuff constantly.

You'll want to read up on all of the above conditions and know them thoroughly, because you will see every one of them. Treating minor cuts and scrapes and burns sounds simple enough, but surprisingly few EMT's or medics have any experience with it other than what their mother did to them, which was usually wrong. Knowing the difference between allergies and strep throat, a lac that needs sutures and one that dose not, otitis media and otitis externa, a sprained ankle and a broke ankle, a tummy ache from appendicitis, a sinus headache from dehydration, and a faker from a really sick kid are skills that can only be acquired through education and experience you didn't get in EMT school. You'll need to know who you need to watch overnight and who can go back to their cabin or tent, as well as what to watch for and how often. You'll also need to know who needs to be isolated for contagion and who does not.

If you are at a boys camp, you're lucky. They hardly even go to the clinic for the minor stuff. They suck it up and usually take care of their own. If you are at a co-ed camp, be prepared for ninety-percent of your patients to be females. Even at an all boys camp you'll typically have a high percentage of female patients because of the female employees and family members. If you are at a girls camp, God have mercy on your soul. You better become an expert on menstruation and "the talk" before you get there. You're going to need it a few times when a ten year old gets a surprise visit from Aunt Flow. Brush up on your patient mom skills. You're going to be constantly busy.

Before the kids arrive, you will want to meet with your medical director and get absolutely straight what your parameters are. Some will want you to send everything that complains to their office. Others will want you to make clinical judgements and decide who needs to see them and who doesn't. If you aren't up to those kinds of decisions, be honest with him or her! Don't try and fake it and act like you know more than you really do. Some kid will end up suffering for it. It is way too easy for a remote EMT or medic to get cocky and start playing doctor without the real knowledge necessary to do so. Resist that temptation. If you're not sure what is wrong with a kid, call the MD and get an opinion. That's what they're there for.

Supplies? You won't need much of the stuff you find in a "trauma bag." You might use a couple of rolls of Kling or a Surgipad or two over the summer. Possibly a handful of triangular bandages if you get a forearm or collarbone injury. There's a good chance you won't need any of it at all, but you'll still want to have it handy just in case a kid falls off a cliff or into catches himself on fire. Kids can indeed get pretty badly hurt out there. Mostly you'll need lots of Bandaids (cloth, not plastic) of every conceivable shape and size. Don't forget the extra large ones for big knee scrapes. Tincture of Benzoin for making the Bandaids stick better in the sweaty summer. Two and three inch Telfa pads for bigger wounds. Bulk 4x4's for scrubbing wounds. Tape (you can get by with just Transpore plastic tape, but elasticised cloth tape is handy for bigger dressings too). Antiseptic spray or solution for cuts and scrapes (Forget about hydrogen peroxide. That went out in the 1980's). NeoSporin ointment (preferably in the little single-use packets, not tubes). NuSkin liquid bandage. Sterile saline irrigation. Eye wash solution (small individual bottles. Don't share between patients.) Visine drops (too long in the sun, dust, and water is hard on kids eyes). Betadine solution. Cotton tipped applicators. Super and Junior tampons. Maxi Pads. Americaine anaesthetic spray for burns and scrapes. Aloe gel with Lidocaine for burns (keep it refrigerated for better effect). After Bite sting swabs or sticks. Lotrimin anti-fungal cream. Anti-fungal foot spray. Anti-fungal foot powder. Hydrocortisone cream. Caladryl lotion. Blistex lip balm. OraJel oral anaesthetic. Swim-Ear drops. Instant ice packs, as well as some re-freezable gel packs. Two and three inch ACE bandages. Some really, really good splinter forceps. Some sewing or hypodermic needles for helping to remove splinters and popping blisters. Some moleskin and blister pads. Assorted splinting material, especially a couple of malleable SAM splints if you can get them. Oral and rectal thermometers with sanitary covers (if they have an ear thermometer, throw it away. They're $hit.). Surface disinfectant for cleaning equipment and exam tables, etc... Some bottles of refrigerated Gatorade for rehydration of heat emergencies and diarrhea kids. Some Sprite or 7up (not refrigerated) for kids with nausea and vomiting to sip on. I can guarantee you that you'll utilise everything on that list over the course of a summer.

As for meds, don't go stocking up on anything until you talk to your MD. No Tylenol. No nothing. Tell him what you are comfortable dispensing and go from there. Remember, your EMT cert didn't cover that thing, so you are sticking your neck out by handing out even OTC meds. The standard OTC fare I recommend -- so long as you are INTIMATELY familiar with their uses and pædiatric dosages -- is Tylenol, Advil, Aleve (especially for menstrual cramps and sprains), Alka Seltzer, Mylanta, Imodium AD, Tums, Benadryl, Sudafed, Claritin, NyQuil, Cepacol lozenges, Robitussin cough drops, and Halls Mentho-Lyptus drops. As for the first three, the MD's office nurse can probably fix you up with a big box of each for free from her sample closet. And individually wrapped meds (including ointments, etc…) are a MUCH better choice than shared bottles. Try to get them if you end up shopping for yourself. If you're lucky, the MD might go for a couple Epi-pens. If you're in fire ant or mosquito country, he might send you some Rx steroid cream sample tubes to keep on hand. They work much better on hardy insect stings than OTC Cortaid. Possibly a tube or jar of Silvadene cream for burns (keep it refrigerated and it makes burns feel MUCH better). And if URI's get so rampant that the clinic starts filling up, he might call in a big bottle of codeine cough syrup for you to help the kids in the clinic get a quiet night's sleep. Don't go asking for any of those until you need them though, and again, only if you are intimately familiar with their use.

Don't forget to wash your hands thoroughly before and after every kid you see. Otherwise, you're likely to end up with some childhood disease that you managed to miss when you were a kid. I never had strep, sinus infection, or erythema infectiosum in my life until I started working pædis. And trust me, kids diseases are hell on adults! Avoid them through good hygiene.

Don't forget meticulous and thorough record keeping. Although you may start to feel more like a mom than a medic, you are still engaged in medical practise. Keep your medico-legal obligations in mind. They should provide you with an official treatment log, as is required by the ACA. But be prepared to keep even more detailed individual records on individual patients. Not all need it, but many will. Especially those that require evaluation of an injury or condition or an overnight observation. The treatment log book doesn't give you room for that, so have some blank lined charting paper available. And, of course, when you treat employees and staff, it requires a whole different set of records, for they are covered by OSHA. Read up on OSHA requirements ahead of time so you know the guidelines.

Good luck, Bro! I love working kids camps. I wish I could make a good year round living at it. It's fun and rewarding and quite a challenge. If you go in with the right attitude and preparation, it will also be a valuable learning experience. You'll definitely be even better prepared the next time you do it.

[Eydawn]

Damn! Thanks, Dust. That's where I'm headed as well, I think I'll print this off and keep it handy.

This is what I've done mostly before.. just not as a full time camp medic but at shorter campouts.

By the way, I've seen little boys weep a lot more than the girls on some of the splinters and stuff.

But then again, Webelos are still likkle tykes.

Wendy

NREMT-B

[akroeze]

Ok, my background. I am a Nurse and I am going back for my second year of camp nursing. The camp has roughly 240 staff and 500 campers at any one time. We work in a team for health care, three nursing staff, a physician and a nursing student. I'll repeat what Dust said.... if you're an EMT-B with no other medical background you won't be able to do anything for most things you will see. Nothing against EMTs, it's just you aren't trained to be a camp nurse. When it all comes down to it, the best person to work at a camp is a nurse, not an EMT/Medic.

Equipment? Well we are an anaphylaxis friendly camp therefore there are epi-pens posted everywhere and each nurse has one in their kit. What is our kit? You know those cheap hip packs that they give away for free sometimes? That's what we use. You don't need any more than that. If memory serves I had... bandaids, a couple of few 4x4s, a roll of tape, a roll of kling, a pen and paper, epipen, gloves x 2pr, maybe some 2x2s?

That's it, that's all you need in your personal kit. It's small and to the point... maybe throw in an ABD pad if you want.

Here is an idea for cleaning of wounds.... make-up pads. Those little round single use cotton things women use. Go to a bulk store and get 'em really really cheap. They're perfect for cleaning a wound (use tap water.... it works) and much cheaper than gauze.

[Defiant1]

my one suggestion, other than brushing up on how to care for sun burn, poison ivy, stuff like that; is to bring an aerosol spray can and a lighter, for the pure and simple reason of getting rid of the flies (if you don't have mosquitos the size of poodles, then nevermind). my times up at Phillips Scout Reservation when i was a boy scout would have been ALOT more enjoyable if i could have taken out those mosquitos.

[Michael]

I've seen little boys weep a lot more than the girls

Others have seen that too, prompting all sorts of inflammatory inferences...

http://www.findarticles.com/p/articles/mi_...i_3187182/print

http://blackinformant.com/index.php?p=215

http://72.14.207.104/search?q=cache:kY8HJh...=clnk&cd=14

Ancient heroes wept freely. I don't know why or when it became * sniff * taboo.

[Sullcofirenet]

[Eydawn]

Oh, I agree, Michael.. I think it's terrible that it's taboo for men to express emotion. I think it leads to all sorts of problems because frustration/sadness is repressed. I was merely remarking I have seen young boys cry more than young girls... Dust had seen the opposite, and I just threw it in there.

I can't wait to get to the camp. Homesick and scraped knees sounds so much more appealing to me than the drama I've had spring out at me

this last term :toothy5: Even puking kids would be better! :pukeleft: :pukeright:

Wendy

NREMT-B

CO EMT-B

MI EMT-B

[Dustdevil]

I was merely remarking I have seen young boys cry more than young girls... Dust had seen the opposite, and I just threw it in there.

Actually, that is not what I was saying. I was merely commenting on the frequency of reported ailments among females as compared to males. I made no comment regarding how well they take it. Little boys tend to frequently wear a bloody knee all day long as a badge of honour. Little girls want it washed off and covered up ASAP. I'm not saying they cry any more about it than boys. I'm just saying that they tend to get things taken care of more often than the boys who are too ADD to stop playing and see the nurse.

By the way, I'm going to be très pissed if WholeHam doesn't bother to come back and read this topic! :x