Health Officer

Camp Health Officer is the onsite health professional. The Camp Health Officer shall have overall responsibility for all areas of the camp participants' health. Responsibilities will include staff orientation, supervision, and organization of the camp health services The Camp Health Officer will reside on camp property and should live within the Health Office and he/she or designee shall be available by radio or phone as needed by the staff on duty. He/she or designee should be able to be reached at any time by calling the numbers posted in the Camp Health Office or by radio. Key camp health staff will be assigned cell phones. Those on duty or call will have their cell phone charged and on their person. Radios will also be issued and will be assigned. Those on duty will have their radio charged and on their person. She or he also has the responsibility of making sure there is one full time camp health staff member present during normal office hours for the summer. The camp health staff members are required to be at camp for the entire time that the camp is in session.

Policy for Written Health Record Requirements for Campers and Staff

Health History: The current official BSA Health Form is required for each camper and for each staff member. The history must be less than twelve months old; therefore a new health history is
required each year. Parts A and B are required for all participants in camp. Part C is also required for all participants in programs that are 72 hours or longer.

Health Examination: A health examination is required for campers and staff participating in programs lasting 72 hours or longer. The physical will have been completed within a twelvemonth period of attending camp; therefore meaning a new physical is required each year for campers and staff. A physician’s signature and date are required if part C is completed.
If the scout or counselor is a minor, parent or guardian written permission is required each year. Camper and Staff medical forms will be kept on file during each camp session and arranged by
unit or staff in alphabetical order.

A health logbook is to be kept by the camp health staff to record distribution of all medications and administration of medical care the campers and staff members. The log is kept in a labeled
single, bound, numbered notebook or folder that is located in the camp health service office. The camp health staff is responsible for keeping the log current and must sign off on all care rendered.

After a Unit arrives at camp, a leader is to meet with the Health Officer. The Health Officer will privately screen each Scout and leader form and verify all forms are current. Any specific
questions on medications or physical needs will be handled privately with the individual Scouts. The Camp Director, appropriate staff, and unit leaders are informed of any scouts with
limitations or special needs.

All medications will either be locked in the Health Lodge or in an approved locked container in the campsite.

First Aid

First aid beyond the capabilities of unit leaders is to be administered by trained individuals. Individuals who are trained in first aid and CPR should talk to the Camp Health Officer during
camp orientation to confirm training and understanding of emergency situations. First aid kits are located in all camp buildings and program areas. An appropriate supply inventory will be kept in the camp health office.

ALL accidents and injuries need to be reported to the camp health staff. The camp health staff has the discretion for treatment or referral to the director. Camp health staff are required to
record the history of injury and any treatment rendered in the First Aid Log. An accident form must be completed by witnesses/victims for any accident or injury incurred by campers or staff.
ALL staff members will attend an orientation presentation by the Camp Health Officer to discuss basic health care principles and the needs of the camp participants.

Emergency Medical Care

Emergency medical care will be administered by the appropriately trained camp health staff. Refer to the physician's standing orders for authorized treatment and procedures.
Emergency transportation and care will be readily available. Call 9-1-1 for any severe medical emergency. Other phone numbers are available by every camp phone. Staff members will
notify the camp health staff or the Camp Director of any medical emergency. The following documents will be taken with the camper to the hospital: the medical form, HSR form, medication sheet, and insurance information if applicable.

It is the responsibility of the camp health staff to record all pertinent information in the camp health log. It is also the camp director's responsibility to record information and events on the accident report form. Available witnesses will be asked assist with this duty.

Routine Scheduled Medical Care

Any required routine scheduled medical care of campers should be discussed with the parent/guardian or unit leader during the check-in time. All concerns should be discussed during this
time. Any concerns or questions should be directed toward the camp health staff. Routine medical care for staff members is the responsibility of the individual staff member unless they become too ill to care for themselves. If a staff member does not feel well enough to work, he/she must see the camp health staff. Depending on the extent of the illness or injury, the staff member may be temporarily excused from his/her duties. If a minor, the staff member’s parent or legal guardian will be notified at the discretion of the Camp Director or Camp Health Officer. The staff member will be referred to his/her personal health provider upon request or at the discretion of the Camp Health Officer. Staff members will also be expected to attend a presentation on maintaining their own personal health. This discussion should include information on camp policies for lights out and quiet hours as well as information of general wellness and stress management. While it is up to each individual staff member to monitor his/her own health and seek assistance when needed, it may be necessary for appropriate staff to monitor staff health needs and quiet times.

Supervision of overall camp health

Camp health staff may have a better feel for the general health of the camp population and because of this they will have direct input to the Camp Director for possible changes in routine. Camp health staff should keep in mind the high degree of activity that the campers and staff members are experiencing and consider the weather, climate, and temperature. Modifications may need to be made to lengthen rest time, increase fluid intake, and avoid direct sunlight on warm and humid days. Changes in weather conditions need to be monitored closely. The camp health staff should periodically inspect the camp to ensure that staff and campers are following proper health practices, including camp sanitation practices. The camp health staff will have the authority, under the guidance of the Camp Director, to take appropriate action should there be a health concern that could affect other camp participants. The camp property is defined as: all land owned by the Mississippi Valley Council

Food Service

The camp health staff shall ensure that food service safety requirements are met. All food provided to campers must be prepared by licensed and inspected providers. Food prepared by the
units must be stored in such a way as to prevent food borne illnesses and shall be checked periodically to ensure all requirements are being met. Procedures for health care and first aid of camp
The following procedures should be followed for any out of camp trips, including hikes, Wilderness Survival, “Older Scout Programs”, ATV, walks off camp, trips to an off-camp pool, and boat/canoe trips:

1. All groups must have a first aid kit and a two way radio or cell phone with them at all times. If a camper wants to take a walk away from the main camp, the Camp Director will be notified and the buddy system will be assured. Two deep leadership guidelines will be followed.
2. Any accidents, first aid or emergency care provided on the trip or outing will be recorded and reported to the camp health staff as soon as possible. Information recorded should include what happened, when it happened, treatment given, and response to the treatment. If the situation is truly an emergency, a two way radio or cell phone should be used to notify the camp health staff immediately.

Procedure for calling Emergency Services:

In the event of an emergency always call 9-1-1
*Only the Health Officer or Camp Director should call 9-1-1. If 9-1-1 is called by a person other than the Health Officer or Camp Director, they will be notified immediately.

Orientation

An orientation to familiarize the camp health staff stations and organize them to the most effective and efficient working space for the camp sessions will be held. Organizing the camp health staff office All supplies need to be organized and arranged to facilitate easy access and use. Arrange supplies by the category that they will be used.

1. All medications and health supplies need to be examined and expiration dates identified. If expired, the medication or health supply should be discarded accordingly.
2. Staff under the age of 18 are required to have controlled medications locked in the health service office. Staff members over the age of 18 are responsible for taking their own medications at the proper time as noted on their Health Form. He/she is to inform the Camp Health Officer prior to the start of camp.
3. Inventory for the camp health staff equipment and supplies will be done prior to and after the summer camp season. A current list of supplies will be kept and given to the Camp
Director. Supplies will be replaced as needed.
4. Physician standing orders are reviewed and updated every year by the council camp physician advisor.
5. It is the responsibility of the camp health staff to prepare and resupply the camp first aid kits on a regular basis. First aid kits are available at all program areas. The camp director will notify the camp health staff at least 24 hours in advance of any off camp activity.

Camp Health Staff Presentation

The camp health staff will give a presentation during camp orientation to educate staff about any health concerns related to camp. The presentation should include: procedures to facilitate  emergency and routine care for campers, personal care, seizure prevention and care, wheelchair safety, universal precautions, and first aid and CPR.

The importance of allergy awareness regarding latex and insect bites or stings should be discussed. Address the issues of eating, drinking, and bowel habits. It is important to keep track of fluid intake and urinary output, especially in the summer time when campers are at greater risk for dehydration and heat related illnesses. Staff should monitor bowel habits in order to identify possible enteric pathogens. Staff take an important role in observing anything out of the ordinary such as a change in emotion, detection of an open sore or injury or detection of an illness.

Staff members spend the most time with the campers and are an excellent source of information. Camp health staff will inform the general camp staff about the various methods of contacting health staff. An emphasis on emergency procedures regardless of time or situation should be made.

Medication administration

Medications will be administered at meal times and before bedtime, or as indicated on an individual basis. It is the responsibility of the parent/ guardian or unit leader to bring his/her camper to the camp health office for bedtime medication prior to "lights out". The Camp Health Officer and Camp Director will be notified of any special needs in dispensing of medications. If the camper fails to report for their medication within one hour of the scheduled time, the Camp Health Officer will do his/her best to locate the camper. The Camp Health Officer will notify the camper's health care provider if the dose of medication cannot be administered. The council's physician advisor may be contacted for clarification or if the camper's health care provider is unavailable.

All medications will be kept in locked storage. Medications requiring refrigeration will be kept in a locked refrigerator at the camp health office. This refrigerator will be monitored for appropriate temperature range daily. Sharps containers shall be available if needed. Units are allowed to keep certain medications at the campsite in a locked storage box. The Camp Health Officer will be notified of this arrangement at the beginning of camp.

Preparation for check-in

Check-in is very busy and stressful but also the most important information gathering time of the week. Patience and calm are essential. Camp health staff should be dressed appropriately in field (class A) uniforms and present themselves professionally. Camp health staff should obtain the camper's records from the unit leader and alphabetize them in the file. Parents/guardians or unit leaders should be prepared to answer questions regarding camper medical care, medical conditions, allergies, current medications, treatments, bowel habits, eating habits, the best way to administer medications and any condition or injury that the camper has at check-in time. This may be the only time the camp health staff will be able to ask specific questions, so take the time to get a complete medical picture of the camper.

Ensure that the camper has enough medication to last for the entire camp session. The medications should be placed into bags labeled with the camper’s name. The BSA requires detailed labeling for medications. Each medication is to be sorted and placed in a separate labeled plastic bag and reviewed for correct name of the camper, the correct prescription and accurate dosing route and time. Controlled substances require an accurate recorded count at check-in and check-out. Preprinted forms will be available for common medications. Detailed forms should be created for the unusual medications by using on-line resources or a commercial computer database. The BSA health form medication list is to be reviewed and reconciled. When dispensing medications, health staff should be aware of those present to avoid accidental ingestion of medications. Ensure that medications needed for the check-in day and evening are dispensed.

Make sure that all of the needed supplies are available before check-in, such as a large supply of plastic bags, pens, paper, and files. Ensure an adequate supply of current BSA health forms as
many camper's will not have brought one. Ensure required health form signatures are completed. Follow the standard procedure to organize the medications for the mealtime and bedtime medication passes. The time between registration and supper is usually very limited so diligent organization will help you to prepare for the medication pass. In the past it has worked best to
write out the name of the camper who has a supper or bedtime medication and focus on preparation of that medication for distribution. You will have plenty of time later to organize the rest of the camper medications.

Medication organization

Medication organization and administration requires patience, efficiency and attention to detail. The camp health staff has the responsibility to organize the medications to the best of their ability to make administration efficient and organized. After the medications have been collected and labeled by camper name they may be organized for distribution. Medications are to be kept safe and appropriately stored so that they are not spilled, mixed or damaged. The evening medications are to be administered at the camp health office. Unit leaders should accompany the camper after-hours. The camper or staff member is to be identified and the appropriate medication(s) identified and verified prior to administration. Medications are to be pre-packaged with needed supplies when a camper is leaving camp to go to alternative locations. It is the responsibility of the Camp Director to ensure staff with the proper certifications escort campers on overnight and off campus trips.

Medical Care

The Camp Health Officer and camp health staff should treat ill or injured campers or staff members to the best of their abilities. The BSA health form should be reviewed at the time care is
rendered. Information from participants parent/guardian or unit leaders should be clarified at check in time and any health questions or concerns should be resolved at that time. Again, the Camp Health Officer or Camp Director may refer any camp participant to his/her health care provider for definitive medical treatment upon request or for care beyond the comfort level of the camp health staff. Severe medical emergencies shall initiate a 9-1-1 call for possible medical evacuation from camp. The camp health staff will stabilize the victim to the best of their abilities with available resources.

Blood borne Pathogens-Exposure control plan

*Refer to the “Blood Borne Pathogens-Exposure” form located in the Health Office. “Occupational exposure” can be interpreted quite broadly, but for our purposes it is acceptable to apply the term to camp health staff and other staff members who are expected to routinely provide first aid. All staff members need training to participate in the Health Care Plan. Information should include the transmission of blood borne pathogens and training in the use of universal precautions. All staff members should receive specific instructions on the use of gloves, along with an understanding of why precautions are important and when they should be used. Practices to reduce the risk of transmission and spread of infectious diseases should be used by all camp staff. Because the risk is minimal with the camp population, the only mandatory precaution in washing exposed skin is with soap and water. Cuts, open sores, and bleeding wounds should be managed in a manner as to minimize direct contact with blood or body fluids. However, under no circumstances should the urgent care of a bleeding camper be delayed because gloves are not readily available.

Hand washing is necessary after any contact with blood or body fluids, and after removing gloves. Disposable gloves are in all of the first aid kits. Any questions about the use of gloves or
first aid should be directed to the camp health staff. Antiseptic hand cleanser is also available in the first aid kits and in the dining hall. It should be reinforced that hand cleansing is the first line of defense against infection. In the event of a bite or scratch, the injury should be reported to the camp health staff and the area cleaned with soap and water and antibiotic ointment applied. The area should be covered with a sterile bandage and monitored for any signs of infection. An accident/incident report will need to be completed by those who witnessed the event.

In the event of blood or bodily fluids being found on the floor or other area it is important to clean the area completely with a mixture of bleach and water in a 1:10 concentration. All cleaning supplies should be available from the Camp Ranger. The Ranger has been trained in safe procedures consistent with OSHA standards. A standard sharps container will be provided for disposal of all sharp objects and syringes. At the beginning of the summer camp session, the container can be picked up at the health office. At the end of the each camp session, the closed sharps container must be returned to the health office for disposal.

Camp Health Staff - Standing Orders

See Addendum for Current COVID-19 Pandemic Protocols When in doubt, ask for help. Everyone has differing levels of comfort and experience. Always review BSA health form for medication allergies or intolerances and current medications. Routine use of aspirin is not recommended.

Definitive medical care refers to the individual's personal health care provider, urgent care center or local emergency center as indicated for the severity of illness or injury. The Health Office is available 24 hours a day in case of emergency.

The following standing orders are for the use at camp during normal operations.
1. Abrasions, Scratches, and Minor Cuts: Cleanse with soap and water and cover with dressing. Check and change dressing daily or more frequently as needed. Apply antibiotic ointment if there is concern for infection. Refer to health care provider if bleeding is difficult to control or the wound may require sutures.
2. Splinters: Remove with tweezers and cleanse area with soap and water. Apply antibiotic ointment and sterile dressing. Change daily or more frequently if needed. For large or worsening infections, refer to health care provider.
3. Infections: If mild and localized, wash with soap and water or soak and apply antibiotic ointment and sterile dressing. Change at least daily or more often if needed. Refer to health care provider for continued or worsening signs of infection.
4. Severe Sprains, Strains, or suspicion of a Fracture: Immobilize, ice and arrange evacuation to definitive medical care. Keep individual calm and comfortable.
5. Head injuries: If there was a loss of consciousness or the injury was not observed, notify the Camp Health Officer immediately and immobilize victim. The Health Officer should arrange for emergency evacuation. If seen and released, notify parents or Unit Leader and have camp staff observe injured patient for 24 hours. Place ice pack directly over injured area for twenty minutes. One hour later place ice on area again for twenty minutes. Person may be allowed to sleep but should be closely monitored. Seek definitive medical care if severe headache, persistent vomiting, seizures or abnormal behaviors occur.
6. Bruises and bumps: Rest, ice, compression and elevation (RICE). Apply ice pack periodically for 48 hours and then apply heat if muscle aches occur. Elevate extremities if swollen. Compression wrap if indicated.
7. Foreign body in eye: Notify the Camp Health Officer immediately. The Health Officer should attempt to irrigate the eye or gently remove the foreign body if visible. Evacuate for definitive medical care if unable to remove foreign body or irritant.
8. Bleeding: Apply constant pressure to site. Place a tourniquet as a last resort as most bleeding can be controlled with adequate pressure. Monitor extremity closely. Evacuate for definitive medical care if bleeding is not controlled with pressure. Treat minor wounds as above.
9. Burns: Refer to Camp Health Office immediately. If the burn is deeper into the dermis or covers greater than 5% of the person’s body, cover with sterile dressing and arrange emergency evacuation for definitive medical care.
10.Sunburn: Keep person out of the sun. Apply cool compresses and sunburn lotion. Administer oral acetaminophen 650 mg every 4 hours or Ibuprofen 600 mg with food
every 8 hours as needed for pain relief. Maintain hydration.
11. Swimming Accidents: For drowning or submersion accidents, remove person from water and activate CPR if necessary. If there are no spontaneous breaths or pulses call 911. For
swimming accidents involving scratches, strains, or sprains, treat as above.
12. Insect bites and stings: Antihistamine lotion should be applied and followed by a cool compress or dressing. Use 1% Hydrocortisone Cream TID if pruritic. If insect bite of sting leads to anaphylactic shock use Adrenalin 1/1000 i.e.: Epi Pens (0.3 cc for person 50–90 lbs and 0.5cc for person over 90 lbs) give SQ. Arrange for emergency transportation. The use of an Epipen ALWAYS requires transfer for medical monitoring.
13.Elevated Temperature: Acetaminophen or ibuprofen according to age or weight.
14.Athletes foot: Desinex powder or similar product to area. Wear shower shoes while in the shower. May use antifungal cream if Desinex is not effective.
15.Constipation: Milk of Magnesia according to age. Typical dose is 15 ml daily.
16.Diarrhea : Kaopectate, Pepto or similar product according to age for diarrhea. Avoid Imodium use until cause of diarrhea is established. Maintain a clear liquid diet until symptoms resolve. Remove from camp and refer to health care provider if diarrhea is persistent or contains blood.
17.Sore throat: Salt water gargles and throat lozenges PRN. Ibuprofen or acetaminophen per age or weight. If soreness is associated with fever or tender lymphadenopathy, refer to
health care provider.
18.Ear Ache: Ibuprofen or acetaminophen per age or weight. If elevated temperature, drainage, persistent pain, or redness is present then refer health care provider.
19. Cough: Over the counter cough medicine per label direction. If worsening cough, fever or shortness of breath, refer to health care provider.
20.Headaches: Ibuprofen or Acetaminophen according to age or weight.
21.Nasal Congestion: Oral antihistamine as directed on bottle as needed.
22.Swimmer’s ear: Isopropyl alcohol applied to ear canal. Swim ear drops if available. Refer to health care provider if significant swelling or uncontrollable pain.
23.Toothache: Ibuprofen or Acetaminophen according to age or weight . If redness or swelling of gum develops see health care provider or dentist.
24.Asthma attack: Person may use prescribed inhaler or medication as needed or ordered. If breathing problems continue or worsen, call 911 for emergent evacuation. Oxygen may
be applied by mask or cannula.
25.Nausea and Vomiting: Assure that symptoms are not related to a heat illness. Encourage clear liquids. Slowly allow advancement of diet when symptoms resolve. See health care
provider if associated with abdominal pain, hematemesis, fever or persistent vomiting.
26.Tick Bites: Staff may remove with tweezers if tick is not tightly adhered to the skin. Grasp the tick head and gently pull for removal. Monitor for the development of a rash
(erythema migrans). If rash appears, have person notify their health care provider when they return home. If tick is tightly adhered, transport for definitive medical care.
27.Heat related illness: Remove to shade or climate controlled room if available. Use cool mist and fan to carefully decrease body heat. Encourage clear liquids (WATER). Avoid
sugar or excessive salt containing fluids. Evacuate to local emergency center if individual becomes confused, lethargic, seizes, develops intractable vomiting, severe headache or
other signs of heat stroke.

Reviewed and updated 5/1/2021
Douglas Peters, MD (Council Physician Supervisor) and MVC Risk Management