Healthy Living

Cleanliness is critical, so each examination and assessment area should have access to a sink for hand-washing in order to control the spread of infection and an adequate, safe waste-disposal system that includes a tamper-proof container for used needles and possibly infected materials.

Since many camps are older, it is difficult to keep up with required, often expensive maintenance, repair and renovation. Uneven floors, rusty nails, inadequate plumbing, electrical systems that are not up to code and infection-prone dirty areas–such as dust and bits of rotted debris dropping from the rafters–are impending medical disasters in a facility intended to be a model for healthcare. Remediating these conditions is a top priority in the camp setting.

Medication Time

Effectively managing medication is a challenge. As many as 30 percent of campers bring with them medications that in most instances are stored in the health center, in addition to the drugs that are dispensed in the course of caring for illnesses and injuries that occur at camp.

Camp leadership and health-center staff will do well to recognize that many states have laws that govern the storage of medications at camp. General guidelines for the camp formulary stock comprise a written procedure for administering medicine, a compendium of available drugs with doses and quantities and a list of all campers who are on medications with the prescribed dosing recommendations.

Computerization with a backup system enhances compliance with these guidelines. Prepackaged camper drugs are a convenience but still require safe, reliable storage.

Equipment

Equipment at modern-day camp health centers, as everywhere, is dependent on power, including electricity with a generator back-up, phone lines, and, preferably, Internet access, even in remote areas.

Refrigeration is a must for drug storage and a source of ice applications. An equipment and supply list is generally readily available and often varies as to whether the health center is at a specialty camp or not.

All camps require automated external defibrillators (AEDs), not only in the health center but distributed strategically throughout the property. The availability of certain equipment, such as ventilators, insulin pumps and assistive devices, depends upon the nature of the specialty camp and the health needs of campers.

Staffing

No summer camp health center is any better than the quality of the staff that supervises it. Proper staffing and training are critical!

According to Dr. Edward Walton, a board-certified pediatrician and emergency physician, who is an expert in camp health, 45 percent of personnel who care for campers are nurses and 7 percent are physicians; the remainder includes licensed practical nurses, first-aiders and paramedics.

Camp directors cannot assume when hiring candidates to treat children and adults that having “M.D.” or “R.N.” after their name qualifies him or her in camp medicine. Is the intended healthcare provider a pediatric physician or nurse who specializes in emergency medicine, an experienced primary-care provider or a geriatrician or radiologist who hasn’t treated a child in 20 years?

Whereas certain guidelines promulgate administrative procedures for an on-site health center, such as the number of required beds, there are no standards for evaluating the competency or knowledge base of healthcare providers. However, training programs exist.

The bottom line is that the best camp health centers make sure their providers, regardless of formal education and degrees, are trained on how to properly diagnose, manage, and prevent minor or potentially catastrophic conditions in residential campers and staff.

For more resources, see Medical Essentials at www.expertonlinetraining.com or Education Center at www.acn.org.

Work Cited

(Walton, E.A., Maio, R.F., and Hill, E.M. “Camp health services in the State of Michigan.” Wilderness and Environmental Medicine. 15: 274-283, 2004.

Warren A. Katz, MD, is president of Medical Professional Services. He can be reached via e-mail at warrenkatzmd@comcast.net.

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