Preparing your staff for emergencies.

Imagine the following scenario .... waiting patiently in line in heat that is exceeding 90 degrees. Suddenly, one camper falls to the ground, is unconscious, and begins to have a seizure. Would you and your staff know what to do?

Many of us understand in the "rational" part of our brains that being injured or suddenly taken ill is a part of life. However, how many of us in the "practical" part of our brains would be able to carry out the appropriate steps to assist a camper, peer, or colleague in an emergency situation? The above scenario is based on a factual incident that took place. Fortunately, for the young camper, all of the staff were trained to deal with emergencies and were prepared and able to assist in this situation. With proper training in both preventive measures for emergencies and guidelines for assistance in case of an emergency in the workplace, your staff can respond appropriately.

The American Red Cross tells us that approximately two million people are hospitalized each year as a result of injuries (ARC, 1993). The likelihood of any one of us being injured at some point in our lives is fairly great. What we also know is that we are more likely to use first-aid skills to help someone who we know personally rather than a stranger.

Prevention and Response

Understanding that injuries can and will take place is the first step in designing prevention techniques for your camp. Simple things such as mandating all camp staff hold current first aid and CPR cards is one preventative measure. This would include all staff -- from counselors to cooks! Realizing, however, that children can be injured or taken ill in other places might also mandate that bus drivers or classroom instructors should also have the same credentials. How many individuals in your camp have these credentials?

We should also understand that adults have the opportunity to get hurt or to be taken ill, and therefore, perhaps it is time to have all individuals that are involved with the camp hold these credentials. Doing so may, in fact, save an adult's life. Another factual example: A camp nurse came to the camp director complaining she didn't feel well. Upon further questioning, the director found the nurse to also be complaining of indigestion and some mild chest discomfort. Luckily, this director was trained in first aid and CPR and understood these to be warning signals of a heart attack.

If your camp has an Automatic External Defibrillator (AED) for use when a person shows no signs of circulation, there must be people who are credentialed in the proper use of the AED. There are new changes that have taken affect as of January 2002, whereby the American Red Cross will be implementing the use of the AED in its courses.

First Aid and CPR

Your camp may want to offer to host these courses (First Aid and CPR) for its employees rather than have individuals seek out the courses on their own. CPR certification is good for one year and first-aid certification is good for three years. Therefore, your people would need to be annually recertified in CPR.

Red Cross First-Aid and CPR courses teach many different life-saving skills, including:

* how to check a victim properly

* what to do if someone is conscious and choking 

* what to do if someone is unconscious and choking

* how/when to perform rescue breathing/CPR.

In addition, the first-aid component teaches individuals how to provide immediate care for burns, poisoning, cuts, sudden illness, as well as shock.

Orientation

As part of your camp's orientation process, you should review, revise, and update your camp's emergency protocols should a student or employee be injured or become ill. One procedure set in place for the entire camp may not be possible or advisable - different procedures may be needed depending upon the place of the incident. For instance, if a camper becomes ill on a field trip, there may be specific protocols for this that would differ from a camper taking ill on the property or in the cabin.

Designing Emergency Protocols

Who?

When designing emergency procedures, involve appropriate personnel. Be sure to include the camp nurse and physician. You may also want to contact the local emergency workers/ambulance/rescue team and review with them the emergency procedures you and your staff have outlined prior to any emergency taking place. These people are experts in emergency care and their insights will be beneficial. This also encourages relationship building in the community with those individuals who provide emergency response and care to your campers. It can also help alleviate confusion when an emergency does arise -- emergency personnel will be familiar with your given protocols, as well as the physical layout of the camp itself. You may also want to be sure to involve legal and insurance advisors to be sure that these important matters are also being addressed.

Determine who does what and when. For instance, who calls 911? Is the nurse called first? If the emergency is on a playing field, how is 911 accessed? Are there gates that must be opened? Who has the keys to the gates? If you are away on a field trip, who is designated to call 911? Where do the students go who are not involved in the emergency? Who is supervising them? Who leaves to be sure 911 is called? Who is responsible to call the parent(s)/guardian(s)?

Keeping Records

There should also be a "paper trail" -- detailed records. Some type of standard injury report should be completed. Usually with this type of report the following information is listed: name of student/staff, age, date of birth, home address, telephone number, description of the incident, care that was provided, any follow-up actions, signature of person filing report, signature of witness, signature of administrator, and the date. You may want to pass this report by your legal department to ensure you have all of the information listed that your camp needs. There must be some standardization as to where injury reports are kept, how quickly after the accident they need to be filled out, and to whom they are turned into once they are completed.

Practice, Practice, Practice

With an emergency plan designed and in place, it is time to practice it prior to any emergency actually occurring. As silly as this sounds, it makes for good operating procedures. If anyone has been involved in an actual emergency situation, one realizes the chaos that can occur. By practicing "mock" emergencies, you can assist your staff in understanding what their roles are when and if an emergency takes place. Practicing the procedures that have been designed may also reveal some "flaw" in the protocol that was not anticipated. This may or may not be easily remedied. There are no "do overs" in real life, so the time to make the mistakes is in the practice sessions!

Part of staff orientation or the first day of camp (prior to campers arriving) should be dedicated to reviewing your emergency protocols with all staff Have each camp area -- waterfront, dining hall, cabins, ropes course, etc. -- go through a mock emergency situation). It may also be advisable to follow up with another mock emergency situation -- a practice run, if you will -- with the campers in session. Remember that they, too, will be part of any emergency situation and need to understand what their roles and responsibilities will be. When working with young people, be sure that any mock emergency is prefaced by learning about the appropriate emergency procedures.

A Continuing Process

Emergency preparedness and training should not be viewed as a one time responsibility. It must be an ongoing process that is reviewed and practiced yearly. Planning ahead, implementing a suitable plan for your camp facility and population, training staff, and practicing procedures may make the difference between a negative and positive outcome. We know that not all emergency situations turn out the way we would like them. However, by being prepared, we can ultimately give the injured person the best chance for a successful recuperation.

RELATED ARTICLE: First Aid/CPR Equivalent Certification Providers

The following list includes certifying bodies that meet specified American Camping Association (ACA) standards. Camps should check ACA's Web site, www.ACAcamps.org/accreditation/firstaidcpr.htm, for more details about course offerings.

* American Red Cross -- www.redcross.org

* American Heart Association -- www.Americanheart.org

* National Safety Council -- www.nsc.org

* Medic First Aid International -- www.medicfirstaid.com

* St. John's Ambulance -- www.sja.ca/english/

* American Safety and Health Institute -- www.ashinstitute.com

* National Ski Patrol -- www.nsp.org

* SOLO -- www.stonehearth.com

* The Mountaineers -- www.mountaineers.org

* Wilderness Medical Associates -- www.wildmed.com

* Wilderness Medical Training Center -- www.wildmedcenter.com

* Wilderness Medicine Institute -- www.wmi.nols.edu

* Wilderness Medicine Outfitters -- www.wildernessmedicine.com

* Wilderness Safety Council -- www.wfa.net

Some certifications are valid for one year (e.g., CPR), and others are valid for two years; camp directors should verify the length of certification with the certifying organization.

Suanne Maurer-Starks is an assistant professor and athletic training program coordinator at Hofstra University in the Physical Education and Sport Sciences Department.