virginia 4-h camping volunteer training modules

Virginia 4-H CampingVirginia 4-H CampingVolunteer Training ModulesVolunteer Training Modules

MODULE 12: 4-H CAMP MODULE 12: 4-H CAMP MEDICAL TREATMENTMEDICAL TREATMENT

(including Blood-borne Pathogens)(including Blood-borne Pathogens)

Developed by Barry A. Garst, Ph.D., Assistant Professor and Extension Specialist 4-H Youth Development, March 2006

If you are a If you are a 4-H adult volunteer leader4-H adult volunteer leader:: 1. Review the 4-H camp-related information contained in this presentation.1. Review the 4-H camp-related information contained in this presentation. 2. Consider the “2. Consider the “Discussion QuestionsDiscussion Questions” listed on the last page.” listed on the last page. 3. Contact your local 4-H Extension Agent (or other person responsible for 3. Contact your local 4-H Extension Agent (or other person responsible for 4-H camping in your county/city) to review this information.4-H camping in your county/city) to review this information.

If you are a If you are a VCE faculty or staff member responsible for 4-H camping in VCE faculty or staff member responsible for 4-H camping in your unityour unit::

1. Review the 4-H camp-related information contained in this presentation.1. Review the 4-H camp-related information contained in this presentation. 2. Use this presentation to support your 4-H camp teen/adult volunteer 2. Use this presentation to support your 4-H camp teen/adult volunteer

leader training.leader training. 3. Use the “3. Use the “Discussion QuestionsDiscussion Questions” listed on the last page as a resource in ” listed on the last page as a resource in

reviewing this information with your 4-H camp volunteers.reviewing this information with your 4-H camp volunteers.

How to Use this InformationHow to Use this Information

NOTE: This Module focuses on medical treatment NOTE: This Module focuses on medical treatment provided during Junior 4-H camp conducted at 4-H provided during Junior 4-H camp conducted at 4-H Centers.Centers.

Health and wellness at 4-H campHealth and wellness at 4-H camp 4-H Health History Report Form4-H Health History Report Form Who provides medical treatment at 4-H camp?Who provides medical treatment at 4-H camp? Role of 4-H volunteers in 4-H camp medical treatmentRole of 4-H volunteers in 4-H camp medical treatment Health screening at 4-H campHealth screening at 4-H camp Medication proceduresMedication procedures Blood-borne Pathogens and “Universal Precautions” Blood-borne Pathogens and “Universal Precautions”

OverviewOverview

As discussed in previous Modules, 4-H Center paid As discussed in previous Modules, 4-H Center paid and volunteer staff act “in place of the parents” and and volunteer staff act “in place of the parents” and have a “duty of care” to act in the best interest of the have a “duty of care” to act in the best interest of the youth who are participating in 4-H camp.youth who are participating in 4-H camp.

This responsibility includes providing appropriate This responsibility includes providing appropriate medical treatment (according to the directives of a medical treatment (according to the directives of a consulting physician).consulting physician).

Health and Wellness Health and Wellness at 4-H Campat 4-H Camp

Prior to 4-H camp, Prior to 4-H camp, a current (within the current year) a current (within the current year) signedsigned 4-H Health History Report Form4-H Health History Report Form must be must be completed and on-file for each 4-H camp completed and on-file for each 4-H camp participantparticipant (i.e., campers, C.I.T.s, teen counselors, (i.e., campers, C.I.T.s, teen counselors, adult volunteers, and Extension faculty/staff).adult volunteers, and Extension faculty/staff).

Participants without a signed Participants without a signed 4-H Health History Report 4-H Health History Report FormForm cannot be allowed to stay in camp. cannot be allowed to stay in camp.

4-H Health History 4-H Health History Report Form Report Form

The The 4-H Health History Report Form4-H Health History Report Form is also important is also important because it provides parent/guardian permission to:because it provides parent/guardian permission to:

Administer over-the-counter medicationAdminister over-the-counter medication

Provide medical treatment (as needed)Provide medical treatment (as needed)

4-H Health History 4-H Health History Report Form Report Form

For Junior 4-H camp conducted at a 4-H Center, For Junior 4-H camp conducted at a 4-H Center, each 4-each 4-H Center provides medical staffH Center provides medical staff..

The level of certification of the medical staff depends The level of certification of the medical staff depends upon the distance of the 4-H Center from emergency upon the distance of the 4-H Center from emergency medical service (i.e., how long it takes an ambulance to medical service (i.e., how long it takes an ambulance to get to the 4-H Center and then get to a hospital). get to the 4-H Center and then get to a hospital).

Many 4-H Centers utilize nurses, emergency-medial Many 4-H Centers utilize nurses, emergency-medial technicians (EMT), or staff who are certified in first aid technicians (EMT), or staff who are certified in first aid and CPR.and CPR.

Who provides medical Who provides medical treatment at 4-H camp?treatment at 4-H camp?

The 4-H Center’s medical staff are responsible The 4-H Center’s medical staff are responsible for providing medical treatment and making for providing medical treatment and making assessments of health condition (within the scope assessments of health condition (within the scope of their training and certification). of their training and certification).

The 4-H Center’s medical staff are responsible for The 4-H Center’s medical staff are responsible for administering all over-the-counter and prescription administering all over-the-counter and prescription medications.medications.

Who provides medical Who provides medical treatment at 4-H camp?treatment at 4-H camp?

The 4-H Center’s medical staff person is responsible The 4-H Center’s medical staff person is responsible for providing medical treatment according to the for providing medical treatment according to the “standing orders”“standing orders” that have been approved by a that have been approved by a consulting physician (usually a Dr. that practices consulting physician (usually a Dr. that practices medicine at a location close to the 4-H Center).medicine at a location close to the 4-H Center).

Talk to your 4-H Center Program Director if you would Talk to your 4-H Center Program Director if you would like to learn more about your 4-H Center’s “standing like to learn more about your 4-H Center’s “standing orders”orders”

““Standing Orders”Standing Orders”

In general, 4-H camp volunteers are responsible for In general, 4-H camp volunteers are responsible for assisting with the following aspects of medical treatment:assisting with the following aspects of medical treatment:

Walking 4-H youth to the infirmary/health center (in a group of 3) Walking 4-H youth to the infirmary/health center (in a group of 3) and/or back to a 4-H camp program/activity after they have and/or back to a 4-H camp program/activity after they have received medical treatmentreceived medical treatment

Providing support to 4-H youth who might be waiting for medical Providing support to 4-H youth who might be waiting for medical treatment. (In other words, sit with them and help them to stay treatment. (In other words, sit with them and help them to stay calm.) calm.)

What is the role of 4-H What is the role of 4-H camp volunteers?camp volunteers?

Transporting 4-H youth to the hospital (as needed in a group of Transporting 4-H youth to the hospital (as needed in a group of 3)3)

If you come upon an injured or ill camper/teen who needs If you come upon an injured or ill camper/teen who needs medical assistance, and you do not know what to do, seek help medical assistance, and you do not know what to do, seek help from the 4-H Center medical staff immediately and be sure that from the 4-H Center medical staff immediately and be sure that the injured/ill person is not left alone. the injured/ill person is not left alone.

Other responsibilities as defined by your 4-H Extension Agent (or Other responsibilities as defined by your 4-H Extension Agent (or other person responsible or your county/city 4-H camping other person responsible or your county/city 4-H camping program)program)


Although 4-H camp volunteers Although 4-H camp volunteers are generally not are generally not requiredrequired to become trained in basic first aid and CPR, to become trained in basic first aid and CPR, this training is always recommended to 4-H volunteers this training is always recommended to 4-H volunteers who work with youth in an outdoor-based camp setting.who work with youth in an outdoor-based camp setting.


During the first 24 hours of 4-H camp, each 4-H Center must During the first 24 hours of 4-H camp, each 4-H Center must provide a provide a health information review and screeninghealth information review and screening of all 4-H of all 4-H camp participants. camp participants.

This health information review and screening is conducted by the This health information review and screening is conducted by the 4-H Center medical staff at each 4-H Center.4-H Center medical staff at each 4-H Center.

All 4-H camp participants under age 18 years old (i.e., campers, All 4-H camp participants under age 18 years old (i.e., campers, CITs, teen counselors) are required to attend the health CITs, teen counselors) are required to attend the health information review and screening. Adults are encouraged to information review and screening. Adults are encouraged to attend.attend.

Health Screening Health Screening at 4-H Campat 4-H Camp

4-H camp adult volunteer and staff screening is 4-H camp adult volunteer and staff screening is determined by each 4-H Center.determined by each 4-H Center.

You can assist with this process by ensuring that all of You can assist with this process by ensuring that all of the youth and teens under your supervision have been the youth and teens under your supervision have been through the health information review and screening on through the health information review and screening on the first day of 4-H campthe first day of 4-H camp


The health information review and screening includes:The health information review and screening includes:

Review of the 4-H Health History Report Form,Review of the 4-H Health History Report Form,Collection/review of any medications to be administered, Collection/review of any medications to be administered, Review of medical forms and other documentation provided by Review of medical forms and other documentation provided by parents/guardians.parents/guardians.Check for observable evidence of illness, injury, or Check for observable evidence of illness, injury, or communicable disease, andcommunicable disease, andDiscussion with the 4-H camp participant to verify information Discussion with the 4-H camp participant to verify information on the 4-H Health History Report Form and to update on the 4-H Health History Report Form and to update information where needed.information where needed.


It is critical that all medications at 4-H camp are It is critical that all medications at 4-H camp are collected, handled, administered, and stored correctly. collected, handled, administered, and stored correctly.

Although 4-H camp volunteers Although 4-H camp volunteers are not responsibleare not responsible for for medications, it is important that volunteers are aware of medications, it is important that volunteers are aware of these procedures.these procedures.

Medications at 4-H CampMedications at 4-H Camp

A “A “Medication Form”Medication Form” must be completed for all 4-H must be completed for all 4-H camp participants (youth, volunteers, adults) who camp participants (youth, volunteers, adults) who bring medication to camp.bring medication to camp.

The The Medication FormMedication Form identifies the following: identifies the following: (1) name of medication, (1) name of medication, (2) purpose of medication, (2) purpose of medication, (3) appropriate dosage, and (3) appropriate dosage, and (4) special directions for the administration of the medication. (4) special directions for the administration of the medication.


Medication can only be dispensed from its original Medication can only be dispensed from its original container.container.

Zip lock bags, other bottles, bottles printed with Zip lock bags, other bottles, bottles printed with someone else’s name, or any other type of container someone else’s name, or any other type of container besides the original besides the original will notwill not be accepted. be accepted.


Medication must be clearly labeledMedication must be clearly labeled with the 4-H with the 4-H participant’s name, medication name, dosage, and participant’s name, medication name, dosage, and instructions. instructions.

Medications must be administered according to Medications must be administered according to the actual dosage listed on the bottlethe actual dosage listed on the bottle, unless there , unless there is a written note from the prescribing physician outlining is a written note from the prescribing physician outlining different instructions for the administration of different instructions for the administration of medications. medications.


Instructions for all medications must be listed in Instructions for all medications must be listed in English.English. If instructions are not in English, the If instructions are not in English, the appropriate translation must be provided.appropriate translation must be provided.

Medications must be stored in a secure, locked Medications must be stored in a secure, locked area.area. Any exceptions for special medical needs (i.e., Any exceptions for special medical needs (i.e., medications that may be in the “controlled possession” medications that may be in the “controlled possession” of the user such as inhalers, epi-pens, etc.) must be of the user such as inhalers, epi-pens, etc.) must be approved by the medical staff for the 4-H approved by the medical staff for the 4-H program/event. program/event.


If the medication is refusedIf the medication is refused, then parents/guardians , then parents/guardians must be contacted. must be contacted.

If anything out of the ordinary occurs, or is requested If anything out of the ordinary occurs, or is requested by the person who is supposed to be taking the by the person who is supposed to be taking the medication, then parents/guardians must be contacted.medication, then parents/guardians must be contacted.


Be sure that none of the 4-H campers and teens under Be sure that none of the 4-H campers and teens under your supervision have medications in the cabins/lodges.your supervision have medications in the cabins/lodges.

If you observe any medications in the cabins/lodges, If you observe any medications in the cabins/lodges, please ensure that they are taken to the 4-H Center please ensure that they are taken to the 4-H Center medical staff so that they can be properly stored and medical staff so that they can be properly stored and administered according to the 4-H medication policy.administered according to the 4-H medication policy.


During camp, 4-H camp volunteers may be exposed to During camp, 4-H camp volunteers may be exposed to infections substances through the bodily fluids of others.infections substances through the bodily fluids of others.

The following information related to The following information related to “blood-borne “blood-borne pathogens” pathogens” andand “universal precautions” “universal precautions” is designed is designed to educate 4-H paid and volunteer staff about the risks to educate 4-H paid and volunteer staff about the risks associated with “exposures” to infectious substances and associated with “exposures” to infectious substances and to inform them about the procedures to follow if they are to inform them about the procedures to follow if they are exposed.”exposed.”

Blood-borne Pathogens and Blood-borne Pathogens and Universal PrecautionsUniversal Precautions

““Blood-borne Pathogens”Blood-borne Pathogens” are microorganisms that can are microorganisms that can be present in human blood and are capable of producing be present in human blood and are capable of producing disease in humans. Some examples of blood-borne disease in humans. Some examples of blood-borne pathogens are:pathogens are:

SyphilisSyphilisHepatitis B virus (HBV)Hepatitis B virus (HBV)Human immunodeficiency virus (HIV)Human immunodeficiency virus (HIV)

Blood-Borne Pathogens Blood-Borne Pathogens GuidelinesGuidelines

An An “exposure”“exposure” is contact with any potentially infectious is contact with any potentially infectious substance (i.e., blood, urine, semen, vaginal secretions, substance (i.e., blood, urine, semen, vaginal secretions, saliva, and sweat), through inhalation, needles, contact saliva, and sweat), through inhalation, needles, contact with an open wound, non-intact skin, eyes or other with an open wound, non-intact skin, eyes or other mucus membrane. mucus membrane.

Please note that contact of blood or bodily fluids Please note that contact of blood or bodily fluids onto onto intact skinintact skin does not signify an exposure does not signify an exposure

ExposureExposure

Roles at 4-H Camp that Hold a “High Occupational Roles at 4-H Camp that Hold a “High Occupational Risk of Exposure”Risk of Exposure”

EMT/Nurse/Medical StaffEMT/Nurse/Medical StaffLifeguardsLifeguardsMaintenance StaffMaintenance StaffAny summer camp staff member required to have First Aid Any summer camp staff member required to have First Aid and CPR certification.and CPR certification.

High-Risk Positions High-Risk Positions at 4-H Campat 4-H Camp

Each 4-H Center has identified Each 4-H Center has identified “primary responders”“primary responders” - - those individuals who can respond to situations those individuals who can respond to situations involving potentially infections substances because of involving potentially infections substances because of training, vaccinations, etc.training, vaccinations, etc.

In most cases, the “primary responder” is the medical In most cases, the “primary responder” is the medical staff person, EMT, nurse, and/or Program Director.staff person, EMT, nurse, and/or Program Director.

Primary RespondersPrimary Responders

The concept of “universal precautions” means that 4-H The concept of “universal precautions” means that 4-H camp paid and volunteer staff should camp paid and volunteer staff should treat all bodily treat all bodily fluids as if they are hazardous. fluids as if they are hazardous.

4-H camp paid and volunteer staff should take 4-H camp paid and volunteer staff should take “universal precautions” (i.e., precautions in all situations) “universal precautions” (i.e., precautions in all situations) by by wearing disposable (non-latex) gloveswearing disposable (non-latex) gloves in all first in all first aid situations. (NOTE: 4-H Centers provide acrylic aid situations. (NOTE: 4-H Centers provide acrylic gloves due to patients’ potential latex allergies.)gloves due to patients’ potential latex allergies.)

Universal PrecautionsUniversal Precautions

If a potentially infectious agent comes into contact with If a potentially infectious agent comes into contact with an open wound, broken skin, or mucous membrane, you an open wound, broken skin, or mucous membrane, you have been exposed. have been exposed.

If exposed, you should first contact the 4-H Center If exposed, you should first contact the 4-H Center medial staff person and then you must contact the office medial staff person and then you must contact the office listed below, who will give you instructions on how to listed below, who will give you instructions on how to proceed.proceed.

ENVIRONMENTAL HEALTH AND SAFETY OFFICE ENVIRONMENTAL HEALTH AND SAFETY OFFICE (540) 231-8751(540) 231-8751

What does a volunteer do What does a volunteer do if “exposed?”if “exposed?”

Each 4-H Center is responsible for providing first Each 4-H Center is responsible for providing first aid/protection kits that include:aid/protection kits that include:

Disposable towels Disposable towels Disposable non-latex gloves Disposable non-latex gloves Waterless medicated hand cleaner such as a germicidal hand Waterless medicated hand cleaner such as a germicidal hand wash wash Small equal size bottles of water and chlorine bleach Small equal size bottles of water and chlorine bleach Small Plastic Bag Small Plastic Bag

Protection KitsProtection Kits

4-H camp paid and volunteer staff should wash their 4-H camp paid and volunteer staff should wash their hands and any other exposed skin as soon as possible hands and any other exposed skin as soon as possible after the removal of gloves (with appropriate hand after the removal of gloves (with appropriate hand washing agents, followed by soap and water.)washing agents, followed by soap and water.)

If eyes or mucus membranes are exposed, then these If eyes or mucus membranes are exposed, then these areas should also be flushed with water immediately or areas should also be flushed with water immediately or as soon as possible following contact of these body as soon as possible following contact of these body areas with blood or other potentially infectious materials. areas with blood or other potentially infectious materials.

Washing Exposed AreasWashing Exposed Areas

When clothing, sheets, furniture, etc. become When clothing, sheets, furniture, etc. become contaminated with bodily fluids, the 4-H Center’s contaminated with bodily fluids, the 4-H Center’s medical staff (or other “primary responder”) is medical staff (or other “primary responder”) is responsible for cleaning the contaminated materials.responsible for cleaning the contaminated materials.

Washing Exposed AreasWashing Exposed Areas

If a camper receives a cut on his/her leg, what is your role in If a camper receives a cut on his/her leg, what is your role in medical treatment as a 4-H camp volunteer?medical treatment as a 4-H camp volunteer?

Who is required to attend a health screening during the first 24 Who is required to attend a health screening during the first 24 hours of camp?hours of camp?

With regards to medical treatment, why is it important the 4-H With regards to medical treatment, why is it important the 4-H Health History Report Form to be signed?Health History Report Form to be signed?

What is the #1 thing that you can do be avoid being exposure to What is the #1 thing that you can do be avoid being exposure to an infectious substance from someone else’s bodily fluids?an infectious substance from someone else’s bodily fluids?

Discussion QuestionsDiscussion Questions

Garst, B.A. (2005). Garst, B.A. (2005). Virginia 4-H Camping Handbook.Virginia 4-H Camping Handbook. Virginia Virginia Cooperative Extension. Publication 388-562.Cooperative Extension. Publication 388-562.

Virginia Cooperative Extension. (2004). Virginia Cooperative Extension. (2004). Risk Management InformationRisk Management Information. . Retrieved on March 19, 2004 from Retrieved on March 19, 2004 from http://www.ext.vt.edu/vce/policies/riskmgt.htmlhttp://www.ext.vt.edu/vce/policies/riskmgt.html

ReferencesReferences

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