Thursday, 5 April 2012

The Easiest Way To Cover Safe Swim Defense Part I: Personal Health Review (Part 3)

All Scouts & Scouters even your youth or the the parents that are not definitely in a primary leadership role within the Troop should most definitely be encourage to do so. Really you aren't asking for someone to give too much time out of their day to do the online training thats available 24 hours a day 365 days per year usually for most it can be accomplished in less then 45 minutes. Heck you could do it watching TV during the commercials in within just about 2 hours worth of TV. The nice thing is that you can pause play or replay that particular section as much as you want. So the medical conditions that are specifically mentioned in the online training course include the following 4 conditions:

  1. Epilepsy
  2. Diabetes
  3. Anaphylaxis
  4. Asthma

Obviously these are not all of the medical conditions that need to be known about but usually these 4 conditions cover the majority of Scouts who would have a higher risk when it comes to aquatic activities in your Troop. Other conditions besides these 4 will also be covered in addition to all the common medical issues except epilepsy will be covered in future posts.

Many people do not know what the word epilepsy means, so a easier to understand term when talking with Scouts or parents who've never heard about this is that of "seizure disorder". Now even then a fair amount of people don't know what is exactly mean't by the term seizure disorder. Instead of understanding these multi-word medical conditions their is a very high likely-hood that a person understands what a seizure is and what some of the symptoms are for a person experiencing a seizure.

One minor problem though is that most people think that full body seizures also as grand-mal seizures are the most common type of seizure that occurs. This is partly due to the medical community explaining it the easiest way possible without covering too much detail but its mostly due to how hollywood displays medical conditions in a very narrow and very extreme light. More or less the other 2 major seizures that a qualified supervisor should be able to recognize is that of petite- and absence seizures. More or less the petite type of seizure is only where certain parts of the body are experiencing jerking movements and finally the last one we come to is that of absence seizures which theirs really no jerking movements but is characterized by spells of staring off into space which makes this the hardest seizure to identify in people because its more often than not described and looked at like a person is just staring off into space.

Before we get to much detailed or on system overload lets move onto the other more important issues to cover. Epilepsy and Seizure Disorder are defined as 3 or more seizures that can not be a symptom or be correlated to another medical condition. The best person to talk to is the parent because they usually know the most of their kid who has Epilepsy. Activity restrictions are generally not needed except when one of the following occurs:

  • Scout forgets or runs out of medication
  • A change in Neurological Status
  • Any pre-seizure activity or potential pre-seizure behavior
  • One aquatic activity that is allowed in Boy Scouts is that of SCUBA Diving but can not or will not be allowed to happen or even get certified in it.

Pretty much the SCUBA Diving item listed above is all that needs to be covered but for the other 4 items a explanation is needed. Several of these situations are call emergency services immediately while some of them do not require emergency services but ultimately it is up to your Troop nurse which basically is the adult with the highest level of training available or when the primary supervisor just isn't comfortable or just a little bit uncomfortable with the situation.

Scouting takes place in the outdoors and more often than not Scouts get into front-country or back-country that would result in serious problems if something were to happen to this youth member. For the majority of the time though this probably won't ever be a issue but then again that isn't always true. Two conditions that would be cause for concerns is the person who for some reason or another experiences their first seizure in their life or the situation where a currently diagnosed youth or adult gets injured in some way or the person may experience another medical condition where their is a possibility of that condition resulting in a seizure. For the majority this won't ever be a issue because many parents, adults with Epilepsy, or youth with Epilepsy tend to be fairly good at knowing in general when theirs concerns about any epileptic activity or control issues.

Forgetting the medication or for some reason the Scout runs out or the medication is lost or destroyed their are basically 2 different ways to handle this depending on whether cell reception is available or not. If theirs mobile coverage immediately contact the parent and let them decide exactly what to do because in some cases not leaving early is a option or it maybe leaving early the best decision. ultimately unless the the parent is present and says yes he can stay but if the parent isn't their you ultimately have to take the action you are most comfortable with. Secondly if theirs no reception and the parent can not be contacted immediate evacuation of you, your group, and the member that had a seizure.

Since Epilepsy is a disorder of the brain any change in the persons neurologic status should result in action being taken immediately. First evaluate the member's signs and symptoms to see if their could be another reason for the change in status such as heat related emergencies, headaches, migraines, dehydration and many other conditions. This is where the parent if present decides what he thinks is the best option but if the parent isn't there its up to you to make the decision with choosing the solution you are most comfortable with.

Next we come to the pre-seizure activity which is normally a neurologically related issue or behavior. Some of the more common behaviors or symptoms of this activity include:

  • Aura: Seeing flickering or solid spots
  • Hearing Sounds that aren't their
  • Seeing stuff that isn't their 
  • Headaches
  • migraines
  • Feeling of increased pressure with in the brain or skull
  • Confusion
  • dizziness
  • Poor coordination
  • Slurred speech
  • Problems talking
  • Disorientation
  • Staring off into space
  • Failure to answer or respond to his name or ask a question

This is most definitely not a complete list and just because its a symptom listed here or that other people with epilepsy experience doesn't mean that it will happen to the person under your care. Also showing one or two of these signs or symptoms doesn't mean the person is having a seizure but it means that the person should be monitored more closely by a adult. So as you can see theirs a-lot of information to know and understand so two of the best ways to help you know how to deal with this problem is communicating with the member if its a adult or when its a youth it would be appropriate with the parent present to try to figure out what exactly happens or what you should look for and getting the highest level of first aid/emergency care that you are willing to do so.

At a minimum their should be at least one person with a wilderness first aid or any training level above that. Since Wilderness First Aid (WFA) is required by National High Adventure Bases that is the reason I suggest that as a minimum level of training but the higher level of trained medical professionals you have can have s serious impact upon the level of care you have available. Beyond that though I think that every youth over age 14 and every adult present at the activity should at least get their WFA certification and also get as many youth from the time they start Boy Scouts to the time they become 14 trained in at least standard first aid. Yes I admit that Boy Scouts younger than 14 have the ability to understand a fair amount of the WFA material but normally most agencies that offer WFA have a restriction that you have to be at least 14 in order to earn your WFA certification.

Lastly Im going to cover a topic that many Scouts, Scouters, parents, & medical professionals consider a controversial topic. This does not necessarily go with the feelings of the majority of people in the world but from what I have seen and experience is what has lead me to form this opinion. Again this is not ENDORSED  BY THE BOY SCOUTS OF AMERICA OR ANY MEDICAL PROFESSIONAL BUT IS JUST WHAT I THINK IS APPROPRIATE AND REASONABLE. ANYONE USING THIS INFORMATION DOES SO AT THEIR OWN RISK & DOESNT MEAN THAT IF YOU DID SO THAT I WOULD FULLY SUPPORT OR BE LEGALLY RESPONSIBLE FOR YOU USING THIS INFORMATION BELOW UNTIL I GO BACK TO THE REAL FOCUS OF THIS POST!

In order to make my point and opinion clear I will first start out with a example related to this controversial topic. As scouters and adults we all know that no matter how hard we try to ensure that we watch every single youth at every single minute of every single day its just impossible to do so. Many times the first person to notice a problem is the various other buddies and members of the Troop that witness what just happened to their peer or friend. Most people say that with any medical emergency the most important thing that can be done is to recognize and respond to the medical emergency as soon as possible. Again that group of people tend to be the youth so telling them what to look for and what to do until a adult gets over to the youth that is injured. One of the more rare awards out their is the Lifesaving or Meritorious Action Awards which include the following:

  • Honor Medal With Crossed Palms
  • Honor Medal
  • Heroism Award
  • Medal of Merit
  • National Certificate of Merit

So you may be asking why in the world would I be talking about the Lifesaving or Meritorious Action Awards in a series of posts all about SSD. Even if you don't believe me at first I can assure you that by the time I finish this post the reason will become very clear. Basically the connection between getting youth able to recognize and respond to a emergency carries a central theme that is obvious in all of these Lifesaving or Meritorious Action Awards has a direct relationship between the two points Im making about youth be able to recognize and respond to emergencies. So, the theme is that all of the Scouts in some way, shape, or form is that of the training in first aid and responding to emergencies that are essential to the Scouting Program.

Everyone earning these Lifesaving and Meritorious Action Awards took their knowledge and training in first aid and emergencies to a level that many people even if given the opportunity to do so would not take interest or spend the time necessary to perform at that level of service to their fellow man. Everyone even if they don't earn one of the Lifesaving or Meritorious Action Awards has the responsibility to help every person they can to the best of their ability. Do not take this the wrong way or think Im promoting in Scouts to put themselves at risk of personal injury or in situations that could result in their death because that is the furthest thing from the truth.

More or less the reason for mentioning this is for me and the youth to break-down and eliminate the stereotype of youth being lazy, unmotivated, not helpful, or not respectful is to show that the youth are more capable and intelligent than many adults give them credit for. This isn't something you can apply to every youth and the stereotype does exist in some youth but remember that you:

  • Were just like them at some point in your life
  • Were told the same thing by your parents
  • Felt hurt when your parents did these things to you
  • Swore you wouldn't do the same thing as your parents did
  • Know somewhere in your mind is the thought of "If I just gave them a chance, who knows maybe they could surprise me?"

By the way I'm the furthest thing from being a perfect angel to my parents but we all do mean things to our parents so it isn't like this is a brand new thing that just started in my generation. The issues maybe different and the ways teens go about doing them may change but theirs always a certain major issue during that time while during this time its something totally different.

I think thats enough of a explanation and a rambling for today but to recap their are many important things to think about here which include who you can get the information from that you need to be aware of as the primary supervisor, the signs and symptoms of epilepsy, the three major types of seizures, what to do in various different situations, why youth can be a great resource when it comes to recognizing and responding to a emergency, and finally giving a explanation of why the stereotype about teens and youth aren't as wide spread as you think.

Next up in the "Personal Health Review" Section of the Easiest Way to Cover Safe Swim Defense Series is to discuss the issues and concerns surrounding the medical condition known as Diabetes. So thats item but as you can see the "Personal Health Review" Section of this particular series is go to end up being quite extensive in nature.

Yours in Scouting Service
Mark West
Assistant Scoutmaster
Troop 1316, Troop 1616(aka 669), Troop 125
Tustumena District/ Denali District/ Eklutna District, Great Alaska Council
NSJ '05 Youth Participant NSJ '10 Subcamp 7 Youth Staff NSJ '13 Subcamp Staff
WSJ '07 Youth Participant WSJ '11 International Service Team(IST)
Eagle Scout OA Brotherhood Honor Big Horn Denver Area Council NYLT QM Philmont AA '08

If you are paid to do Scouting, you are called a professional. If you are not paid to do Scouting, you are called a Volunteer. If you pay to do Scouting, then you are called a Scouter.

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