First Aid.

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I don't write much here about my professional life, but as some of you may know, I'm a doctor in training to be a cardiologist. As part of my residency, I'm currently in the Intensive Care Unit, and have to deal with patients that survived after cardiopulmonary resuscitation (CPR). Whereas paramedics and emergency physicians are usually well trained, I find it shocking to hear how badly the non-medical people perform CPR: It's really just a few basic things you need to know to improve the outcome of people's lives...

How does this relate to CISV? Quite obviously, CPR is usually mostly necessary with people, who suffer from chronic or acute heart disease. Among the kids and leaders in most of our camps this disease is quite rare. More common are way less dramatic emergencies like minor injuries or trauma. However, how much more shocking would it be, if you made the wrong decision when dealing with a serious situation with a kid participant.

How much emergencies are we talking about? Gaby from IO tells me, there are about 240-270 medical incidents every year, mostly minor scrapes, allergies, and broken bones. Also, a few people have to go home for medical reasons.

What I'm hinting at, is that if you are going to be a leader or staff in a camp soon, I strongly suggest, you get your first-aid skills up-to-date. Some NAs require a first-aid certificate, I would go beyond that and suggest that you specifically inform yourself about first-aid and children of the respective age-group.

If there's no course available in your area, here's at least two websites, that can help you be better prepared:

- deals specifically with children.
- CPR-Dude is also quite informative:
- The American Heart Association even offers online courses for a few bucks:

Maybe NAs should also invite a first-aid trainer to their national leadership trainings, and focus in exactly the kind of incidents, that happen in camps. Or we even get CISV international to prepare a "first-aid"-reader with the most important rules for every camp.

(Oh...and just so that nobody gets me wrong - this is not an indirect online application to become a member of the international risk management committee!)

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Excellent point made! It is essential that at least 1/4th of the staff/leaders in the same camp be first aid certified or know how to do CPR/first aid. I'm considering going a leader or be a staff this year and I'm taking (on a personal initiative) a first aid certified workshop with the Lebanese Red Cross to make sure I am well prepared for emergencies or simple medical emergencies.

Good point!
We, the Staff, organized a first aid course during the leaders' weekend at the beginning of our Village this year. Each leader received a certificate afterwards.
I my eyes a first-aid course should be regarded as necessary event at the beginning of a camp even though it takes some time (ours took about 4 hours.) Of course there is no time for an extensive course but everybody should be enlightened about the basics.
This solution might be better than expecting all leaders to have a certificate prior to camp. It is already difficult enough to find leaders.

Here's the question though- do you (Nick, or anyone)think that the real need is to have a medical professional on site?

At least in New York (granted, perhaps as much for legal reasons as health) it is required that we have a Emergency Medical Technician or Nurse at the camp site all the time.

It adds to the cost of the camp, but it also prevents the kind of "non-professional" injuries that you are seeing in your cardio ward. I definitely agree that training staff in first aid is really important, but with CPR, can a 4 hour class really prepare someone to do it?

i definitely agree with this point.
i did a kids first aid course before staffing this summer, though i had done one some years ago, and i have to say that it was really good cause it makes you remember the important "little things" but also prepares you for how to react in an emergency.
of course it would be nice to have a doctor or nurse in the camp all the time but i actually dont think it is neccessary to make it a rule. of course bad things can happen but therefore we have 911...i see it as much more helpful to have leaders and staff trained at least in first aid so that 40 kids dont depend on one person doin the right thing but several. and in the end youll need to call 911 anyways if a bad emergency happens.

The New York standard of having a nurse on site reminds be a bit of the 10 lifeguards on duty for a tennis court size lagoon that we visited during our seminar camp in San Francisco. Ok seriously, obviously safety standards vary around the world.

Just recently I witnessed a 3-year old daughter of a friend hit the back of her head badly on the floor, with a lot of blood everywhere. Even being a doctor was of not of much help: No diagnostic tools, no dressing material - I simply called 911, tried to keep everybody calm, checked that the girl wasn't passing out, asked for something cold to stop the bleeding and finally pressed a towel against the wound. The ambulance arrived 10 minutes later, took the girl to the next hospital and a surgeon fixed everything. The four things I did could have been done by anyone who had received just a bit of training (or simply with common sense).

So, I guess training yes, on-site-doctor only for remote areas. Which reminds me, that for the IPP on Hallig Hooge (a tiny island in the North Sea) there was barely a nurse.

I agree with the fact that all leaders and staff should have basic first aid knowledge, and that it is not hapenning as a standard procedure.

Concerning CPR and deeper medical knowledge:

1. This conversation made me think about the IPP in Mozambique, in 2008. Even though the staff was trained for most of the eventualities, some treatment was just too complex for the staff to be trained on. A doctor on-site would be just too expensive (considering the location), possibly making it impossible to host a programme like that. So the solution was a previous deal with local resources, drawing an emergency plan in case something happened.
The point is, a doctor on-site is probably impossible to afford for many Chapters/NA's out there, specially if in remote areas, where nurses or doctors may have to be brought from somewhere else..

2. Is there exactly the need for an on-site doctor? Have there been serious problems in CISV programmes that would have been avoided by a doctor being present. Maybe some statistics would help(I assume IRF's are confidential, so no use on that), but from my point of view, there is no exact need.

In stead of overcharging our staff members (who are volunteer, most of the time) with medical-ish training, we should focus on making sure that every staff group has proper logistics knowledge to act fast in case something happens, which I think hasn't totally been a failure so far.

And of course, first aid has to be there...!

That's a really good point. Being first a leader in Brazil, there's was never a talk about first aid, but here in Canada all leaders, and staff are required to have first aid/cpr training and it does help, even if it's just to keep everyone calm in case of an emergency.

At my village this summer, all the Canadians had training but nobody else did. I like the idea of a calling an instructor to national training..

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