Microsoft word - treatment protocols 201

GIRL SCOUTS OF NORTHERN CALIFORNIA
TREATMENT PROTOCOLS
To be approved and signed annually by Camp/Council physician NOTE: a) Since treatment of campers must be recorded, a record of emergency treatment by counselors (if counselors/volunteers perform any health care) is to be kept and returned to the Health Supervisor for inclusion in camp files. b) Camp Administrator / Director along with Health Supervisor will define counselor/ volunteer c) Each Counselor/Volunteer should be informed of emergency procedures and evacuation d) Campers and counselors will receive group education concerning emergencies from the Health Supervisor and/or Camp Director/Administrator at the beginning of the camping period. e) The Camp Director / Health Supervisor will consult and identify the parameters of health care responsibilities of mutual concern to patient care before campers are on-site. This includes the scope of care that the Health Supervisor can provide to the campers. f) Health forms will be checked for parent’s and health care provider’s signatures (if resident camp), any restrictions, prescribed medications, allergies, and other pertinent information. Campers or staff exhibiting any of the following symptoms on a prolonged basis will be sent home. ∗ Diarrhea ∗ Vomiting ∗ Oral temperature over 101.5 F ∗ Sore throat accompanied by fever ∗ Unusually dark, tea-colored urine ∗ Unusual rash or spots ∗ Yellowish skin or eyes ∗ Infected skin patches ∗ Grayish or white stools ∗ Inflamed or bloodshot eyes with discharge ∗ Severe itching of body or scalp ∗ Severe headache accompanied by stiff neck
If more than five people in camp exhibit the same symptoms, the Health Supervisor/Camp
Administration is instructed to consider the situation an epidemic and to contact the
Council Office. The Council Office will then contact the Public Health Department
Communicable Disease Unit for consultation.


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The camp is instructed to follow the procedures listed below for each identified situation or
condition. Any situation or condition not listed should be referred to the council office.
The Health Supervisor/ Director will need to discuss and agree on the type of care both are
comfortable given. Some of the protocols may not apply to the level of care that can be given at
the camp. If the Health Supervisor is not comfortable given the below care, please contact the
parent.
Prior to giving any medication, check allergy record, current medications, and restrictions as
listed on health form.
Allergic Reaction, Anaphylaxis
Administer diphenhadrymine in age-appropriate dosing if no restrictions are noted on health
form. Qualified persons may administer epinephrine in age-appropriate dosing in cases of severe
reaction (anxiousness, difficulty breathing, severe swelling) and patient should be transported to
nearest medical facility. If patient has own medication, administer as ordered on health form and
transport to nearest medical facility.
Asthma
Use patient’s own medication. If severe, patient should be transported to nearest medical facility.
Athlete’s Foot (Tinea Pedis)
Wash with soap and water, dry thoroughly, and apply clotrimazole or other antifungal cream or
powder if no restrictions are noted on health form. Instruct patient to keep feet dry and to wear
clean cotton socks. Teach patient to avoid spreading to other campers and staff.
Bleeding
Apply pressure with sterile dressing (not tourniquet) over wound to stop bleeding. If injury is on
an extremity, elevate that extremity. If severe, transport to the nearest medical facility.
Bruises, Bumps, Contusions
Apply ice or cold compress on injured area for 20 minutes every 1-2 hours. Administer
acetaminophen or ibuprofen in age-appropriate dosing every 4-6 hours as needed for pain if no
restrictions are noted on health form. If tenderness or pain is severe, treat as sprain, strain,
dislocation or fracture until medical advice is available.
Burns
Immediately run cool water over burned area and continue for several minutes. For first and
small second degree burns, clean with soap and water and apply antibiotic ointment and sterile
dressing. Do not break blisters. Administer acetaminophen or ibuprofen in age-appropriate
dosing every 4-6 hours as needed for pain if no restrictions are noted on health form. Give the
patient an abundance of fluids. Extensive second and all third degree burns should be considered
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serious injuries. Cover with sterile dressing and loose bandage and transport to the nearest
medical facility.
Canker Sores
Rinse mouth with warm saline. Recommend no citrus, spicy food, carbonated drinks or tomato
products.
Cardiac Emergencies
Call 911. Begin CPR as appropriate.
Communicable Diseases
The following conditions should be suggestive of communicable disease: fever greater than
101.5 F, severe sore throat, vomiting, rash, inflamed eyelid or red eye with discharge, ear
discharge, skin lesions, tea-colored urine, yellowish skin or eyes, grayish or white stools, severe
itching of body or scalp, and/or severe headache accompanied by stiff neck. Isolate patient.
Refer any of these conditions to health care provider as necessary. Patient may be sent home.
Congestion, Cough, Rhinorrhea
Check temperature. Administer pseudoephedrine, chlorpheniramine, diphenhydramine, cough
drops and/or guiafenesin cough syrup in age-appropriate dosing as needed for symptoms if no
restrictions are noted on health form. Encourage increased fluid intake. If fever is present, or if
symptoms are severe or persistent, refer to health care provider.
Constipation
Administer magnesium hydroxide in age-appropriate dosing if no restrictions are noted on health
form. Offer a quiet atmosphere. Encourage increased fluid intake, increased exercise, and
laxative foods.

Cuts, Abrasions, Lacerations, Scratches, Blisters, Wounds
Inspect and cleanse with hydrogen peroxide or soap and water. Apply a topical antibiotic
ointment and dressing as needed. If bleeding is severe or laceration extensive or if a tetanus shot
is needed, apply a sterile pressure dressing as necessary and transport to the nearest medical
facility.
Diarrhea and/or vomiting
Check temperature. Patient should be allowed bed rest and isolation in health center. Give
patient an abundance of fluids. For diarrhea, Administer loperamide or bismuth subsalicylate
(adults only) in age-appropriate dosing if no restrictions are noted on health form. Check diet as
the diarrhea may be caused by too much laxative food. Encourage bland diet for 1-2 days. Notify
staff to watch for other cases. Check sanitation of food, kitchen, and food service workers.
Check sanitation of camp bathrooms. Refer to health care provider if condition is severe or
persistent.
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Dysmenorrhea, Menstrual Cramps
Administer acetaminophen or ibuprofen in age-appropriate dosing every 4-6 hours as needed for
pain if no restrictions are noted on health form. For severe cases, apply heat to abdomen and
allow to rest.
Ear Ache, Ear Discharge
Check temperature. Qualified persons may examine ear with otoscope to assess for signs of
infection. Administer acetaminophen or ibuprofen in age-appropriate dosing every 4-6 hours as
needed for pain if no restrictions are noted on health form. If temperature is elevated or pain is
persistent or there are signs of infection, refer to health care provider. Patients with chronic ear
discharge may only be admitted to camp with permission from patient’s health care provider. If
the condition is discovered after admittance to camp, the patient should be isolated until she/he
can be evaluated by a health care provider. Do not allow swimming for anyone with ear
discharge.
Eye Injury, Foreign Body in Eye, Red Eye
Foreign Body in Eye— If possible, remove foreign body with sterile cotton swab or irrigation
with eye wash solution. If irritation persists or foreign body is not easily removed, apply dry
protective covering to both eyes and transport to the nearest medical facility.
Eye Injury—Apply dry protective covering and transport to the nearest medical facility. If due to
contact with chemical solution, flush with copious amounts of water or eye wash solution, apply
dry protective covering, and transport to nearest medical facility.
Red Eye—Flush with eye wash solution. If redness persists or is accompanied by discharge or
pain, isolate patient and refer to health care provider. Patient may need to be sent home.
Fever
Allow patient to rest. Monitor in health center. Check temperature every 1-2 hours. Observe for
other signs and symptoms. Administer acetaminophen or ibuprofen in age-appropriate dosing
every 4-6 hours as needed for fever if no restrictions are noted on health form. Give patient an
abundance of fluids. For persistent temperature over 101 F, refer to health care provider. Patient
may need to be sent home.
Fractures, Dislocations
Splint to immobilize any suspected dislocation or fracture with the least possible disturbance.
Call health care provider at once or transport to the nearest medical facility. Make no attempt to
reduce fractures or dislocations.

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Head, Neck and/or Spine Injuries
Severe head, neck and spine injuries should be immobilized and treated by the Emergency
Response Team (call 911). For walk-in injuries, assess vital signs and neurological status (level
of consciousness, pupillary response, strength of grips, presence of amnesia, etc.). For minor
injuries, monitor for 1-2 hours and administer acetaminophen or ibuprofen in age-appropriate
dosing every 4-6 hours as needed for pain if no restrictions are noted on health form. If any
injury is accompanied by dizziness, unconsciousness, headache, nausea, vomiting, change in vital
signs, change in mental status, and/or bleeding from nose or ear, immobilize and transport to the
nearest medical facility.
Headache
Check temperature. Administer acetaminophen or ibuprofen in age-appropriate dosing every 4-6
hours as needed for pain if no restrictions are noted on health form. Encourage increased fluid
intake. If headache is prolonged or severe or fever, neck stiffness, rash, or mental status changes
are present, refer to health care provider.
Heat Exhaustion, Heat Stroke
Check temperature. Assess vital signs and neurological status (level of consciousness, pupillary
response, strength of grips, slurred speech, etc.). Slowly lower body temperature by keeping
patient in cool area, applying cool compresses to body, and giving patient an abundance of fluids.
If persistent high fever, abnormal vital signs, or mental status changes are present, transport to
nearest medical facility.
Hypoglycemia
Administer glucose tablets or gel or high sugar food such as orange juice, then complex
carbohydrate snack. If patient is unresponsive, transport to nearest medical facility.
Insect Bites and Stings
Remove stinger if present by using flicking motion of thumb and finger (do not use tweezers).
Apply ice or cold compress and sting kill swab. Administer diphenhydramine in age-appropriate
dosing every 6 hours as needed for local reactions if no restrictions are noted on health form.
Observe for 30 minutes for signs of allergic reaction (anxiousness, severe swelling, difficulty
breathing, hives). Qualified persons (M.D. or R.N.) may administer epinephrine in age-
appropriate dosing in cases of severe reaction (anxiousness, difficulty breathing, severe swelling)
and patient should be transported to nearest medical facility. If patient has own medication,
administer as ordered on health form and transport to nearest medical facility. To avoid future
bites, apply insect repellent.

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Lice
Wash hair with approved lice shampoo or rinse. Wash all clothes and bedding. Check all other
people in the unit carefully. Re-check in 2-3 days. Notify staff to watch for recurrence and teach
appropriate behavior regarding sharing of clothing, combs and brushes.
Motion Sickness
Administer diphenhydramine in age-appropriate dosing every 4-6 hours as needed if no
restrictions are noted on health form.
Nose Bleeds
Sit patient erect with head forward. Gently and firmly compress nostrils against nasal septum
with thumb and forefinger for 5-10 minutes. May apply cold compress or ice to nose, forehead,
or back of neck. If severe, transport to the nearest medical facility.
Poison Ivy, Poison Oak, Poison Sumac
Prevention—Teach campers and staff to recognize and avoid the plants.
Treatment—After exposure, wash all exposed areas with oil-removing soap or liquid. If area of
irritation is small, apply calamine lotion or hydrocortisone cream. Administer diphenhydramine
in age-appropriate dosing every 6 hours as needed for itching if no restrictions are noted on
health form. If area of irritation is severe or has weeping areas, refer to health care provider.
Poisoning
Call poison control center (1-800-222-1222). If advised by poison control, administer
appropriate antidote (syrup of ipecac if indicated) in age-appropriate dosing. Transport to nearest
medical facility.
Rash, Dermatitis, Ringworm
Investigate possible causes (soap, shampoo, lotions, skin products) and remove contact with
suspected items. Apply hydrocortisone cream to affected area if no restrictions are noted on
health form. Administer diphenhydramine in age-appropriate dosing every 6 hours as needed for
itching if no restrictions are noted on health form. For ringworm, apply clotrimazole cream to
affected area three times a day until lesion is completely resolved. Educate patient about
avoiding transmission to other campers and staff. If any skin rash does not improve, if affected
area is severe or extensive, and/or a cause other than contact dermatitis or ringworm is suspected,
refer to health care provider.

Respiratory Emergencies
Call 911. Begin rescue breathing as necessary.

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Skin Infections (local), Abscesses, Boils, Styes
Apply warm compress to infected area or soak in warm water with povidone iodine. Administer
acetaminophen or ibuprofen in age-appropriate dosing every 4-6 hours as needed for pain if no
restrictions are noted on health form. Observe for signs of increasing inflammation. Check
temperature and vital signs. If temperature is elevated or infection is severe or worsens, refer to
health care provider. Handle infections in such a way as to eliminate spread of illness to other
campers and staff.
Sore Throat
Check temperature and assess for signs of infection (reddened throat, enlarged tonsils, tonsillar
exudate, enlarged lymph nodes). Treat symptomatically with rest, fluids, salt water gargles, and
cough drops. Administer acetaminophen or ibuprofen in age-appropriate dosing every 4-6 hours
as needed for pain if no restrictions are noted on health form. If severe or persistent or if signs of
infection are present, refer to health care provider.
Splinters
Clean with soap, water, and isopropyl alcohol or povidone iodine. Superficial splinters may be
removed with forceps, tweezers, or a sterile needle. Apply a topical antibiotic ointment and
dressing as needed.
Sprains, Strains
Apply ice or cold compress on injured area for 20 minutes every 1-2 hours. Do not pack in ice. If
necessary, apply compression bandage (ace bandage, muslin or outing flannel). Administer
acetaminophen or ibuprofen in age-appropriate dosing every 4-6 hours as needed for pain if no
restrictions are noted on health form. If pain or swelling is severe, keep injured area elevated and
immobilize until evaluated by health care provider.
Stomach Ache, Nausea, Indigestion, Heartburn
Check temperature. Administer antacid or bismuth subsalicylate (adults only) in age-appropriate
dosing as needed for symptoms if no restrictions are noted on health form. Encourage bland diet
for 1-2 days. Encourage increased water intake. If fever is present, or if symptoms are severe or
persistent, refer to health care provider.
Sunburn
Prevention—Warn campers and staff to avoid long sun exposure to uncovered skin and to wear
head coverings. Recommend that sunblock be applied frequently throughout the day and after
swimming and showering.
Treatment—Apply cool compresses, lotion and/or aloe gel. Give the patient an abundance of
fluids. Administer acetaminophen or ibuprofen in age-appropriate dosing every 4-6 hours as

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needed for pain if no restrictions are noted on health form. Keep sunburned area covered in the
sun and apply sunblock or zinc oxide to avoid further burning. If sunburn is severe or extensive,
refer to health care provider.
Tick Bites
Remove tick carefully with tweezers, taking care to remove entire tick. If tick cannot be
removed easily, refer to health care provider. Notify camper’s parents via letter or phone call.
Tape removed dead tick to health log next to entry. Make a ring with permanent marker around
tick bite and monitor daily for redness or swelling. Follow-up in clinic if rash develops.
Toothache
Rinse mouth with warm saline. Check temperature. Administer acetaminophen or ibuprofen in
age-appropriate dosing every 4-6 hours as needed for pain if no restrictions are noted on health
form. Arrange for dental care if severe or persistent.
Health Center Routine Medication List
The following medications are used for routine treatment of conditions at camp:

Acetaminophen (liquid or chewable tablets and regular tablets)
Aloegel
Antacid (chewable tablets)
Antibiotic ointment
Bismuth subsalicylate (liquid and chewable tablets) FOR ADULTS ONLY
Calamine lotion
Chlopheniramine antihistamine (liquid or chewable tablets and regular tablets)
Clotrimazole antifungal cream
Cough drops
Diphenhydramine (liquid and tablets)
Guaifenesin cough syrup
Glucose tablets or gel
Hydrocortisone cream
Hydrogen peroxide
Ibuprofen (liquid or chewable tablets and regular tablets)
Insect repellent
Ipecac syrup
Isopropyl alcohol
Lice shampoo or rinse (Rid or Nix)
Loperamide (liquid and tablets)
Lotion
Magnesium Hydroxide (liquid)
Povidone iodine
Pseudoephedrine (liquid and tablets)
Saline eye wash
Sting kill swabs
Sunblock
Tolnaftate
Yellow soap
Zinc oxide
Other:

Source: http://www.girlscoutsnorcal.org/documents/treatment_protocols_2011.pdf