dScouter15

If we find ourselves in a situation where a scouts life is on the line, I hope that we'd all use the most of our available resources, training and common sense to do our best to keep that scout alive.

However, WildernessStudent asked whether or not persons with standard first aid or first responder training should be allowed to carry Epi in a first aid kit, and administer it to persons without a prescription. I do not believe that this should be allowed, as a first responder lacks the necessary amount of education to adequately assess and treat a patient using a drug like epinephrine.

Based on my experience in emergency medicine, I can say with some certainty that untrained personnel administering dangerous drugs to others is not the "industry standard." While certain WFR or WFA courses may teach participants HOW to administer Epi, that does not mean that they have the necessary training to know WHY and WHEN to administer it. It also does not give them the legal capability to carry or administer it. I bet, Beavah, that if you look into any situations where Epi was administered on a standing order, you will find that it was administered by medical personnel with more education than the first responder level. But, for those who lack the necessary education to be able to administer medications correctly and safely, they should not be allowed to carry it with the intent to administer it as they see fit. Fortunately, you don't have to take my word for it - I'm pretty sure every emergency physician in the country would agree with me.

But, jblake - what a FR is trained to do is assist someone in administering their own EpiPen, which is why someone carrying an EpiPen may want to inform leadership of their condition.

That said, I am fully supportive of all efforts to put the necessary lifesaving equipment and medication into the hands of our scouters. But, if you decide you want to carry Epi, you also NEED to get the necessary education to know why, when and how to properly administer it - and this education is not covered in FR training.

(This message has been edited by dScouter15)

Gern - I think that because many people carry easy-to-use EpiPens, lay people get the impression that Epi is a relatively "easy" drug, like Tylenol or Aspirin, that can just be given to someone who we think might need it. But, without having the education to even know what Epi does, how would you decide when to give it? A bunch of drugs could potentially stop someone from dieing. Atropine, Sodium Bicarbonate, Lidocaine, Dopamine, D50, Glucagon, Narcan, Norepinephrine and Lasix (just to name a few off the top of my head) are common drugs that could save someone's life. Do you think that all of those should be carried with us in our first aid kits? Do you think that you could just give them to someone you perceive to be "dieing" in the off chance that they might work?

I've made most of these points already, so I'll try to say them clearly here for the last time:

1) Epi is a dangerous drug. We use it to get someone's heart to start beating again following cardiac arrest. It is NOT something that we can administer "just in case," or if we think that it "just might help" the patient. It simply does not work that way.

2) For these reasons, only educated medical professionals should be administering it. Medical care needs to be provided based on a thorough, accurate assessment of the patient. A lay person, or even an FR or EMT does not have the education necessary to perform this type of patient assessment. A lay person, FR or EMT cannot decide whether Epi is indicated, or whether some other form of treatment should be used instead.

3) If you're so concerned about having Epi available, you need to bring someone with the necessary education, equipment, certification and license along to evaluate the patient, and administer it. At the very least, you need to have a physician provide you with some type of protocol for administering a dangerous drug - a drug you don't have sufficient knowledge of, a drug whose potential side effects you cannot manage.

Honestly, if you're this concerned about being able to give Epi, there are far more common, serious issues that you could also be worrying about. Perhaps, rather than trying to be allowed to administer dangerous medications without the necessary training, you should plan activities that keep your scouts close to professional EMS and hospital services, if this is a serious enough concern for you.

EDITED TO ADDRESS BEAVER'S POST:

I agree with what you say - trained, educated personnel should administer life-saving medications to sick people. Untrained persons should not.

Just a few things in that quote you provided: being trained in a WFR course to perform a certain skill, such as administering Epi, does not mean you are legally allowed to carry Epi, and actually administer it to a patient. The ability to carry and administer epinephrine is determined by state laws, and the physicians whose medical direction you operate under. As that quote said, Epi is a prescription medication, and is regulated.

Just to be clear, if you are adequately trained in administering Epi, and have the state's and a physician's approval, go for it. But, I'd wager that these "examples of new onset anaphylaxis in outdoor programs that have been treated by epinephrine carried by the program" were actually treated by medical personnel with more medical training that the First Responder course.(This message has been edited by dScouter15)

GernBlaster - If you ask me, if you are "holding the very technology that just might save their life" - you should have the education necessary to know when, where and how to use it. If you don't have that education, you shouldn't be have that "technology" in your possession. There are a lot of types of medical equipment, and a lot of medications that "just might save a life." However, before using any of them, you need to know when, where, why and how they are used. First aid and first responder training teaches how to use a number of pieces of equipment, and a handful of medications, to potentially save someone's life. Epinephrine is not one of these medications. Giving drugs, or performing medical procedures, because you think they "just might help", is a very dangerous approach to first aid and medical care - if you're wrong, you could easily make a situation much, much worse.

Bob - you're absolutely right on the good samaratain law - except that I don't think an esophageal airway is what you think it is. But, that kind of proves my point further - a little knowledge can be very dangerous.

My primary concern is not necessarily the (completely valid) legal aspects that Bob and others pointed out - its not just about being legally allowed to "store and disburse pharmaceuticals", not about being trained to follow protocols. My concern is that a person with the very limited training provided by FR training presumes to administer dangerous medications to persons without a prescription. Fact is, an FR receives very basic training. The amount of training given is barely adequate to teach a FR to identify anaphylaxis, let alone treat it using medication. In fact, the amount of first aid care that an FR is allowed to provide is barely more than that we teach our scouts to perform. Epi is not some wonder drug that you can just give to magically fix anaphylaxis (assuming that the patient you administer it to is actually suffering from anaphylaxis). Epi causes many different parts of the body to respond in many different ways. There are many situations in which is use is indicated. There are many, many situations in which it is contraindicated. It can have dangerous side effects. If you give it, and it was not indicated, or contraindicated, you could seriously injure or even kill a person. If you give a wrong dose, or give it the wrong way, you could kill a person. An FR just does not have the education necessary to adequately assess and evaluate a patient, and administer a dangerous drug like epinephrine.

If you perform some medical procedure, or give some medication, and cause a person greater harm, or death, I'd certainly hope a jury would consider whether or not you had sufficient education to know how to do the procedure you attempted, or to know whether to give the medication you gave. The education required to give Epi - a drug powerful enough to restart your heart during cardiac arrest - is much more than what standard first aid or first responder courses provide.

I guess if you feel that its so important that epi be available to be given to hikers without a prescription, you have a couple of options:

1) Bring a medical professional along with you who has the necessary education, and certification or licensure to treat patients using dangerous medications.

2) Have some of your group leaders receive education and certification necessary to administer epi

3) Find a doctor who will write a protocol allowing you to administer epi at your current level of training and certification. I doubt this will happen, and I think its a VERY bad idea, but all you need to do is find one doctor who disagrees with me.(This message has been edited by dScouter15)

As a paramedic, I'll throw my two cents in, for whatever its worth, to clear up some apparent misconceptions:

A First Responder or WFR is not trained on the protocols for administering Epi, or any other drug for that matter (with the possible exception of oxygen). Under some protocols a FR may assist a patient showing signs of anaphylaxis in administering the patient's own Epinephrine Auto Injector. FRs are not qualified to determine a correct dose of epi, draw it up into a syringe, etc. Nor are they qualified to administer benadryl, terbutaline, solu-medrol, albuterol, or any other drug (again, with the exception of oxygen). The reason for this is that FRs do not receive enough training in pharmacology, patient assessment or medical patient management to be able to decide whether epi (or any other drug) is indicated or contraindicated in a given situation, what dose of said drug to administer, the route to administer it through, and how to manage the patient if there is some adverse side effect. After all, FR and WFR training is only 40-80 hours in length. In contrast, an EMT course is approximately 140-180 hours in length, while a paramedic course is more than 800 hours.

So, as a WFR, say you find a patient with no hx of severe allergic reactions, showing severe respiratory distress. What are you going to do? Before you dive in to your first aid kit and give him a shot of life saving epi, what further assessment are you going to do? What findings would suggest that epi is indicated? What findings would contraindicate epi? What other interventions should you be prepared to perform?

That said, if you find a doctor willing to write a protocol for you to carry epi, and administer it on a standing order, than go for it. But I'd be surprised if you find a doctor who will do that, given the lack of necessary training as I described above.

I'd advise you to search out a physician who can advise your group, and provide you with some guidance as to what training would be most appropriate, and perhaps help you develop some operating protocols to treat injuries and illnesses you expect to encounter.

Actually, I'd kind of like to have the last word - watching my position on BW's scoreboard...

Well, I'm a paramedic, so I guess you could say I go looking for trouble ;-). But, one thing I've learned in my career in EMS is that as soon as you start thinking you won't need something - some training, some piece of equipment - you'll almost immediately have a situation in which that training or equipment would have been invaluable.

So, how often will you run into a "serious" situation - I have no idea. Depends a lot of the type of activities you participate in, and the training and preparation you put in to them. But, what are you going to do if you do find yourself in a "serious" situation, and there's no one else more knowledgeable immediately available to handle things?

I would say take the training. As far as being afraid of blood, the best way to overcome that is just to practice treating fake (or real) injuries, which your WFA training should give you some opportunity to do. Also, once you have some training, and you do find yourself in some kind of medical emergency, you'll be able to just apply your training to begin treating the actual injury, rather than getting distracted by the appearance of the blood.

Also, consider, that which appears to you now as a "serious" situation, might, after receiving some advanced training, appear to you as a manageable, treatable situation.

Ed -

What reason do you have to ask the scout who he will vote for? You say that the question is "directly related to [...] citizenship," but what aspect of the scout's citizenship are you looking to evaluate? How can this question be used to evaluate a scout's citizenship better than other questions, involving the HOW or WHY aspects of voting?

I just think that there's better questions that could have been asked to assess citizenship. Personally, if I wanted to ask a question along this line, I would ask something to the effect of "How are you deciding who you will vote for in the next election?" This way, the scout could explain his values, his though processes, critical thinking, etc - i.e., the very things that Scouting tries to develop. Also, the scout will not feel compelled to reveal information he might prefer to keep to himself, and the board could have a discussion that focuses more on values, morals and citizenship than on politics. It also requires a lot more thought to answer this question than simply saying "Obama" or "McCain" or "Steven Colbert!" Personally, as an Eagle Scout, I'd be upset if I was asked such as question at my EBOR. I can say now, looking back, my thoughts on politics have changed greatly since that time. However, I'd like to think that my values, and commitment to citizenship have not changed. And isn't that what we're trying to assess?

One every campout, someone will forget something important.

That same item can always be replaced by an appropriate combination of wooden poles, twine, garbage bags and/or duct tape, and a little ingenuity.

If the scoutmaster picks the date for the campout, it will rain.

If you're planning on doing swimming or boating, it will be freezing.

If you let the adults read the map, you will get horribly, horribly lost.

It can actually rain, non-stop, for 72 hours.

Bob White really likes training.

The parts of the training about knowing your resources, and knowing your troop's needs are REALLY important.

If you spend too much time grumbling about the little things wrong with your unit, you'll miss out on all the great things that it does well.

If you find yourself relaxing on a camping trip, you really should stop by the troop's axe yard or fire pit.

Some of the most friendly, humble, loyal, knowledgeable and generous people; some of the best teachers, best role models, and biggest advocates for youth you'll ever meet will be Scouters. These are the kind of people that you stop and thank God that you've had the opportunity to meet.

Some of the most pompous, arrogant, self-centered, rude, snobbish people you'll ever meet will be Scouters. These are the kind of people you dread having to work with, but help to show you where you fall in this spectrum.

I would say that the best thing you can do is allow your youth leadership to see an example of an effective boy-led scout troop in action. If your council has an NYLT program coming up this summer, that would be an excellent opportunity for your SPL and other leaders to see first-hand how a boy-led troop works.

Another idea - is there another troop in your area that is boy-led? See if you can identify such a troop, that shows good youth leadership and a healthy program. If you're friendly with the SM, see if they'll allow some of your youth leadership to attend a couple of their troop meetings and maybe a weekend campout as guests. If this is not possible, try attending camporees, summer camp, and other events with multiple other troops. Pay attention to how the other troops operate - note what works and what doesn't work.

I'd recommend using this type of strategy in addition to the training resources provided by the BSA. The BSA resources will provide objective "educational" type information about how the troop program should work. The opportunity to see a real unit implement the program will supplement the training, allowing your youth leadership to see how it all fits together in the "real world."

Our troop runs a very successful event each year at our town's annual fair/carnival shindig: a dunk tank. We find this works well, as its not a fundraiser that the scouts need to put a lot of "work" into. The PLC and adults handle reserving a spot for a booth at the fair (free), and renting a dunk tank ($200-$300). We divide up the time the fair is open into equal-length shifts, and assign each patrol to a shift. For its shift, the patrol's members sit as "victims" in the tank, and handle collecting money, passing out balls, and trying to entice fairgoers to pay for a chance at the dunk tank. Throughout, we have a couple of adults there as well to supervise. If I remember correctly, we charge $1/ball, or 5 throws for $3.

We make somewhere between $1000-$2000, so its not the biggest cash cow. In the past, the PLC has voted to put the proceeds directly into the scout accounts of those who participated. Other years, the money has been used to subsidize some summer camp fees.

Even though the proceeds aren't fantastic, we find that this is probably the most fun, popular event outside of camping trips. The scouts seem to like this as a fundraiser because there's no door-to-door selling, or other "work" involved. The scouts just have to show up in their activity uniform, and have fun for the duration of their shift. Just something worth considering.

fgoodwin - I hear what you're saying, and your point is well taken. A very wise Scouter once instilled in me that a fundamental of enabling youth leadership is to provide opportunities for "guided discoveries." That is, youth leadership should be given every opportunity to make decisions, implement and execute the Scouting program. However, this should all be occurring under the guidance of trained adult leadership. Obviously, the youth leadership will be developing and conducting the majority of this training. However, as an adult leader, it is my obligation to ensure that certain lessons are conveyed, and this is very the "guided discovery" principle comes in - in terms of focusing discussion in the planning phase, so that the youth are able to stay focused on the overall objective, and develop a program suited to achieving that objective. Thus, in order to prepare myself for this planning phase, seeing as I'm not too familiar with the movie scene, I simply asked for some ideas I could share with our youth leadership. Perhaps I should have made that more clear in my original post, though, honestly, I didn't expect a scouter asking an innocent, specific question about good movies to turn into a "you're not really doing The Program correctly" discussion.

I'll throw my two cents in:

I think the BSA needs to more clearly specify how they define "bullying". A lot of the conversation on this thread, up to this time, has involved how there are many definitions for bullying. I think that if they provided a clear, precise definition of the type of behavior they are trying to address, units will have an easy time developing programming to enable scouts to complete the requirement.

The cynic in me thinks that these requirements are a convenient way for the BSA to be able to say, "We're taking an aggressive stance against bullying!" Regardless of the motivations for having the requirements, I think that they are appropriate for the T-2-1 group of requirements. Bullying is common around 5th and 6th grades, when Scouts would likely be working on T-2-1 requirements. Unfortunately, bullying also occurs within Scout troops. Thus, it seems logical to encourage Scouts to learn how to handle bully early in their Scouting career.

I think that the biggest problem in these types of requirements - regarding bullying, drugs, alcohol, sex, etc - is that, to be effective, they need to be targeted at specific ages. Obviously, the best way to address a 5th grader is much different from the best way to address a 12th grader. The BSA does have some age-targeted materials available, of varying quality. However, since the requirements being discussed are one-size-fits-all, I don't see them being very effective in actually combating the bullying problem.

I guess, though, since they're pretty vague, it gives the unit and SM a greater ability to tailor and target their program to the needs of the scouts in their unit.

As I see it, we all need to do our best to be courteous. I personally feel that those familiar with BSA policies have a responsibility to, in the course of our discussions online, point of where a scouter may have deviated from these policies. That said, can we all avoid making snotty comments like, "are you sure you've been trained?", "you're not obedient to the BSA!" and so on? Think about it: if you had trained a scout in your unit to perform some function, and you observe that he's not performing it exactly to the specifications you've set, are you going to question his obedience? Or, are you going to attempt to work with the scout to identify the reasons behind him not complying with his training, and work on correcting the problem?

Bob - seems like a straw man argument you created here, but OK, I think you're right. Now what?

Thanks everyone for the advice.

To clear up a few issues -

Firstly, Bob, I am a "licensed medical professional," and am very well aware of the actions my license permits, and those which it does not. However, if a physicians provides me with a protocol, or standing order allowing me to manage prescription or OTC meds, I may act in accordance with that protocol (whether a doc would actually do this is another story). What happens is, provided I act correctly, in accordance with the protocol, the doc takes responsibility for that action. I've heard of this type of situation occurring, and am wondering if anyone has any experience with it. I'd be perfectly content to allow scouts to handle their own medications; however, some scouts do need supervision in taking their meds. For instance, last year (I was involved with the program, but not as the "health officer", per se), several scouts were taking various kinds of psychiatric drugs. If you're not familiar with these drugs, the effects of withdrawal can be very serious, and dangerous. We also has cases of scouts not wishing take their medications. We've also had scouts taking psych meds, whose parents told them that they were allergy pills. Thus, the parents entrusted the staff with the responsibility of ensuring that the scout took these medications on schedule. Right or wrong, this is what occurred, and this is the situation I'm faced with.

Secondly, Eamonn - I understand my role to include both of those general areas. Fortunately, we have some general "camp safety" policies in place from previous years. Also, the camp ranger is very much on top of his facility, and works very closely with the staff to ensure that the camp itself is safe, and has emergency procedures. I don't see this part of the job being as complex at the medication issue.

Thirdly - As far as treating injuries goes, I do plan on giving a head's up to the local volunteer EMS department, and well as the local emergency department. We've only had to send scouts to the ED a few times in the time I've been involved, as that has always run very smoothly.

So, to synthesize the advice to this point - the council should have a physician who oversees health and safety operations, and I should get in contact with him/her to establish protocols and procedures? Seems easy enough - I'll have to see if my council has such a doctor.

I absolutely agree with you that the key is that we do our best dScouter15. So let me ask you this. Is a leader who chooses to not attend training "doing his or her best"?

Is a leader who takes training and knowingly doesn't follow the Methods or use the program as taught "Doing their best"?

Is a trainer who chooses not to follo0w the syllabus even though they are told to.... "Doing his or her best".

Bob -

Its been a long day, and I'm getting a little confused here. To begin with, I can't determine whether a leader is doing his or her best based on his or her compliance with the Official BSA Program. Regardless, I thought that your intention with this thread was to discuss methods of conducting training in such a way that each volunteer has reasonable access to training material in an effective learning format. In my reply, I posted my ideas for reaching this goal.

So, are you trying to brainstorm effective training methods, or just lamenting the fact that Scouting is not always delivered "correctly?"

Bob -

I don't really understand what, exactly, you want to know, or why you want to know it, but I'll contribute my theory anyway -

You just can't do it. You can't coordinate the training of over 60,000 volunteers of various ages, skill levels, ability, reasons for being involved in scouting, access to technology, access to facilities, family situations, other commitments, learning disabilities, egos, interest, etc - so that each one of the 60,000 people receives the same information, presented correctly, in such a way that they can internalize and remember it. Even if you could do that, you still can't force them to actually use the training to do Scouting correctly.

What we can do, is DO OUR BEST. At the council level, training committees can be formed consisting of Scouters experienced with the program. This group will have to be diverse - there will be a need for people with a good handle on technology, people skilled at teaching (not just using flip charts and powerpoint, but actual teaching), people who have a strong knowledge of BSA policy and the training material, and people who are good at relating to unit-level Scouters. And, the chair of this committee will need to oversee its operation in such a way that all training is conducted consistent with the standards set by National.

Once this committee is going, develop training courses in response to the needs of the volunteers in your council. Consider delivering training over the Internet, distributing materials on CD/DVD, printed material, district level training, unit level training, one-on-one training - whatever works. Make the training practical, available and inexpensive. Delegate some training responsibility down to the unit level. I feel that with a model like this, you will be able to reach a majority of volunteers, and provide them with information they can actually use.

Also, determine which training elements need to be delivered at which time to which volunteers. At a national level, develop an outline of "required training," "suggesting training," and "extra training" required for each position. For instance, for an Asst Scoutmaster, required training would include youth protection, overview of Scouting as a national organization down to the troop level, how a troop functions, and the job descriptions of each leader in the troop (both youth and adult). This is something that could easily be done in 2-3 hours, which shouldn't be that unreasonable. Suggested training would include whatever the current incarnation of OLS is, first aid/CPR/AED, and youth leadership development training. Extra training would be Wood Badge, specialized outdoor skills training, etc.

For this type of model, National would need to re-work some of their training materials to allow it to be more "modular," and to give volunteers the flexibility to deliver the material in whichever way they see fit. I'm not suggesting that the content of the training materials change in any way, but instead that the context because less rigid, and that the delivery method be determined by the trainers at the council/district/unit level.

I think this has the best chance of working, and I'm eagerly awaiting replies telling me why I'm wrong ;-)(This message has been edited by dScouter15)

The ceremonies in my troop also have "a little bit of everything." Generally, the ceremony starts with welcoming speeches, a prayer, and a short ceremony about the scout law and oath, and then the eagle charge. This portion tends to be serious, but we try to maintain a "warm" personal feeling.

Then, the new Eagle Scout generally gives a brief thank-you speech. Then, our current SM has a tradition where he'll give a brief speech. As he says, "I'm the Scoutmaster, I get the last word." (He joking when he says that, by the way - his wife gets the last word!) Anyway, the SM will give the final short speech, which generally consists of funny stories about the Scout. But, its structured in a way that shows how the Scout has grown and matured over the time he's been in the troop.

Honestly, who said Scouting had to be serious? I am an Eagle scout, and I know I had a ton of fun in Scouting. At my ECOH, a bunch of us told funny stories, myself included. I'd be kind of offended if we didn't. But, at the same time, it is important to reflect the importance of the achievement, and this is done through "serious" periods in the ceremony.

I've been asked to serve as the health and safety officer for a council-wide week-long youth training event this summer. I have experience working as a paramedic in the EMS industry, but never volunteering in this kind of capacity in the BSA. I understand my job to basically cover three general categories:

1) Work with the staff to ensure that the program itself is carried out with health and safety in mind. Preventing illness/injury is preferable to treating illness and injury.

2) Ensure that scouts are taking their prescribed medication appropriately.

3) Be available 24/7 to treat illness and injury situations as they arise. Disposition patients appropriately.

Obviously #1 is pretty easy. My questions involve #2 and #3.

Has anyone with any EMS certification volunteered in this capacity before? Did you have any type of medication direction provided, or protocols for while you were volunteering at camp? Particularly, how did you handle distributing scout's prescription meds? Were there any provisions for providing OTC meds?

I'm basically thinking that, in terms of treatment, it will just be BLS care. I'm concerned that, because I have a license, I may be opening myself up to liability, both in terms of care rendered, and the medication issue.

Any advice?

If anyone has any advice, I'd like to hear it. Thanks.

So, who's going to enforce all this? Professionals? Commissioners? Off duty law enforcement moonlighting as the Patch Police?

And, how will it be enforced? Take the unit that allow scouts to wear blue jeans instead of Scout pants/shorts? Will they be fined? Have their charter revoked? Have their transgressions printed for all to see in the councils bimonthly newsletter?

I know my council has intervened in the affairs of the units when safety issues are raised, or if someone appeals advancement decisions. I'm thinking that if the council was more aggressive in "enforcing" uniform policies, making sure no one adds to the requirements for the Pulp & Paper MB, etc, they'd really aggravate a lot of leaders who, in general, deliver an excellent Scouting program to their unit. They'd also probably alienate a lot of potential scouts and scouters. Seeing as the council's (professional) interests seem to involve limiting liability, and registering as many members as possible, I don't see them doing ANYTHING to "enforce" uniforming, advancement, etc policies, unless they somehow relate to safety and liability. From a practical standpoint, I think that this particular case is closed.

From a more philosophical standpoint, I'd love to see a BSA with policies and procedures that individual units want to follow. Perhaps this means loosening up on some policies - for instance, make the uniform more flexible, practical and cheaper (in their defense, they seem to be heading in this direction with the switchbacks). Maybe provide additional training to show volunteers the benefits of the BSA's policies (this would require, by the way, that the policies actually have some benefit to volunteers and scouts).

I guess, maybe, the question shouldn't be "how can we make units following BSA policy, exactly?" But rather, "how might National update their policies to be relevant, practical, and beneficial for professionals and volunteers at the national, council, and individual unit level?"

As an EMT myself, I have to say that first aid training can be the easiest, most flexible, and most fun training that can be conducted in a scouting setting. I think that this comes from the fact that most of the first aid we teach isn't that "hard", theoretically or practically. And, its easy to tailor the training to different age groups and experience levels - from teaching tiger cubs how to wash a cut and put on a bandaid, call an adult, or call 911, to teaching older scouts and adult leaders CPR, and advanced stabilization and treatment techniques - and everything in between.

One thing that seems to be under-emphasized in BSA first aid training is the proper use of body-substance isolation - aka gloves. Ask anyone whose received even a little EMS training - the first two questions you ask yourself are, "Do I have gloves on? Is the scene safe?" I'm surprised to see that the first aid MB doesn't have a requirement similar to "Discuss the importance of taking body-substance isolation procedures when performing first aid. Explain common items that should be used to protect yourself and the ill/injured patient when performing first aid." When I teach any kind of first aid, I make sure to include a discussion on this topic (without adding to the requirements, blah blah blah). HIV and Hep-C are both very common (moreso than you might imagine), and there's no sense in taking a chance infecting somebody.

Another facet that I think should be incorporated more into BSA training is the use of AEDs. Fact is, in a cardiac arrest situation, most "younger" scouts will not be able to do effective CPR for very long, or at all - they're just not strong enough. Contrary to what you see on TV, good CPR isn't just lightly pressing on someone's chest, and having them magically come back to life. Instead, if you're giving good CPR for anything longer than a couple minutes, you'll be TIRED, sore, sweating and aching. And, unfortunately, your patient probably won't spontaneously regain a pulse. AEDs, on the other hand, are mind-numbingly simple to use, after a little instruction. Most models found in public places have an electronic voice that will completely walk you through the procedure. And, the success rate of resuscitation when an AED is used far surpasses that when its not used. Granted, it can be hard to find a training AED to practice with, but good places to start would be a local hospital (see if they have a "community outreach" division), fire or police department, college offering EMS classes, or a Red Cross organization.

Along similar lines, if you have a scout in your troop who has an epi-pen, invite him to teach the troop how to use it. That another thing that is very simple to operate, but could quite literally save someone's life. Training epi-pens (the same thing as a real epi-pen, but without the medication and needle) are available - check with the same places as above.

One final comment regarding the "first aid meets" and such. I think they are great, if not the best, tools for teaching first aid. However, remember to keep your instruction age appropriate. I've seen 1st-year scouts taught how to pull traction on a broken femur (a potentially dangerous situation - I, as a trained EMT, would be very careful and deliberate about how I do that procedure). However, these scouts still couldn't correctly do simple first aid, like treating a 2nd degree burn, or bee sting.

Just my 2 cents.

My troop runs a leadership training/team building weekend about every six months. We usually do it as a cabin campout, and integrate parts of the current Troop Leader Training material, the older JLT material, and some of the troop's unique, traditional training conducted by the SM, SPL and other older scouts. On Friday night, we like to show a movie with a message pertinent to leadership and team building. Following the movie, the SPL and JASM(s) lead the group in an informal discussion about the themes in the movie, and how they can relate to our troop.

I'm wondering if anyone can suggest any age-appropriate movies (our guideline is usually PG-13). In the past, we have used October Sky, Remember the Titans, and Apollo 13. The youth all responded to these movies quite well (probably the first two more so than the third). We'd like to try something new this year, so I'm just curious is anyone has any suggestions.

I''m not really a fan of a cell phone ban (that sounded catchy - I could write a rap song!). It seems like a lot of the arguments for banning cell phone are something along the lines of a few adult leaders who personally don''t care for that mode of communication, and see fit to prevent others from using it.

A couple of reasons I don''t mind allowing scouts to have cell phones:

1) Its a respect thing. There are hundreds of possible ways a scout can act disrespectfully, and Scouting is a great way to help a scout discover how to act courteously and respectfully. For instance, a scout, who, during lunch preparation, excuses himself to take a quick phone call is acting respectfully. A scout who answers his phone while the troop is at attention at a flag ceremony is not acting respectfully. So, rather than taking away an inanimate object, lets try to teach the scouts how to act respectfully.

2) Cell phones (and other electronics) can just help everyone feel more relaxed. A lot of people might like to listen to music (through headphones) as they go to sleep, or a patrol might want to listen to the ballgame while preparing dinner (again, quietly and respectfully). This can help people bond, ease tension, and work together easier. I''ve seen it happen.

3) It can be used for safety. If a scout, patrol or troop wanders off course, use the cell phone to call for help! Yeah, you might not have coverage where you happen to be, but what if you do? Go a head and call 911.

4) Its doesn''t really detract from safety. We restrict usage on knives, firearms, fireworks, swimming, boating, etc because acting inappropriately can cause injury or death. Cell phones don''t really present that problem. I guess there can be issues with homesick kids calling home, etc, but those issues aren''t caused by the cell phone - they''re caused by inappropriate preparation of the scout and the parent. Those issues should be solved by a conference with the troop leadership, scout and parents in question, not by a blanket cell phone ban.

5) Many scouts have a legitimate reason for using a cell phone on a campout. For instance, many older scouts may have an appointment to call a college admissions counselor, coach, boss, etc while camping. I''d much rather have the scout come to the campout, and excuse himself for a few minutes to make the call, rather than stay home. Other scouts may drive to the campouts themselves, and their parents may want them to keep a cell phone with them while traveling. I''ve also had parents tell me that their scout may be receiving a call regarding a close friend or family member who was undergoing a moderately serious surgery to let him know the outcome.

So, I guess I just try to be reasonable. If a scout is participating in the program fully and safely, but happens to talk on the phone for a few minutes, I don''t have a problem with that. If he starts missing out on the program, or the situation becomes unsafe, I work with the scout and parents to rectify that situation. I guess I don''t really understand what the problem is. We let scouts use digital wrist watches, flash lights, lanterns, GPS units, and other electronic tools all the time. A cell phone is just another electronic tool, granted with a much greater capability for misuse, but just a tool. If they want to use it, go for it.