What First Aid?

[TAHAWK]

As many know, several "outdoor" Merit Badges have a similar requirement:

 

"Show that you know first aid for and how to prevent injuries or illnesses that could occur in the backcountry, INCLUDING hypothermia, heat reactions, frostbite, dehydration, blisters, insect stings, tick bites, and snakebites." [emphasis added]**

 

A Scoutmaster asked how I could require a Wilderness Survival MB candidate to show knowledge of how to treat burns (including sunburn), splinters, sprained ankle, and cuts -- all very common outdoor activity injuries.

 

After reviewing the USSSP sites, and talking to other counselors, I discover that many are de facto amending the requirement to read:

 

"Show that you know first aid for and how to prevent injuries or illnesses from hypothermia, heat reactions, frostbite, dehydration, blisters, insect stings, tick bites, and snakebites."

 

I asked my local council, and they had nothing to contribute beyond suggesting that I write to National Council.

 

I wrote to National Council asking for clarification and received no response. (A Scout is . . .Courteous)

 

Comments?

Suggestions?

Any way in the world to get National Counsel to communicate with their field forces?

 

**

One wonders at the variations in the examples given for each MB.

 

 

CAMPING: "including hypothermia, frostbite, heat reactions, dehydration, altitude sickness, insect stings, tick bites, snakebite, blisters, and hyperventilation."

 

BACKPACKING: "including hypothermia, heat reactions, frostbite, dehydration, insect stings, tick bites, snakebite, and blisters. [Apparently, one does not backpack at altitude.]

 

CANOEING: "including hypothermia, heat reactions, dehydration, insect stings, tick bites, and blisters"

 

CYCLING: "including hypothermia, heat reactions, frostbite, dehydration, insect stings, tick bites, snakebites, blisters, and hyperventilation. [Abrasions? I guess we never go down.]

 

EMERGENCY PREPAREDNESS: takes the logical step of requiring the First Aid MB

 

FISHING: "including cuts, scratches, puncture wounds, insect bites, hypothermia, dehydration, heat exhaustion, heatstroke, and sunburn."

 

GEOCACHING: "including cuts, scrapes, snakebite, insect stings, tick bites, exposure to poisonous plants, heat and cold reactions (sunburn, heatstroke, heat exhaustion, hypothermia), and dehydration."

 

HIKING: "including hypothermia, heatstroke, heat exhaustion, frostbite, dehydration, sunburn, sprained ankle, insect stings, tick bites, snakebite, blisters, hyperventilation, and altitude sickness." [so we do contemplate hiking at altitude.]

 

HORSEMANSHIP: none [We do NOT fall off or get whipped by branches. Murphy has been banned.]

 

ORIENTEEERING: "including cuts, scratches, blisters, snakebite, insect stings, tick bites, heat and cold reactions (sunburn, heatstroke, heat exhaustion, hypothermia), and dehydration. Explain to your counselor why you should be able to identify poisonous plants and poisonous animals that are found in your area."

 

PIONEERING: "including minor cuts and abrasions, bruises, rope burns, blisters, splinters, sprains, heat and cold reactions, dehydration, and insect bites or stings." [No major cuts, please.]

 

ROWING: "including cold and heat reactions, dehydration, contusions, lacerations, and blisters." [We do NOT sunburn while rowing.]

 

SMALL BOAT SAILING: "including hypothermia, dehydration, heat reactions, motion sickness, cuts, scratches, abrasions, contusions, puncture wounds, and blisters." [No sunburn. Cloudy days only.]

 

SNOW SPORTS: "including hypothermia, frostbite, shock, dehydration, sunburn, fractures, bruises, sprains, and strains"

 

SPORTS: "including sprains, strains, contusions, abrasions, fractures, blisters, muscle cramps, dehydration, heat and cold reaction, injured teeth, nausea, and suspected injuries to the head, neck, and back" [Never break bones.]

 

SWIMMING: "including hypothermia, dehydration, sunburn, heat exhaustion, heatstroke, muscle cramps, hyperventilation, spinal injury, stings and bites, and cuts and scrapes."

 

WATER SPORTS: "including hypothermia, heat exhaustion, heatstroke, dehydration, sunburn, minor cuts and blisters"

 

WHITEWATER: "including hypothermia, heat reactions, dehydration, insect stings, blisters, bruises, cuts, and shoulder dislocation."

 

 

[KC9DDI]

I'm not really sure what your question is...

 

Does it have something to do with testing a Scout's knowledge of first aid topics outside of the examples listed in the requirements? If this is the case, I would say you hit the nail on the head - the requirement reads "Show that you know first aid for and how to prevent injuries or illnesses that could occur in the backcountry" and then lists some examples of common injuries. I'm surprised that an SM would nit-pick over something as small as knowledge of first aid for burns and cuts.

 

Not sure why your council or National would want or need to get involved over something so small...

 

Or am I missing your point?

[TAHAWK]

You seem to have grasped the issue.

 

I think it is an issue, especially for National Counsel, when we have requirements for Merit Badges that are so ambiguous that different candidates face materially different requirements for the same badge depending on whether their counselor reads the requirement or not.

 

Further, I think it is an issue for National Counsel when their list of examples omits most of the most common injuries or illnesses encountered in the "backcountry." The medicos at Philmont told me sunburn, blisters, sprained ankles, and "the runs" were the most common problems they encountered. Yet, only blisters are listed in the examples for Wilderness Survival Requirement 1.

 

Because I can get no help on this from National Council, I was hoping someone here could help. Long ago, that was called, "using your resources,"

[KC9DDI]

Fair enough, but I still don't think its a substantial issue. A qualified MB counselor should be familiar with common injuries that can occur in the course of the MB's subject matter, and should verify that the Scouts are familiar with first aid to treat them. A list (that's not all-inclusive) of examples of injuries is provided as a starting point.

 

If someone's trying to tell you that you can expect the Scouts to know first aid for any common ailment that's not on that list of examples, then I'd say that the problem is with them - not with you or with the requirements. I wouldn't afford much credibility to an SM that wouldn't want his Scouts to know how to treat sunburn or a twisted ankle as part of the Wilderness Survival MB.

 

Because I can get no help on this from National Council, I was hoping someone here could help.

 

Help with what exactly? You have very reasonable expectations of your Scouts, and are not adding to or modifying any of the requirements. The only problem I can see is with making a huge issue out of a non-all-inclusive list of possible injuries that may occur in the course of a given activity. They can make those lists of examples as long as they want, but someone will always be able to come up with some possibility that's not on there. That's why we use humans with the ability to use some common sense and good judgement to counsel Scouts as they work on merit badges...

[CalicoPenn]

I'd use the merit badge book as a guideline. If the merit badge book covers hypothermia, heat reactions, frostbite, dehydration, blisters, insect stings, tick bites, and snakebites but doesn't cover other possibilities, like sprains, burns, etc., then go with the book.

[TAHAWK]

The MB pamphlet discusses the examples listed in the requirement, although it's treatment of Anaphylactic Shock is pretty poor as it is treatment most appropriate for a non-wilderness setting.

 

The pamphlet also discusses sunburn, cuts, and abrasions.

 

It omits ankle sprains and the "runs," both common wilderness problems.

 

The pamphlet's substantive material on first aid and illnesses does not trump the requirement, but requirement is unclear and the substantive material goes beyond the examples in the requirement. (Much of the substantive material on other subjects is inaccurate, so other BSA and non-BSA sources are typically used.)

 

The SM doesn't bother or worry me. The ambiguity of the requirement certainly does. Every Scout that earns a MB, special needs Scouts aside, is supposed to meet the same requirements. This requirement invites counselors to invent greater or lesser hurdles for the candidate to overcome.

[Beavah]

Yah, I don't think I get it either, Tahawk.

 

Tryin' to come up with a laundry list of first aid requirements to my mind is just silly. A Florida scout might need to know about jellyfish stings, while a Minnesota scout needs to know chilblains. No need for altitude medicine in these parts, but I reckon that's not the case in Utah.

 

That's why we have these things called "merit badge counselors", eh? . You know, real experts or at least solid mentors in an area who can exercise their judgment and knowledge to determine what is appropriate for a lad who is hiking, camping, fishing, etc. in their area.

 

Beavah

[TAHAWK]

Beav, yes, after 42 years I know who MBC's are, and their range of competency and eccentricities. I suppose some of us are "silly," at least on occasion. In fact, I hope so.

 

I was focused on candidates in my area who face drastically different requirements.

 

As usual you make a good point. This is a national program.

 

So the requirement should add "in your area." And it should not read, as USSSP and one poster here has suggested, "Show that you know first aid for and how to prevent injuries or illnesses from hypothermia, heat reactions, frostbite, dehydration, blisters, insect stings, tick bites, and snakebites."

 

But how to have that happen?

 

[Scoutfish]

Assuming i understod your point in this post...... .......

 

I am willing to bet that BSA won't reply since it seems you have a bigger issue with the USSSP's wording of it on their site than what the MB books say.

 

And to BSA's credit, the books do carry a disclaimer in them that says the books get edited and re e3dited occasionally. It also says they are general interests and intended to be used as an aid.

 

So they are not 100 % thorought nor do the books cover every single instance that can be expect in regards to the skills required for the particular MB.

 

Funny thing about the First Aid MB class I just finished teaching a few weeks ago to our troop: Alot of the boys already new and could easily demonstrate the skills necessary to meet the requirementrs.

 

And althought we didn't have any 3rd degree burn victems lying around, they did explain what they would do if there was one there.

 

I also used magic marker to draw cuts, scrapes, blisters, snakebites and broken bones on the boys arms at which time they had a blast demonstrating what to do.

 

Now, having been a former EMT for 12 years at Fire Dept/Rescue Squad/Water Rescue station... I could go pretty well in depth about the tyupe of stuff they could find in our general area from chiggers to jelly fish to rabid animals to snakes.

 

But I agree with the idea that you may spend more time towards the stuff you might actually come across based on where you are going and what is common for your area..(This message has been edited by scoutfish)

[Oak Tree]

I had never had any counselor interpret that requirement the way you did TAHAWK, although I can see how it's a valid interpretation.

 

My take:If I were writing the merit badge requirements I wouldn't use the word including unless I said including but not limited to or if there was a catch-all at the end and any other injuries common to your area.

I would not list the first aid requirements at all. They are a repeat of other requirements, they are often ridiculous, they are too frequently the same from badge to badge, and I doubt very much that they contribute to any actual safety.

I find it strange for you to focus on this very minor item as a big beef with National Council. The national policy is clear - the counselor is the one who interprets the requirement. There's not going to be any "clarification" until a new book comes out.

 

So yes, your point that their grammar is imprecise is correct. It can lead to varying interpretations from counselor to counselor. That happens in much bigger and more important ways all the time. Some of the variation is intentional.

 

I'd suggest you relax and not worry about it, but I doubt you'd take the advice and I think it might be fun to watch your quixotic crusade for precision in BSA materials.(This message has been edited by Oak Tree)

[Beavah]

Yah, Tahawk, I was just funnin' with yeh, eh? . I know yeh know what a MBC is. That was part of the fun. Kinda a "lighten up Francis" moment.

 

I think anybody who expects "standardization" in the BSA program is just goin' to drive themselves and everyone around 'em crazy. Scouting is a kids game, offered by volunteers and a wide range of organizations with different goals and values. You're never goin' to standardize that. Heck, da public schools in a state spend a truckload of gold every day with professional staff and standardized tests and they fail spectacularly at creating a standard experience for a high school kid across just one state, let alone 50. What you're proposin' can't be done.

 

What's more, I don't think even if we could do it we'd want to. There's strength in diversity, eh? Each troop and SM and MBC is different. Each reaches different kids. That's mostly a good thing. Yah, yah, sometimes Eagle is da equivalent of a top-tier high school award and sometimes it amounts to a consolation prize for a middle schooler, and that's clearly a bit frustratin' if you're in a place that believes in the former. Da problem is if yeh go the standardization route, like as not yeh standardize on mediocrity, like active=registered. . Or yeh end up with da fellow who measures the margins on the Eagle project report to make sure they're standardized.

 

Me, I like the fact that you can be out there holdin' kids to high expectations. I interpret da requirement the same way you do. I like havin' freedom to do that, and troops having freedom to set da bar high. I also like not havin' to deal too often with some standardization freak who rejects an advancement report because the optional blue card wasn't filled out in black ink.

 

In short, I like the free market. I don't want it replaced by one size fits all. So if it's all da same, can yeh perhaps joust with a different windmill?

 

Beavah

[Eagle92]

Me personally, I'd handle it like this. If the scout has First Aid MB, then he has met the requirement. Could these requirements be a holdover of when FA MB was required for First Class? let's face it BSA sometimes takes a long time to change things, i.e. Tigers still have separate socks and are called "Tiger Cubs" after how many years of being part of Cub Scouts and not a separate program, the Sea Scout lapel pin is still call teh Sea Explorer Miniture pin, etc.

[Beavah]

Could these requirements be a holdover of when FA MB was required for First Class?

 

Nah, they were all added in the last decade, long after when FA MB was required for first class.

 

I think the intent was to reinforce outdoor first aid.

[CalicoPenn]

Refining my answer a bit - all the things mentioned after the word "including" should be read as items the Scout and MBC must cover. That's your standardization. Every Scout, everywhere, should have covered those items with their MBC, no matter whether they are in Barrow, Alaska or Key West, Florida.

 

Covering what the Merit Badge Book has in it's pages won't let you down.

 

Can you add extra? Sure, but keep it reasonable. The items you mentioned seem reasonable to me. Hauling out the First Aid Merit Badge book and covering all of that is probably not reasonable.

 

Looking over the lists, some seem to be included because we generally don't think of them when we think of the activity - cuts and scrapes in swimming? Happens - but who thinks you'll get cuts and scrapes while swimming?

 

I have to agree with Beavah that the intent is likely to reinforce outdoor first aid. I'll take it a step further and suggest that the intent is to reinforce the first aid that we aren't already covering multiple times already. Scouts may only talk about certain things in the context of the First Aid Merit Badge, but if Troops are using Scouts to teach new Scouts the first aid requirements for T-2-1 all the time, then those items are much more often reviewed and practiced.

[GKlose]

Of all the MBs that I counsel, Cooking MB is the only one that has first aid requirements. At first I thought it was kind of silly, but now I'm on-board with it. When I have my initial discussions with a Scout, I'll always ask what kinds of things can go wrong in a kitchen, and then I'll lead them through a fairly thorough discussion of likely kitchen injuries (hey, why are kitchen knives supposed to be sharp?), sanitation and food-borne illnesses. If I get a sense that they don't know, for example, why some foods should be thoroughly cooked, I'll ask them to read up on microbes like salmonella and e. coli, and then tell them we'll continue the discussion the next time.

 

Guy