Standby EMT at Baseball Camp

[mycrofft]

The best advice has been offered, all else is polishing.

HOWEVER....harrumph...if you get proactive you will virtually NEVER need an IV for "heat exhaustion" in this setting. Anything to get them to drink water and eat will make IV's an invasive superfluosity (??). After ten years doing Guard field support, I noticed that failing to eat meals was prodromal to heat exhaustion. Cooling and rest, getting first some oral sugar with lots of water (1/2 strength Gatoraid) then some easy food with starch, then a sandwich, did wonders. Teach them that a real breakfast and eating lunch are signs of a real athelete. If they look bad, pull them aside and evaluate/intervene.

Now, vomiting and diarreah in the heat...another matter.

I inadvertantly had a "trial" of this with adults; our real world support MD's were at one end of the base, I was on the other in the middle of the action (chem warfare readiness inspection in 80+ heat and simulated combat). They hospitalized about half a dozen in three days, while I returned all but one to duty within two hours (that one wolud not eat or drink. was sent to the docs, and was one of their hospitalized cases).

 

[Hastings]

If a heat incident has progressed so far as to REQUIRE IV fluids, then the OP needs to be fired and investigated. There is plenty of time before it's that extreme (especially in standard camp settings) for basic intervention, including cooling and hydration the natural way.

 

[triemal04]

If a heat incident has progressed so far as to REQUIRE IV fluids, then the OP needs to be fired and investigated. There is plenty of time before it's that extreme (especially in standard camp settings) for basic intervention, including cooling and hydration the natural way.

If, and this is a big if, he see's the kid before that. If you haven't figured it out by now, people can be very, very stupid, and none more so than a parent who's pushing their kid to excell in a sport.

 

[CFRBryan347768]

Wonder how come its a big deal to use a glucometer. Its not that hard to use one, I don't see why sometimes B's can't use them. Just :censored::censored::censored::censored::censored: and go.

Why is it a big deal? Think about it, its not just pr!cking and taking the blood, it is knowing what it actually means. Ive heard this many times here, learning the skill is the easy part, understanding it is the hard part. Should we be able to take EKG's too? All it is is connecting some electrodes and turning it on and pressing print.

 

[CFRBryan347768]

I am not sure if it was said, but I would also have ped's BP cuffs too.

 

[alleghenylover]

So, I don't know if this goes here but I have a few more questions know that I've checked the situation out and have been there for a day.

I'm operating under first aid auspices (not EMS agency). I don't carry an epi-pen (remember I have to supply my own stuff..so epi is a no go) meaning I can only adminster it to children who already are prescribed it and have it physically on them. Not that I can really afford one, but I can't get one, if its outside an agency, correct?

I need to work on getting medical records and such but I was actually concerned about the AED situation. Its a sports complex and they don't have one, when I asked they said they didn't have one because their insurance company(ies?) told them there were more liabilities with having one that may malfunction. I explained they were pretty much idiot proof, and lots of people are certified to use them (beyond EMS personnel). The concern seemed to lie in the fact that AED's may not be properly charged or functioning. Correct me if I'm wrong, they stay mounted to the wall unless they are used and a company would periodically come to service them/ensure its operational? This was really my main concern (although he mentioned most kids with problems have heartguards??). What about the kid who drops in the middle of the game and has no previous cardiac history???

Beyond just making a kid sit out, ensuring vitals are stable, he/she eats a little/drinks a lot, would anything else be effective for dehydration/heat exhaustion? (maybe cold packs strategically placed, but would that really be that helpful?). I'm banking on sending them to the air conditioned building(still monitoring them of course) if they aren't feeling well within a few minutes of sitting in the shade with water.

Although, thankfully, the coaches were great about reminding (pretty much demanding) that all the little campers drink water periodically (about every 20 minutes or so) there was a snack break and about a forty minute break for lunch.
And slightly off topic, I'm not from PA I did however study and work with Allegheny Mound Ants in highschool for an extended science research project thus the name...

Again thanks for the input!!

 

[Hastings]

Why is it a big deal? Think about it, its not just pr!cking and taking the blood, it is knowing what it actually means. Ive heard this many times here, learning the skill is the easy part, understanding it is the hard part. Should we be able to take EKG's too? All it is is connecting some electrodes and turning it on and pressing print.

Usually I don't argue against knowing the information behind a skill, but in this case, it really is simple. It's all numbers. It is nothing like an EKG.

A glucometer is really quite Basic friendly. If the number is 100, it's perfect. The farther away from 100 it is, the more sugar is probably an issue. If it's <60, the patient has less sugar than average, and if <120, the patient has more than usual.

With an EKG, it's far from a simple numbers game.


That being said, it's not really necessary anyway. Parents of diabetic children (and the children themselves) usually are pretty good about managing the condition and knowing when an emergency is occurring and taking appropriate action. I'm sure the OP will have nothing more serious as far as sugar emergencies go than the kid that feels dizzy because he skipped lunch and played a hard game. Emergency care for that? Get a sandwich, kid.

 

[Hastings]

So, I don't know if this goes here but I have a few more questions know that I've checked the situation out and have been there for a day.

An AED is actually an excellent suggestion, although wildly expensive. Yes, you're right about your assumptions. It is stored until it is needed, checked occasionally, and I've never heard of one malfunctioning. And, in a sport's situation, it is often vital. Sometimes all it takes is a ball being hit into the chest of a child.