Camp Odayin Medical Training

1. Camp Odayin Medical Training Winter Camp

2. Objectives Roles and responsibilities of camp medical staff Common camper diagnoses and their implications Common camper concerns

3. Roles and Responsibilities Doctor Lead Nurse Cabin Nurse

4. Camp Doctors At Winter Camp and Residential Camp, we always have a cardiologist onsite and available to respond to any cardiac emergencies. Dr. Peter Bartz of the Herma Heart Center in Milwaukee will be the pediatric cardiologist at Winter Camp. Dr. Pete will be available 24/7 by walkie talkie. Dr. Pete will be present at Winter Front each day.

5. Lead Nurse Jody Warren is the lead nurse at Winter Camp. Jody is available by walkie talkie 24/7. Responsible for overseeing all health care aspects at camp including doctor and cabin nurse staffing and camper/volunteer health and safety. Jody is available stay in the Health Center with tired or sick campers so that cabin nurses can continue participating in activities with the rest of their cabin.

6. Cabin Nurses There will be one cabin nurse for every cabins. Cabin nurses are responsible for the health and safety of their campers. They will attend all camper activities and report any concerns to leadership staff. They will administer medications to campers each day.

7. Common Camper Diagnoses Congenital Heart Defects (CHD) Implantable Pacemaker/Defibrillators Heart Transplants

8. Normal Heart Function • The Plumbing: • In normal heart function blood travels through a series of blood vessels, valves, and heart chambers. • The heart pumps deoxygenated blood from the body to the lungs. • It then pumps oxygenated blood from the lungs back to the body.

9. Normal Heart Function The Electricity: • An electrical current travels from the top of the heart to the bottom. • The electricity causes the heart muscle to contract, squeezing the blood forward.

10. Congenital Heart Defects (CHD) Most of our campers have CHD, which is a defect in the “plumbing” of their hearts. CHD is the number one birth defect in the United States. The defect can be simple, such as a small hole between two of the heart chambers or a valve missing one leaflet. Defects can also be complex, such as a chamber that is too small or valves that are completely closed off. Some campers may have multiple, very complex defects.

11. Congenital Heart Defects (CHD) Many campers have had multiple open heart surgeries to correct their CHD. Some of our campers have had their chests cracked open 5-6 times by the time they are a teenager. Sometimes the surgeries work well. Other times the campers continue to have trouble. They may have blue lips and nail beds. They may also tire more easily than other campers.

12. Congenital Heart Defects (CHD) Most campers know how to listen to their bodies. They may need to take a break sometimes. There is a one hour rest hour after lunch on Sunday. This allows campers (and staff) some time to reboot. It is very important for campers to stay well hydrated, especially campers who have had a Fontan procedure. These campers need enough fluid in their blood system to get blood to their lungs.

13. Congenital Heart Defects (CHD) • If you would like more information on common defects our campers may have, here are some good resources: • http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/Congenital-Heart-Defects_UCM_001090_SubHomePage.jsp • http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/Congenital-Heart-Defects_UCM_001090_SubHomePage.jsp

14. Pacemakers and Defibrillators Some campers have trouble with the electrical system in their heart. They may have an implanted device under their skin. This device sends electrical currents to their heart muscle if it goes out of rhythm. Pacemakers are used to speed the heart up if it gets too slow. Defibrillators are used to slow the heart down if it goes too fast.

15. Pacemakers and Defibrillators Pacemakers and defibrillators are implanted under the skin, either under the left collar bone or in the abdomen.

16. Pacemakers and Defibrillators • If your camper’s defibrillator gives a shock: • The shock will likely knock the person to the ground. They may pass out before the shock happens. • People often say it feels like being kicked in the chest by a horse. Ouch! • Remember, the defibrillator went off for a good reason! • Remain calm. Call for help on the nurse’s walkie talkie. • Avoid any rough play. Trauma to the device can cause malfunction.

17. Heart Transplants Some of our campers have been given the most precious gift, a heart transplant. Some campers may have they contracted a virus which made their hearts weak. Some campers had congenital defects which were too complex to survive without a transplant.

18. Heart Transplants • Campers who have had a heart transplant are on antirejection medications. These medications make it more difficult to fight off infections. • Please encourage your campers to wash their hands before meals/snacks, after using the bathroom, and after activities. • Notify medical staff if your camper develops a fever or chills. • For more information on organ transplantation visit www.unos.org • Are you signed up to be an organ donor????

19. Common Camper Concerns

20. What should I be prepared for? • Most of what we see at camp are your typical “kid things”: • Bumps and bruises • Headaches • Slivers • If you notice your campers looking more pale, blue, short of breath, tired, or swollen (especially their abdomen, ankles, or feet) please report it to the medical staff right away.

21. Winter Precautions We are especially conscious of the dangers of cold weather for our campers. For children with CHDs it can be more challenging for the body to produce enough energy to keep the internal body temperature warm enough. Campers MUST wear snow pants, hats, gloves and coats to participate in Winter Front outside. Please let leadership know if you have a camper who does not have these required clothing items. Half way through Winter Front everyone is required to come inside the dining hall for a warm-up break and snack. When outside, check in with your campers often and work with other staff to ensure that a child who wants to go inside can do so, with an adult, right away.

22. Do we ever have emergencies at camp? • We do our best to keep campers safe. Kids with heart disorders can be at a higher risk for having a sudden cardiac event. • We are prepared for emergencies • We are well staffed, with one nurse for every cabins, a cardiologist onsite, and a lead nurse available at all times. • AEDs and emergency medications are readily available. • Local hospitals and EMS are aware that we are in the area.

23. Walkie Talkies All nurses have a Walkie Talkie with them (but turned off) at all times. The lead nurse, doctor and Winter Camp directors (Alison and Brooke) have their Walkie Talkies turned on at ALL times. At Winter Camp, all “cabins” sleep in the same building. There will be a room of nurses on each floor. Nurses will share there sleeping location with counselors so they can be located in the event they are needed during the night. During the day, if you need help, use your nurse’s Walkie Talkie to reach other staff.

24. ALL INJURIES AND ILLNESS MUST BE REPORTED TO THE LEAD NURSE! That means you! We need to know if campers AND volunteers are getting hurt. We need to know if campers AND volunteers are not feeling well. All injuries and illness MUST be recorded in the health center log by a member of the health care team.

25. Water! Water is just as important in the Winter as it is in the Summer! Please remember to keep yourself and your campers hydrated! If your camper is more tired they might be dehydrated. Campers will follow your lead. Even the teenagers! Make a game of it if you have to.

26. Coumadin and Aspirin A lot of our campers need to be on blood thinners. They will be more prone to bleeding and bruising. Avoid contact sports and rough housing. We try to have activities that are appropriate for all campers. If you think an activity is too rough please tell Odayin leadership.

27. Handwashing Infection control is VERY important, especially with our heart transplant kiddos. Please remind your campers to wash their hands before they eat, after they use the bathroom, and after activities.

28. Bedwetting Two nurses will look through cabins every morning and choose the winner of the clean cabin awards! (Secret confession: they are also looking for wet beds. Shhhh….) If you notice a camper with a wet bed please let your cabin nurse or lead nurse know. We will wash bedding every day. Please be discrete if you notice a camper has wet his or her bed. It is very embarrassing.

29. Staff Medications It is very important that we keep ALL medications out of the cabins. Medications are locked inside the health center, with the exception of Epi pens and rescue inhalers (albuterol). On Saturday morning there will be a bin for staff to put their medications in. We will provide brown paper bags for your privacy.

30. Staff Medications You may come to the health center for your medications after breakfast, before the nightly staff meeting, and as needed. Just ask a member of the health care team to let you in the medication room! Cabin nurses often have over-the-counter medications (Tylenol, ibuprofen, Neosporin, etc) in their backpacks. Just ask!

31. Thank you! If you have any questions or concerns please feel free to ask the health care staff Thank you for helping us make camp a safe, healthy, and fun place to be!