Helping Junior Bunk Down in Good Health

Kids today are flocking to residential summer camps in greater numbers than ever, with an estimated 9 million set to pack their duffel bags this summer.

But in the rush to gather up shorts, flashlights and other necessities of camp life, parents may not stop to realize that kids at camp can experience the same kinds of minor illnesses and injuries that occur at home. And the need to monitor chronic health conditions or take medications doesn’t end simply because children are away from Mom and Pop.

For both their children’s well-being and their own peace of mind, parents should thoroughly check out a camp to make sure their children will get competent health care, says Dr. Wayne Yankus, a Midland Park, N.J., pediatrician and a member of the American Academy of Pediatrics committee on school health.

The academy recently updated its guidelines for health care services at day camps and residential camps. And the recommendations are eye-opening.

Do you know if your child’s camp will check all campers for head lice upon arrival?

If your child uses an electrical medical device, such as a nebulizer to treat asthma, do you know if electrical outlets are conveniently located?

Will a doctor or nurse experienced in treating children be on site full time? And if not, how far away is the nearest hospital?

According to the academy, all these things should be clarified before Junior boards the bus.

“Camp directors ought to be able to refer questions on health care to someone,” Yankus says. “Camps have to satisfy all kids, including medically fragile kids.”

Surprisingly little is known about kids’ health at summer camps, experts say. There are few studies on the subject and even fewer organizations that try to ensure that children’s health needs will be met.

Besides the pediatrics academy’s guidelines, which are merely recommendations, the American Camping Assn., in Martinsville, Ind., has detailed guidelines that closely mimic the academy’s.

However, only about 25% to 30% of the nation’s estimated 8,500 residential camps have the association’s accreditation, says Patricia Hammond, who oversees the accreditation process.

“Our accreditation standards include written protocols that are reviewed by a physician,” says Hammond. “In ACA-accredited camps, parents can have assurance that there is good health care.”

As for the many camps without the association’s accreditation, parents may have to ask more questions, such as whether the camp has accreditation from another body (the Boy Scouts, for example, accredit their own camps) or whether the camp follows the pediatrics academy’s guidelines.

Don’t assume that camp health services are governed by laws.

“A great majority of states don’t have regulations,” Yankus says.

Camps in California must meet any requirements set by county environmental or health departments. But those requirements vary widely.

According to the American Academy of Pediatrics, all camps should have written health policies approved by a doctor.

Campers should produce updated immunization records.

Campers should have had health evaluations within the last year, and those with medical problems (asthma, seizure disorders, diabetes, etc.) should have had an exam within the last six months.

On arrival at camp, all children should undergo a simple exam by a medical professional to detect infectious conditions such as impetigo or lice.

Camp medical records should have the name and number of the child’s doctor and emergency phone numbers.

Parents should be informed if there will be strenuous activities at camp.

In the absence of a full-time health professional, camps should have personnel on site who can at least administer first aid and cardiopulmonary resuscitation.

A policy should also specify how to store and distribute medication, an issue that has been of growing concern to the camping association, Hammond says.

“We have seen quite an increase in the last five to 10 years in the amount and type of medication children have,” she says. “That is quite a challenge for camps to manage. They have had to develop more sophisticated methods for training staff to deal with medication.”

Parents must do their part too, experts note, including providing a detailed health history. Parents of kids with health problems need to make specific arrangements--such as speaking with the doctor, nurse or camp manager--to provide particular health services such as applying a topical medication or using an inhaler for asthma therapy.

Shared Responsibility

Children should also bear some responsibility. For instance, they should understand the importance of taking medications, using sunscreen, washing hands before meals and avoiding leaps from the campground’s tallest trees. After all, most trips to the camp nurse or doctor are initiated by the children themselves, Hammond says.

Treating kids without their parents’ input is one of a camp doctor’s most difficult tasks, says Dr. Julie Kohl, a pediatrician at Kaiser in Mountain View, Calif., who worked one summer as a camp doctor.

“I felt my mother skills were more important than my physician skills,” says Kohl, who served as a camp doctor at the same camp in north Georgia that she attended as a child. “You don’t know these kids, so you don’t know how seriously to take the complaints. Is this stomachache homesickness or is it something else? As a pediatrician, you usually rely on the parents [for information]. When you don’t have that piece of it, it’s a little more complicated.”

Sometimes, just supplying a slightly injured child with an Ace bandage did the trick, says Kohl, laughing.

“An Ace bandage was a nice status symbol at camp,” she says.

Other adults at camp who know the kids’ personalities play an important role in identifying health problems, experts say. Parents should feel satisfied that the camp has selected mature counselors.

“All camps should be training their staff on what [medical problems] to watch for,” Hammond says.

In addition, camp counselors are usually the people in charge of preventing health problems.

“It’s important to make sure kids wear sunscreen, get enough water and get enough rest,” Hammond says of the counselors’ duties.

Don’t wait for a bad experience to check out your child’s camp, experts say.

Even day camps, from which children go home for the night, should have detailed health care guidelines that include the completion of health and immunization forms, maintaining emergency phone numbers for doctors and parents, promoting sunscreen use and adequate water intake on hot days and provisions for storing medications, according to the American Academy of Pediatrics.

And, by the way, the American Camping Assn. says more adults than ever are going to summer camps as well. So before you set off with your hiking boots and badminton racket, check to see who might be taking care of you if you fall ill.

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The American Academy of Pediatrics guidelines for day camps and resident camps can be found at https://www.aap.org/policy/re9843.html.

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Frequent Ailments of Campers

These are the most typical health problems children experience at camp, according to the American Academy of Pediatrics.

* Upper-respiratory tract infections.

* Vomiting and diarrhea.

* Impetigo and fungal skin infections.

* Asthma and allergies.

* Ear inflammations.

* Strep throat or sore throat.

* Lice and scabies.

* Conjunctivitis.

* Poison ivy and poison oak.

* Sunburn and heat-related illness.