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Funk T, Quach L, Mahajan A, Modi S, Supenia E, Schellpfeffer N, Ambrose M, Gaslin T, Garst B, Hashikawa A. Keeping children healthy at summer camp: A study of medications administered in the camp setting. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2063127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Tara Funk
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Leon Quach
- Oakland University William Beaumont, Royal Oak, MI, USA
| | - Aditi Mahajan
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sarang Modi
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Emily Supenia
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Tracey Gaslin
- Association of Camp Nursing, Ln Fisherville, KY, USA
| | - Barry Garst
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
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Kolberg K, Saleem N, Ambrose M, Cranford J, Almeida A, Ichesco I, Schellpfeffer N, Hashikawa A. Pediatric Head Injuries in Summer Camps. Clin Pediatr (Phila) 2020; 59:369-374. [PMID: 31976762 DOI: 10.1177/0009922819901009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Summer camps have a unique supervisory environment that may lead to increased head injury risk for children. The epidemiology of head injuries in camps is unclear. We partnered with CampDoc.com to review head injury reports from camp nurses in 2016 from 197 camps in 36 states. A total of 4290 (92%) reports were coded as definite head injuries, 47% (n = 2002) in female campers, with median camper age of 10 years. Head injury severity was coded as mild (94%, n = 4040), moderate (6%, n = 248), or severe (<1%, n = 2). Only 3% (n = 134) were medically evaluated, and 29% (n = 1221) were sports-related. Head injuries were categorized as definite (3%, n = 137) and probable (13%, n = 572) concussions, with 39% (n = 277) being sports-related and 61% (n = 83) of definite concussions incurred by female campers. Summer camps, while an important location of head injury risk, appear to be a safe environment for youth.
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Camp Leadership Perspectives on Food Allergy-Related Anaphylaxis Events and Training for Camp Staff: A National Survey of Summer Camps. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:1247-1252.e1. [PMID: 31770654 DOI: 10.1016/j.jaip.2019.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/14/2019] [Accepted: 11/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Training of camp staff to recognize and treat anaphylaxis is recommended because food allergies are prevalent among summer campers. The frequency of food allergy anaphylaxis events and the extent of anaphylaxis training for camp staff are unknown. OBJECTIVE To estimate the frequency of food-allergic reactions in camps across the United States and to assess the state of food allergy anaphylaxis training for camp staff. METHODS We partnered with CampDoc.com to send a 20-question survey in February 2016 to camp leadership representing 528 camps. Questions addressed demographic characteristics, food allergy policies, training, medication availability, anaphylaxis events, and confidence in staff to recognize and treat anaphylaxis. RESULTS A total of 559 responses were received, representing 258 camps. The majority surveyed (n = 529 [94.6%]) reported food-allergic children attending their camps. Only 47.6% (n = 266) respondents reported requiring individualized emergency action plans as required for camper attendance. Anaphylaxis treated with epinephrine was reported by 24% (n = 134) of leadership within the previous 2 years at their camp. These respondents were more likely to have a training session for staff (odds ratio, 2.46; 95% CI, 1.4-4.3). A total of 63.3% (n = 354) reported training session presence. However, 15.6% (n = 87) of leadership were unsatisfied with training materials and one-third were not confident in staff to manage anaphylaxis. CONCLUSIONS Appropriate policies to manage food anaphylaxis events and anaphylaxis management training were missing in a substantial proportion of camps. Camp-tailored food allergy training is needed given the number of camps reporting food allergy reactions requiring epinephrine.
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Chang M, Sielaff A, Bradin S, Walker K, Ambrose M, Hashikawa A. Assessing Disaster Preparedness Among Select Children's Summer Camps in the United States and Canada. South Med J 2017; 110:502-508. [PMID: 28771646 DOI: 10.14423/smj.0000000000000678] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Children's summer camps are at risk for multiple pediatric casualties during a disaster. The degree to which summer camps have instituted disaster preparedness is unknown. We assessed disaster preparedness among selected camps nationally for a range of disasters. METHODS We partnered with a national, web-based electronic health records system to send camp leadership of 315 camp organizations a 14-question online survey of disaster preparedness. One response from each camp was selected in the following order of importance: owner, director, physician, nurse, medical technician, office staff, and other. The results were analyzed using descriptive statistics. RESULTS A total of 181 camps responses were received, 169 of which were complete. Camp types were overnight (60%), day (21%), special/medical needs (14%), and other (5%). Survey respondents were directors (52%), nurses (14%), office staff (10%), physicians (5%), owners (5%), emergency medical technicians (2%), and other (12%). Almost 18% of camps were located >20 mi from a major medical center, and 36% were >5 mi from police/fire departments. Many camps were missing emergency supplies: car/booster seats for evacuation (68%), shelter (35%), vehicles for evacuation (26%), quarantine isolation areas (21%), or emergency supplies of extra water (20%) or food (17%). Plans were unavailable for the following: power outages (23%); lockdowns (15%); illness outbreaks (15%); tornadoes (11%); evacuation for fire, flood, or chemical spill (9%); and other severe weather (8%). Many camps did not have online emergency plans (53%), plans for children with special/medical needs (38%), methods to rapidly communicate information to parents (25%), or methods to identify children for evacuation/reunification with parents (40%). Respondents reported that staff participation in disaster drills varied for weather (58%), evacuations (46%), and lockdowns (36%). The majority (75%) of respondents had not collaborated with medical organizations for planning. CONCLUSIONS A substantial proportion of camps were missing critical components of disaster planning. Future interventions must focus on developing summer camp-specific disaster plans, increasing partnerships, and reassessing national disaster plans to include summer camp settings.
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Affiliation(s)
- Megan Chang
- From the Departments of Emergency Medicine and Pediatric and Communicable Diseases, Michigan Medicine, Ann Arbor, Michigan, and the Departments of Emergency Medicine and Pediatrics, St Joseph Mercy Hospital, Ann Arbor, Michigan
| | - Alan Sielaff
- From the Departments of Emergency Medicine and Pediatric and Communicable Diseases, Michigan Medicine, Ann Arbor, Michigan, and the Departments of Emergency Medicine and Pediatrics, St Joseph Mercy Hospital, Ann Arbor, Michigan
| | - Stuart Bradin
- From the Departments of Emergency Medicine and Pediatric and Communicable Diseases, Michigan Medicine, Ann Arbor, Michigan, and the Departments of Emergency Medicine and Pediatrics, St Joseph Mercy Hospital, Ann Arbor, Michigan
| | - Kevin Walker
- From the Departments of Emergency Medicine and Pediatric and Communicable Diseases, Michigan Medicine, Ann Arbor, Michigan, and the Departments of Emergency Medicine and Pediatrics, St Joseph Mercy Hospital, Ann Arbor, Michigan
| | - Michael Ambrose
- From the Departments of Emergency Medicine and Pediatric and Communicable Diseases, Michigan Medicine, Ann Arbor, Michigan, and the Departments of Emergency Medicine and Pediatrics, St Joseph Mercy Hospital, Ann Arbor, Michigan
| | - Andrew Hashikawa
- From the Departments of Emergency Medicine and Pediatric and Communicable Diseases, Michigan Medicine, Ann Arbor, Michigan, and the Departments of Emergency Medicine and Pediatrics, St Joseph Mercy Hospital, Ann Arbor, Michigan
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Schellpfeffer NR, Leo HL, Ambrose M, Hashikawa AN. Food Allergy Trends and Epinephrine Autoinjector Presence in Summer Camps. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 5:358-362. [PMID: 27923649 DOI: 10.1016/j.jaip.2016.10.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 10/04/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Pediatric campers with food allergies are at greater risk for exposure and anaphylaxis. A diagnosis of asthma increases risk for anaphylaxis. Epidemiological investigations of food-allergic children at high risk for allergic reactions requiring intervention in camp settings are lacking. OBJECTIVE The objectives of this study were to estimate the prevalence of food allergies among otherwise healthy campers in summer camps throughout the United States and Canada, and to assess asthma comorbidity and determine rates of epinephrine autoinjector prescriptions present in this population. METHODS We partnered with CampDoc.com, a web-based camp electronic health record system. Deidentified data were abstracted from 170 camps representing 122,424 campers. Only food allergies with a parental report of symptoms requiring intervention or with a camp prescription for an epinephrine autoinjector were included, whereas gluten, lactose intolerance, and food dyes were excluded. Asthma status and epinephrine presence on the camp medication list were assessed. RESULTS Overall, 2.5% of campers (n = 3055) had documented food allergies. Of these campers, 22% had multiple food allergies. Median age was 11 years; 52% were female. Nuts (81%), seafood (17.4%), egg (8.5%), fruit (8.1%), and seeds (7.2%) were the top 5 food allergies reported. Of food-allergic campers, 44.3% had concurrent asthma and 34.7% of those campers were taking multiple asthma medications. Less than half (39.7%) of food-allergic children brought an epinephrine autoinjector to the camp. CONCLUSIONS Life-saving epinephrine is not necessarily available for food-allergic children in camp settings. A substantial proportion of food-allergic campers are at higher risk for anaphylaxis based on concurrent asthma status.
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Affiliation(s)
| | - Harvey L Leo
- Department of Health Behavior and Education, School of Public Health, University of Michigan, Ann Arbor, Mich
| | - Michael Ambrose
- Department of Pediatrics, St. Joseph Mercy Hospital, Ann Arbor, Mich
| | - Andrew N Hashikawa
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Mich
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Cohen MB, Saunders SS, Wise SK, Nassif S, Platt MP. Pitfalls in the use of epinephrine for anaphylaxis: patient and provider opportunities for improvement. Int Forum Allergy Rhinol 2016; 7:276-286. [DOI: 10.1002/alr.21884] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 10/19/2016] [Indexed: 02/05/2023]
Affiliation(s)
- Michael B. Cohen
- Department of Otolaryngology-Head and Neck Surgery; Boston Medical Center; Boston MA
- Division of Otolaryngology; Department of Surgery; Veterans’ Affairs Boston Healthcare System; Boston MA
| | - Stefanie S. Saunders
- Department of Otolaryngology-Head and Neck Surgery; Boston Medical Center; Boston MA
| | - Sarah K. Wise
- Department of Otolaryngology-Head and Neck Surgery; Emory University; Atlanta GA
| | - Samih Nassif
- School of Medicine; Boston University; Boston MA
| | - Michael P. Platt
- Department of Otolaryngology-Head and Neck Surgery; Boston Medical Center; Boston MA
- School of Medicine; Boston University; Boston MA
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EMS Activations for School-Aged Children From Public Buildings, Places of Recreation or Sport, and Health Care Facilities in Pennsylvania. Pediatr Emerg Care 2016; 32:357-63. [PMID: 27176901 DOI: 10.1097/pec.0000000000000702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the etiology of emergency medical services (EMS) activations in 2011 to public buildings, places of recreation or sport, and health care facilities involving children aged 5 to 18 years in Pennsylvania. METHODS Electronic records documenting 2011 EMS activations as provided by the Pennsylvania Department of Health's Bureau of EMS were reviewed. Data elements (demographics, dispatch complaint, mechanism of injury, primary assessment) from patients aged 5 to 18 years involved in an EMS response call originating from either a public building, a place of recreation and sport, or health care facility were analyzed. RESULTS A total of 12,289 records were available for analysis. The most common primary assessments from public buildings were traumatic injury, behavioral/psychiatric disorder, syncope/fainting, seizure, and poisoning. The most common primary assessments from places of recreation or sport were traumatic injury, syncope/fainting, altered level of consciousness, respiratory distress, and abdominal pain. The most common primary assessments from health care facilities were behavioral/psychiatric disorder, traumatic injury, abdominal pain, respiratory distress, and syncope/fainting. When examining the mechanism of injury for trauma-related primary assessments, falls were the most common mechanism at all 3 locations, followed by being struck by an object. Of the 1335 serious-incident calls (11% of the total EMS activations meeting inclusion criteria), 61.2% were from public buildings, 14.1% from places of recreation or sport, and 24.7% from health care facilities. CONCLUSIONS Our identification of common EMS dispatch complaints, mechanisms of injury, and primary assessments can be used in the education of staff and preparation of facilities for medical emergencies and injuries where children spend time.
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