Weird Hospital Visits

Medical Treatment Photo

Nobody really likes taking kids into hospital. Most of the time it ends up being the teacher who’s got time off, or the last person out of the room! Let’s be honest it’s a crap job that nobody wants. Firstly you have to take at least two kids with you, so you’ve got one injured and one bored. Secondly the wait… there’s no such thing as a fast track in emergency unless you’re not breathing although arguably by this point you're probably beyond the services available in the emergency ward. Thirdly have you ever been able to get a decent coffee in a hospital?

The trip to hospital all starts when an injury is more serious than your staff can manage. I've had all sorts of visits with students, from fractures, to cuts, to unknown issues each visit if often a unique experience...

Medical Treatment Photo

My longest wait was 8 hours and this gave me the opportunity to talk about all sorts of things with the student. It's amazing what you find out about life the universe and just about everything when chatting!

However, my weirdest experience was when I took one of the kids in with multiple cuts after he took a dive in a bed of oysters. I won't go into the gory details, but he was a mess to say the least. We sat and waited for some time after seeing the triage nurse, who rifled through the stack of papers which were suppose to be a medical 'summary'. When the nurse finally brought us in to the examination room, she took one look at him and proceeded to fill a tub with warm water and a dash of disinfectant. She then said to me 'here you go, take this into the waiting room and clean him up'. I looked at her for a moment wondering if she was serious... Yes she was!

I looked back at her and said 'can I at least have a pair of gloves'. She half indignantly grabbed me a pair of glove and off we went. I sat there apologising profusely to the couple sitting next to us as I cleaned out the painfully deep wounds and collected a pile of tiny oyster shells as I did. I've heard of cut backs but seriously do I get a discount on my Medicare levy for do it yourself work in hospital?

Anyway, we were there about another hour and a half and the boy ended up with stitches in his hand and bandages everywhere.

When You're On First Name Basis With The Staff Here...

When You're On First Name Basis With The Staff Here...

To be honest I still try and avoid the hospital trip (mainly because of the bad coffee), but at the end of the day when you're responsible for the kids welfare and safety, prompt action and quick decision making to get them to hospital can mean the difference between an injury becoming an extremely bad injury. So really it's always better to err on the side of caution and take them in to be sure, rather than risk it just to avoid a long wait. At the end of the day, you can always get a coffee on the way home!

Policing The Lunch Box

Policing The Lunchbox - Risk Management

I recently read an article about a teacher writing a letter home to a parent telling them not to bring chocolate cake to school. In terms of earth shattering issues, this is rather low on the scale of importance in the world today, however, still worth a mention.
 
As a teacher, you see all sorts of weird and wonderful things that kids bring to school for lunch. You smell the amazing aroma of exotic spices and foods from all over the world in soups, pastas, noodles, wraps, burritos and even sandwiches. It makes my mouth water just thinking about it.
 
My question to the parents is, why didn't you send enough for me too? Some of the lunches I see are amazing and I just wish someone would pack that for me. In comparison, the classic cheese and salami sandwich doesn't seem to cut it anymore.
 
Whilst I'm a very strong believer that parents should stay out of trying to tell teachers how to teach, with one important exception to the rule, schools should stay out of kids’ lunch boxes.
 
For some reason, many schools have decided that telling parents what they can and can't give their kids for lunch will solve countless ‘dietary’, ‘allergy’ and ‘lifestyle’ problems. Much of this has been born out of two different concerns. The first one is the increasingly prevalent nut allergies, the second, childhood obesity.
 
For the first concern, I completely agree with very black and white rules. Any school's stance on maintaining a nut free campus is a great idea. The number of kids today who have a potentially fatal allergy to nuts is alarming and keeping the campus nut free is a smart way of reducing this risk and protecting the community from what can be a confronting and horrendous ordeal.
 
If someone has an anaphylactic reaction, untreated, their airways close up and they can be dead within minutes. Even if it's treated with an epi-pen, they must get to hospital as fast as possible and there's still no guarantee of recovery.  
 
Now anything which can kill someone in minutes needs to be taken seriously and parents should respect this decision on banning nuts. You're not going to put a brown snake in your kid’s bag which could bite someone and have the exact same result of a fast and painful death, so don't give your kids nuts to take to school.
 
On the other hand, in some schools, this concern has gone way too far and slowly but surely other foods have been added to a pointless list of contraband, driven by a misguided notion that if you ban lollies, chocolates and cakes, you will miraculously solve the societal problem of childhood obesity. It just doesn't work that way. Unlike an anaphylactic reaction, being fat won't kill you in 5-10 mins and the reality is most kids will burn off their cake fuelled calories, as they run around the playground.
 
At the end of the day, unless the school wants to provide lunch for everyone themselves, then they need to trust parents to make informed choices about what they're feeding their own children. If the concern is really about healthy eating, then the solution isn’t telling parents what they can and can't give their kids for lunch, because as soon as you tell people they can't have something or do something, it just makes them want to do it more.
 
If teachers have time to write letters home about the evils of chocolate cake or otherwise to tell parents not to let their kids have this food or that food for lunch, then they seriously have too much time on their hands and need something better to do. There's a reasonable and rational argument for nut free schools, but ultimately, schools need to balance this sort of real risk with a bit of common sense, so they don't start overreaching and trying to exercise control to the point of stupidity. 

Preparing For Anaphylaxis On Excursions

Anaphylaxis - Camp Food Preparation

Managing medical concerns at school and on excursions is one of my biggest worries as a teacher! Anaphylaxis is at the top of that list, since a reaction can be almost instant from the allergen and has a cascading effect. This means the longer you leave it, the more difficult it is to recover. However, despite this serious concern, it just means effective strategies need to be in place to ensure preventative measures are the number 1 priority.

In outdoor education, we usually run our programs a considerable distance from emergency medical care. As a result, this adds an additional layer of risk to any trip away. However, rather than worry about this and feel as though it’s too risky to take kids away, my focus has always been on effective preparation and management. This ensures that the chances for an anaphylactic reaction becomes so low, it’s not an issue.

Camp Supplies

Camp Supplies

If a student’s medical profile is flagged with an anaphylactic allergy, I’ll phone home and talk to mum and dad. What I need to know when I call is what are the specific triggers? Can they have foods which might contain traces of the allergen? When was the last reaction and what happened? Even though this information might be in the medicals, I prefer the first hand information from parents, so I can effectively brief my staff. I also want to know how well their son or daughter manages their allergy. Are they aware of what can happen? Are they aware of what foods they can and can’t have? This information is vital in helping provide teachers with the best management strategies in the field.

As an example, on one program, I had 247 students out in the field for a week long camp. 11 of the students had allergies which could result in an anaphylactic reaction. Based upon the information from the parents, and the fact some activities were hours away from emergency care, I carefully placed students with the highest needs in the closest proximity to emergency healthcare facilities. In one of the extreme cases, given the number of allergens that the student was affected by, I asked his mum to provide and pack the week’s food in an esky for her son and I provided a clean stove which was specifically for his personal use.

At the end of the day, it about clear channels of communication between parents, teachers and the child. Even though all staff are trained in first aid and anaphylaxis treatment, effective preparation and prevention is far more important. For every activity we do, we go armed with a list of dietary requirements and only shop according to each individual excursion. We don’t plan meals months in advance to save time. It’s about providing the best meal options for each individual group. This way, we’re prepared and able to ensure we provide a safe environment for every child and a wonderful memorable experience away from school.

First Aid Re-Cert

Nail Through Arm

Nail Through Arm

Once again my three years were up. It’s almost like Logan’s Run with the light going red on my hand… Well not quite, but first aid certification in Australia only lasts three years. So last week it was back to the classroom for first aid update training!

Often the quality of basic first aid courses is pretty woeful. You sit there in front of an instructor who has the power point burning hot. He monotonously steps you through each and every pain-staking slide and reads everything to you that you could easily have read yourself. Most courses are simply the ‘compliance’ stuff you need to ‘maintain’ your qualification so you can treat a paper cut in the office or be eligible for the ‘official First Aid officer’ payment. If you can, avoid these sorts of courses at all cost, as they really teach you nothing more than CPR and how to dial 000.

Although most of the first aid you’re likely to be doing in your day to day work is going to be relatively sedate, you never know what will happen and you can get thrown in the deep end and find yourself outside your comfort zone very quickly. The reality is that most causalities don’t sit there calmly whilst you bandage their non-broken arm. If someone needs your help, there's usually going to be pain, covered in blood, collapsed, vomiting or all of the above.

Case in point, one day I was walking along the corridor outside the classrooms. One of my colleagues yelled out to me to come and help. I stepped into the room to see one of the students collapsed, fitting on the floor, frothing at the mouth and going blue in the face. Everyone in the room had frozen and didn’t know what to do. If you’re dealing with kids in particular, the reality is that something like this is eventually going to happen. You’re better to be prepared for it and not have it happen, than not to be prepared when it does. Walking into a confronting scene and being able to react appropriately is something that only training and experience can provide. The better the training, the easier it is to get your head around what needs to happen next.

I didn’t know what to expect from this course, as every course I’ve done over years has varied dramatically. Within the first hour, we were into scenarios and this was where it got interesting. Casualties were made up with some awesome looking wounds, injuries and scenes were staged with heavy machinery, vehicles and boats. With fake blood everywhere, it was scarily realistic!

First Aid Scenario

First Aid Scenario

You’re thrown into each scenario with little or no information, which will be the case if you find yourself dealing with a similar situation in real life. It's up to you to work with the resources you have to contain and respond to the situation at hand. This is generally easy when you've only got one casualty, but add in two or three and a bit of anger and conflict to the mix, then you have some tough situations with which to deal.

Smoke Signal

Smoke Signal

The course was amazing with some short sessions of instruction, followed by a variety of these intense, realistic scenarios. Each and every one of them got the adrenaline pumping! From someone running at you yelling for help, to approaching a scene that's chaotic, full of noise, smoke, casualties, blood and screams, it was challenging. Even though you know it's setup, it still has the effect of raising your heart rate and throwing you in to manage what could be a real-life situation, a workplace accident, a vehicular accident or even an accident at home.

Car Crash

Car Crash

Training in this manner is important, as it helps you to pause, check for danger and potential risks and hazards as well as assess the situation in as calm a manner as possible. Many people rush into situations, which often puts them at risk of harm as well. Making situations feel real means that your brain is being pushed to make those informed decisions before you're confronted with the complex challenge of a real situation.

The great thing about the course was the fact that everyone was pushed. No matter how experienced we were, the scenarios pushed the limits and I certainly got a lot out of it. The remote area course was far more than just completing the 3 year compliance check. It was interesting, it was challenging, but overall it was rewarding, as I've come away with more confidence in how to assess complex situations that in reality might one day happen.

As a good guide for first aid training, forget Senior First Aid, seriously what's the point? In my opinion, it's a complete waste of time and money that won't really do anything more than train you in the most basic of first aid theories, which doesn't prepare you very well for the real thing. Look for something like a Remote Area or Wilderness First Aid run by a reputable provided such as Remote Safety Solutions. It's even better if it can be tailored to your specific areas of operation. It's well worth the time and effort to do this. You and your organisation will be far better prepared if something does happen.