CAP Talk

Cadet Programs => Cadet Programs Management & Activities => Topic started by: captrncap on March 30, 2006, 07:53:36 PM

Title: Cadet Medications
Post by: captrncap on March 30, 2006, 07:53:36 PM
Does anyone know the policy on Health Service Officers holding cadet medications at CAP meeting and activities?
Title: Re: Cadet Medications
Post by: Al Sayre on March 30, 2006, 08:05:11 PM
I believe that at encampments etc. they have to turn in all medications to the HSO.  At meetings I guess it depends, for example if a cadet needs an inhaler for asthma, I would let him keep it.  If he's on some kind of pain medication, he should probably be at home.  Insulin/Needles etc. should be in the car or with the HSO or Senior Staff.
Title: Re: Cadet Medications
Post by: captrncap on March 30, 2006, 08:24:51 PM
That's what I have done in the past. Wasn't really sure if NHQ had a formal policy.

Title: Re: Cadet Medications
Post by: arajca on March 30, 2006, 09:30:06 PM
There is no set policy on it. That is one of many items the Health Services Working Group is working on. There are significant legal issues to be addressed with any medication policy we decide on which automatically involves the lawyers.
Title: Re: Cadet Medications
Post by: shorning on March 30, 2006, 09:40:57 PM
Does anyone know the policy on Health Service Officers holding cadet medications at CAP meeting and activities?

Here's my question:  why would they? 

If it's prescription, It's prescribed to me, not them.  Why would I entrust my medication to some one else?  If it's insulin, that should be with the member, or at least where they have access to it.  Why would they need to be at home if they are taking pain medication?  I took Roxicet for a broken finger after a motorcycle accident.  Why couldn't I be at a meeting?  My doctor decided it was okay for me to be at work. 

What gives CAP any authority in the medical area?  Knowing what medications members are on or conditions that exist are necessary for things like encampment.  Holding medications is not.  There is also a difference between OTC and prescription medications. 

According to CAPR 160-1:

Quote from:  CAPR 160-1
SECTION C – DUTIES OF HEALTH SERVICE PERSONNEL
7. CAP health service personnel are responsible for advising CAP commanders and unit personnel on the health, fitness, disease and injury prevention, and environmental protection of CAP members relevant to CAP activities, with special emphasis on those members involved in flying, emergency services and disaster relief activities, field exercises, encampments, and special activities.


The HSO's job is to advise the commander.
Title: Re: Cadet Medications
Post by: Al Sayre on March 30, 2006, 09:51:34 PM
I generally agree that medications should be with the person they are prescribed to, BUT as Seniors we have a duty to prodect the cadets from themselves so to speak.  Pain medication is easily abused, and I don't want to chance a cadet hurting him/herself because his/her head isn't clear, or being accused of giving them to another cadet.  eg. Tylenol3 for a headache... "But it was only Tylenol" said on the way to the hospital due to a allergic reaction to the codine...  Participation limits depend on the activity classroom only, probably OK.  Insulin and needles don't belong in a cadets pocket on the drill pad or PT area.  What I am saying is put them in a safe place where he/she can get them if they need to.
Title: Re: Cadet Medications
Post by: shorning on March 30, 2006, 11:55:10 PM
At the risk of approaching the absurd...

"But it was only Tylenol" said on the way to the hospital due to a allergic reaction to the codine.

The same is true for seniors.  If someone asks you for an asprain, who are you to supply it?  Even though it's OTC, you're not their doctor.

  Insulin and needles don't belong in a cadets pocket on the drill pad or PT area.  What I am saying is put them in a safe place where he/she can get them if they need to.

Certainly not, but most diabetics are going to know that.  I don't think that's really an issue.

But why do we have to "protect" cadets from themselves?  There's an underlying assumption that the cadets are going to do something wrong.  Why would we trust them less than seniors?  Are we going to require seniors to turn in their medications at activities as well?  If so, how far does it go?  Which ones do you hold and which do you allow them to keep? 

Again, there is a difference between knowing what medical conditions people have at an activity and actually collecting their medications.
Title: Re: Cadet Medications
Post by: Al Sayre on March 31, 2006, 12:26:04 PM
OK, I think we are both on the same page here.  The point is that we have to use some common sense.  I realize that the cadets are not idiots, but some of the newer ones are afraid to ask questions, and may do something that they probably shouldn't out of simple ignorance.  When we take charge of the cadets after their parents drop them off, we are essentially in what the lawyers call "loco parentis" (sp?). This doesn't mean "crazy parents" :D, but that we act as the parents while in charge, and therefore have the same duties and responsibilities to ensure the safety and welfare of the cadets as if they were our own children (within certain boundaries).  Seniors on the other hand are pretty much on their own as far as medical issues.  As long as we don't do something stupid that will put them in the hospital, they accept responsibilities for their own actions.
Title: Re: Cadet Medications
Post by: arajca on March 31, 2006, 02:29:15 PM
As long as we don't do something stupid that will put them in the hospital, they accept responsibilities for their own actions.
Unfortunately, that's not always the case. There are some who will always blame someone(anyone) else for their follies.
Title: Re: Cadet Medications
Post by: Al Sayre on March 31, 2006, 03:44:43 PM
Agreed, see our overburdened court system...
Title: Re: Cadet Medications
Post by: Eclipse on March 31, 2006, 04:11:08 PM
Does anyone know the policy on Health Service Officers holding cadet medications at CAP meeting and activities?

Here's my question:  why would they? 

If it's prescription, It's prescribed to me, not them. 

We have struggled with this at ILWG Spring for years.

The two main reasons we store and track med intake, are:

A:  Many cadets show up to encampments with cocktails that would make Elvis uneasy.
(whether our kids these days are over medicated is fodder for an entire separate bulletin board, not just a thread).  Some of these meds are opiates or similar narcotics
which can used abused very easily for "recreational" use.

B: An encampment is the perfect place for a cadet to try and see if he "really needs these yucky meds..." For those of you who know the score on behavioral meds, missing just a few doses can spiral a patient out of control and it can take weeks to
stabilize levels again.

I will grant anyone reading this that we are likely on shaky legal ground no matter how we slice this issue.  Loco Parentis is something they don't talk about on the recruiting brochure.

At least the way we do it now has long-standing precedent, and intervenes immediately f there is an issue.




Title: Re: Cadet Medications
Post by: dws on March 31, 2006, 08:18:39 PM
Sorry for the long post and external links, but this is an important issue.

There are laws in most states that regulate overnight camps (read: encampment, bivouac, etc) with regard to medications and the adminstration thereof. All Activity commanders should be well aware of these laws to 1) ensure the best interests of the cadets and 2) protect the activity director and CAP with regard to litigation in the event of something going wrong. When I was running encampments, we spent a lot of time deciding how to tackle this issue.

Recreational camps in MA are required by law to meet certain standards regarding the administration of participant medications:
http://www.mass.gov/Eeohhs2/docs/dph/environmental/sanitation/camp_medication_guidelines.pdf

About proposed legislation (2003) to allow children at school or camp to carry and self-administer asthma medication in Massachusetts:
http://www.eagletribune.com/news/stories/20030115/NH_010.htm

In 1999, Governor Pataki (New York) signed the Epinephrine Auto-injector Device Law (Chapter 578 of the Laws of 1999), which permits specially trained staff in children’s day and overnight camps to use an epinephrine auto-injector device in life-threatening emergencies:
http://www.health.state.ny.us/nysdoh/camps/epinephrine.htm

In New York, the State Sanitary Code requires the health director, and other key staff (inlcuding camp trip and activity leaders)  to possess valid certification in first aid. standard:
http://www.health.state.ny.us/nysdoh/camps/firstaid.htm

An article (7/2005) in Connecticut that discusses the law. Some quotes are excerpted here
"Children enrolled at youth camps may self administer medications with documented parental and authorized prescriber's permission.  Children may request and receive assistance from staff in opening containers or packages or replacing lids."
 "The written permission of the parent shall be required prior to the administration ..."
 "Prior to the administration of any medication by program staff members, the program staff members who are responsible for administering the medications shall first be trained by a pharmacist, physician, physician assistant, advanced practice registered nurse or registered nurse in the methods of administration of medications and shall receive written approval from the trainer indicating that the trainee has successfully completed a training program as required herein.  "
http://www.dph.state.ct.us/phc/docs/9_Youth_Camps.doc

Finally, here is a link to the parental permission form used in NY. This is tracked in a confidential part of the Encampment Management System used to run encampments.
http://www.burns-computing.com/encampment2006/downloads/permission_to_self_medicate.pdf