Pediatric Injury Prevention: Rescue Camp 2003

If you travel through Virginia on Interstates 81 and 64, you pass through Rockbridge County. Named for its distinctive natural landmark, the Natural Bridge (one of the “Seven Wonders of the Natural World”), Rockbridge County straddles the upper Chesapeake Bay watershed. Located in the Glenwood and Pedlar districts of the George Washington National Forest, several thousand acres of wilderness spread across both sides of the county. Inhabited by a diverse mixture of academics, farmers, factory workers, commuters and horse enthusiasts, the county brings in nearly 100 million tourist dollars annually.

Five volunteer rescue squads serve the population. Like other areas in Virginia and the United States, the decline in volunteer EMS providers has prompted scrutiny of available manpower in an effort to meet the growing public demand for prompt ambulance transportation. Recently, the City of Lexington solicited requests for proposals, seeking a “fee for service” ambulance company to respond to daylight 9-1-1 calls. The volunteer EMS providers in the county did not greet this turn of events with enthusiasm. The leadership of the volunteer squads comprises a committee known as the Rockbridge Emergency Rescue Group (RERG).

In a recent meeting with the mayor, members of the Lexington City Council and Rockbridge County Board of Supervisors, a discussion was hosted on the ramifications of “going paid.” An RERG spokesperson stated that one of the factors contributing to the decline in available volunteers is the failure of rescue squads to cultivate members at a younger age. He recalled childhood visits to the nearby fire station and rescue squad in his community. On summer weekends, you will find carnivals and parades hosted by volunteer squads and departments throughout the county. These fundraising venues provide opportunities for younger citizens to view and climb in, around and on fire engines and ambulances. RERG-sponsored recruitment drives aimed at adults have attempted to bolster volunteer rescue squad membership. The most recent campaign for new volunteers featured a variety of fire and rescue apparatus and free food. Ten citizens completed a survey expressing interest in volunteer rescue squad membership.

After leaving that meeting, those words about the untapped “fountain” of youth in the county kept echoing in my head. One way to introduce elementary and middle school students to fire and EMS is to host a “camp”—a one-day program for children emphasizing injury prevention and safety at school, on the road and at home. Other camps held in nearby counties always attract plenty of schoolchildren. I contacted Petra Menzel, MPH, at Virginia Commonwealth University, who is the director of the Virginia EMS for Children program. She provided several sources of information, including the Central Virginia SAFE KIDS Coalition and the National Fire Protection Association’s Risk Watch program.

Injury Prevention Campaigns

In late 1987, the first national nonprofit organization dedicated to the prevention of childhood injury was launched. The National SAFEKIDS Campaign was co-founded by Dr. Martin Eichelberger and Herta Freely at Children’s National Medical Center, Washington, DC. U.S. Surgeon General C. Everett Koop, MD, chaired the campaign. Major funding was provided from founding sponsor Johnson & Johnson.

One of the goals of the SAFEKIDS Campaign is to stimulate changes in attitudes, behaviors and the environment. The campaign relies heavily on legislation to spur these changes. For example, when SAFEKIDS was founded, only one state had a bicycle helmet law. Today, 19 states and the District of Columbia, as well as many smaller localities, require that helmets be worn by children on bicycles.

As part of the strategy to make the world a safer place for children, the campaign uses a “data-driven” focus. The science of injury prevention forms the basis for this effort. With statistics on injury and mortality from around the country, the campaign models community-based strategies developed from prevention research. In May 2003, to celebrate their 15th year, the National SAFE- KIDS Campaign released a report detailing a 40% reduction in childhood unintentional injury death rates. In spite of this dramatic decline, preventable injuries still rank highest as the leading killer of children under the age of 14.

Other injury prevention programs have developed across the country. The Injury Free Coalition for Kids, a project of the Robert Wood Johnson Foundation, evolved from the Harlem Hospital Injury Prevention Program. Created in 1988 by Barbara Barlow, MD, director of pediatric surgical services at Harlem Hospital in New York City, the HHIPP studied injury data for children in central Harlem. Guidelines for safe play areas, safety education and other safe activities for youth were developed. The initiative was so successful in reducing accident-related emergency room visits by children it was considered a model for other urban centers. Atlanta, Dallas, Chicago, Kansas City, Los Angeles, Philadelphia, Pittsburgh and St. Louis all adopted the program.

In 1996, NHTSA released a Consensus Statement on the Role of EMS in Primary Injury Prevention: “Emergency medical services (EMS) organizations and individual providers must participate in primary injury prevention activities. This participation will benefit patients, communities and the EMS system. Implementation of primary injury prevention activities is an effective way to reduce death, disabilities and healthcare costs. EMS has an obligation to actively participate in primary injury prevention activities.”

Our goal in Rockbridge County was simple: Find a credible program for childhood safety and prevention of injury and invite the participation of school-aged children. The NFPA’s Risk Watch program met all of the criteria.

Designed as a curriculum for kindergarten through eighth grade, Risk Watch is correlated to the Virginia Standards of Learning, as well as school curricula in every state. The program consists of eight “modules”: Fall Prevention, Poisoning Prevention, Choking, Strangulation and Suffocation Prevention, Fire and Burn Prevention, Firearms Injury Prevention, Bike and Pedestrian Safety, Motor Vehicle Safety and Water Safety.

Begun in 1998 under the auspices of the NFPA, Risk Watch is a collaborative effort of the nation’s leading child safety advocates. A Technical Advisory Group, (TAG, the partnership that brought Risk Watch into development) was led by a steering committee of members from the NFPA, Duke University Medical Center, the Home Safety Council, the Consumer Federation of America and the National SAFEKIDS Campaign. Other members of the TAG read like a Who’s Who of injury prevention specialists. The already-mentioned American Academy of Pediatrics, Emergency Medical Services for Children, the Maternal and Child Health Bureau, and the National Highway Traffic Safety Administration all provided input, along with an alliance of 11 other major public interest and safety organizations.

The NFPA collects data for Risk Watch in the form of saves and successes. These incidences, submitted by schoolteachers, document situations where children effectively used learned safety behaviors to protect either themselves or others from potentially dangerous situations.

In 1998, the NFPA commissioned an independent three-year study in six communities. The results show indisputable evidence that Risk Watch really works. The external evaluation firm of Interwest Applied Research collected pre- and post-test scores in Palm Beach County, FL; Portland, OR; Philadelphia, PA; Brockville, ON (Canada); Champaign, IL; and Plano, TX. Confirming the overall efficacy of the program, the final report was released in 2000. Evaluations continue in other communities to collect even more data.

After teaching an EMT-Basic class in Lexington, I approached several of the students to ask for assistance. The response was immediate and enthusiastic. We met as a committee once a week for 12 weeks to design a fun, educational, thought-stimulating and memorable “camp” that would introduce children to safety and injury prevention. We hoped children attending such a camp would one day don turnout gear as firefighters or become emergency medical care providers.

Committee members began canvassing area businesses to seek financial help. Every EMS agency in Rockbridge County expressed interest in supporting the project. A Virginia state trooper agreed to teach the module on Motor Vehicle Safety. The Buena Vista Police Department provided both a bike patrol officer and firearms training officer for the Bike and Pedestrian Safety and Firearms Injury Prevention modules. The Buena Vista fire chief promised to provide a fire engine. The Buena Vista Rescue Squad agreed to supply an ambulance. The Kerr’s Creek Fire Department offered the county’s “Fire Safety House.” The remaining modules were divided among members of all those fire and EMS agencies that had volunteered to help the camp.

We chose the “Double-Decker Pavilion” for the site: a two-story picnic shelter that sits atop a hill in Buena Vista’s Glen Maury Park, offering a panoramic view of the surrounding mountains. We invited the Lifeguard 10 helicopter from Roanoke Memorial Hospital to participate. Lifeguard 10 has a long history of supporting endeavors targeting children. Flight schedule permitting, Lifeguard 10 agreed to visit the camp.

Two weeks before the end of the school year, every third- and fourth-grade student attending Buena Vista’s two elementary schools went home with a simple registration form designed on a computer. Signatures were required from a parent or guardian granting permission for attendance at what had become “Rescue Camp 2003.”

The modules became “stations” to be taught on the upper level of the pavilion. Adhering to the Risk Watch program, outlines were provided to the “teachers” that listed objectives and equipment needs for each station. Colored “team tags” cut from construction paper had a schedule of activities for each team of campers. Each student would choose a colored tag to wear for identification. At each station, colored pencils filled a plastic cup sporting the Natural Bridge Fire Department logo. The pencils were provided for the purpose of completing activity sheets that accompanied each station.

Fortunately, one of the committee members was a Buena Vista fourth-grade teacher. Her input and oversight would provide much-needed assistance in determining what the students and staff would need for the day. Every participant would receive a T-shirt to commemorate the camp. The children would be given other items provided by the Virginia EMS-C program, the Virginia Office of EMS and the Blue Ridge Poison Center. Sparky the Fire Dog activity books, available from the NFPA, would go home with every student. The entire camp would be free of charge.

The response from the community was encouraging. Domino’s Pizza of Buena Vista donated pizzas to feed everyone at the camp. A T-shirt vendor offered shirts at cost, complete with a logo on the front and list of sponsors on the back. Lowe’s Home Improvement Center donated a carbon monoxide detector, and a local hardware store donated a smoke alarm. WalMart donated a bicycle helmet and some additional funding. Stonewall Jackson Hospital in Lexington and other area businesses contributed money as well. In all, the total cost of the camp was less than $500, and donations totaled nearly $400.

The day dawned overcast and hazy but promised lots of sun. At 8:30, the Buena Vista Bike Patrol officer kicked off the camp, showing a video demonstrating the correct use of a bicycle helmet. Each of the remaining seven stations took about 30 minutes to complete. The children toured the Fire Safety House, with demonstrations of a smoke detector and EDITH drills (Exit Drills In The Home). At noon, Lifeguard 10 appeared on the horizon and soon landed 200 feet south of the pavilion. The children spent an hour crowded in and around the helicopter as the crew summarized their mission. After lunch, the Buena Vista fire chief presented a demonstration of the capabilities and equipment on Engine 107. The campers took turns operating the nozzle of a charged 1¾-inch hose line. The cool water proved such a temptation, the children frolicked in the breakover mist from a solid stream as lights flashed and the sound of the air horn echoed from nearby hillsides.

Once the children had reassembled, the Firearms Training Officer gave a presentation on the importance of keeping ammunition and guns safely and separately locked away. Because of Rockbridge County’s rural environment, hunting and fishing are everyday recreational activities. The presentation included information regarding general firearm safety. The officer stressed that any firearm not properly secured in a safe or gun cabinet presents an immediate danger to young children.

Plans are already underway to expand the camp in 2004 to include children in all Rockbridge County schools. The goal is that eventually Risk Watch will be part of the curriculum taught in every school. And though there may be no immediate increase in the current number of volunteers in the county, the future will always present opportunities for combination career/volunteer agencies.

For more information on injury-prevention programs, visit www.safekids.org or www.nfpa.org/riskwatch. The EMS for Children program in your state can provide information, handouts and supplies to help you establish similar camps.

John Blankenship is a former firefighter, paramedic, EMS instructor and Navy veteran who earned his NREMT-P certification in 1997, his CCEMT-P certification in 1998, and BSN degree in 2013. He served as manager of the neonatal/pediatric transport team of the Nightingale flight program at Norfolk General Hospital in Virginia. The author would like to thank Petra Menzel, MPH, director of the Emergency Medical Services for Children program in Virginia, for her guidance and invaluable assistance with this project.

Bibliography

• American Academy of Pediatrics. Section on emergency medicine www.aap.org/sections/pem/.
• Emergency Medical Services for Children (EMSC) National Resource Center. Preventing Childhood Emergencies: A Guide to Developing Effective Injury Prevention Initiatives, Revised Edition, p. 4, 2000. www.emsc.org/injury/frameinjury.htm.
• Injury Free Coalition for Kids. www.injuryfree.org/about.cfm.
• Lexington-Rockbridge County Chamber of Commerce. www.lexrockchamber.com/ChamberAreaInfo/Demographic.html.
• National Academies Press. Emergency Medical Services for Children, 1993. https://books.nap.edu/books/0309048885/html/26.html#pagetop.
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