Abstract
To the Editor:
Summer vacations represent important opportunities for recreation and travel of young people from schools and universities. These students may be involved in many different activities, organized and not. A common source of recreation for such students is participation in summer camps, in the city or outside it. In either case, these activities can result in acute medical problems and exacerbation of pre-existing chronic medical conditions.1,2 Here we describe the experience related to the medical needs of students during urban summer camp activities held in Caracas, Venezuela, during school vacation in 2008.
A summer camp organization prepared daily activities for 2 groups of school children during 2 separate weeks and lasting 5 days each during August and September. Different logistical elements were taken in account in planning these activities, including medical care. Resources included 1 medical doctor per group and 1 paramedic per subgroup of 100 children. In the first group of campers, 500 children participated (cared for by 1 medical doctor, 5 paramedics, and 1 trained ambulance driver). In the second group of campers, 300 children participated (cared for by 1 medical doctor, 5 paramedics, and 1 trained ambulance driver). One dedicated ambulance was always with each group during all activities. Children and organizers were transported between the activity locations in comfortable, air-conditioned, 2-level buses. Activities took place in different locations and facilities of the city, including cinemas and theaters, zoo parks, country clubs with swimming pools, beach clubs, and public and private parks (both groups visited the same places during different weeks). We reviewed, and here describe, the medical issues that arose with students, and which were treated and recorded by the medical staff.
In total, 800 children were included in this analysis: 58% girls and 42% boys (P <.05) (no significant differences of sex distribution between camper groups, P >.05). All were school-age children with a mean age of 7.2 ± 1.7 years (±SD) (no significant differences between groups, P >.05). From the total, 83 (10.4%) suffered some medical condition during the summer camp (a mean of 8 children per day, 10.38 adverse events per 1000 camper-days), with no significant differences between the first group (10.0%, 7 children per day) and the second group (11.0%, 11 children per day) (P >.05). There were no significant differences in incidence according to sex (P <.05). Ten children were known with asthma requiring treatment with inhalers, and 1 child was an insulin-requiring diabetic trained on capillary glycemia monitoring and self-administration of the drug; however, none of them required medical attention. No children required transportation to any medical center—all were managed on-site by the organization medical staff.
The most common medical problems during the camp were headache (24.1%, a mean rate of 2.5 cases per 1000 camper-days), fever (9.6%, 1 case per 1000 camper-days), abrasions (9.6%, 1 case per 1000 camper-days) and vomiting (9.6%, 1 case per 1000 camper-days) (Table). Abrasions were most frequent in lower limbs (5/8), as were lacerations (4/5). All abrasions were very superficial and small (<5 cm diameter), as were the lacerations (<1 cm long). Abrasions and lacerations were cleansed with antiseptic solution and dressed. All cases of headache and fever were treated with acetaminophen. For vomiting, metoclopramide (10 mg/kg) was administered up to 2 times, spaced 4 hours apart, and accompanied with ad libitum oral rehydration.
Medical conditions presented by children during summer camps activities
Comparing the crude rate of events, ours was higher than in a previous report in a large study in the United States 3 ; however, no previous similar studies have been reported from any country in Latin America. In the US study, results from a convenience sample of summer camps yielded a total of 177 camper illnesses and injuries occurring during 122 379 camper-days, with a median rate of 1.15 events per 1000 camper-days. 3 In our study, this figure was 9 times higher (10.38). Similar to our study, abrasions were the most common diagnosis (10.7%, 3 9.6% in our series).
Although medical issues arising in summer camps have been studied for some time, 4 surveillance is constantly necessary, especially in countries and regions where no previous reports have been published, such as Venezuela and other Latin American countries. Children at summer camp are at risk of injury and illness. 5 In the United States, the American Academy of Pediatrics and the American Camping Association have specific guidelines for the medical care of children in summer residential camps.6,7 Potential common camp medical problems can be avoided by simple medical preventive care. As we have seen in our study, recreational injury and associated conditions are common in school-aged children attending summer camps in Caracas, Venezuela. Education and prevention should be increased to reduce the rate of these events. Finally, as we did, careful recording and tracking of health incidents over time can reveal which campers and camper groups are at greatest risk for injuries and illnesses during participation. 8