Scoutmaster

Laceration Repair in the Wilderness

By Jeremy Joslin, M.D. from Medicine for the Outdoors

It always happens by accident. You're using your new, lightweight pack saw to collect downed wood for an evening fire when the saw slips and slices into the back of your left thumb. Blood flows immediately, and you feel a rush of pain up your hand. You're four days' hike from civilization and the cut looks like it needs stitches.

Let the first aid begin. You apply pressure and the bleeding stops. After irrigating the wound with clean water, you reach into your pack to find your sewing kit and sutures. But should you really be stitching up this cut?

The answer doesn't necessarily hinge solely on your training. I've discussed this subject with emergency physicians who repair lacerations daily, as well as with first responders who learned from their grandmothers that if they could sew cloth, they could sew skin. My personal opinion is that people should take great pause before sewing a laceration outside of a medical exam room. In my mind, the decision about whether or not to sew a wound in the field is related to the issue of "wound appropriateness."

Wound appropriateness takes both wound size and cleanliness into account. A small wound that remains contaminated with dirt and debris shouldn't be closed because the closure would trap all the necessary ingredients for an infection. On the other hand, a small wound that's fairly clean probably doesn't need stitches anyway - perhaps not even in the Emergency Department! An article (1) reviewed this particular topic and came to the conclusion that uncomplicated lacerations less than 2 cm (just under an inch) didn't heal better or ultimately appear better when sutured (stitched) compared to when they were left unsutured. A small, debris-filled wound should be cleaned with water that is disinfected enough to drink, and then left open to heal or closed (e.g., skin edges brought together) with an adhesive bandage (strips).

My preferred technique for caring for small wounds is to clean them thoroughly, then use skin (tissue) glue to make the initial closure, after which I cover the entire wound with a piece of gauze and duct tape or with Tegaderm (a thin, clear, plastic adhesive covering) for protection. Some people have used "super glue" to close wounds, but this is not recommended for several reasons. Any laceration can be sutured by a physician in a delayed fashion upon your return, if such a repair is necessary for cosmetic or other reasons.

Any large wound needs to be examined with three things in mind:

How contaminated is the wound?
How much will the wound bleed?
Are there any other structures involved?

Every large wound will have different answers to these questions, which is where clinical acumen comes into play. Always prioritize control of blood loss, and consider closing the wound(s) loosely with stitches if this is the only way to staunch the bleeding. If the wound is deep, there may be damage to structures beneath the skin, such as tendons, ligaments, and/or nerves, any of which may require formal wound care not possible in the outdoors. Therefore, consider evacuation for all large wounds. While evacuating, the wound should be covered and compressed with a clean bandage.
 

The Boy Scouts need to wise up, or they'll lose out

Eric Eckstein is assistant Scoutmaster. He posted this opinion at philly.com

I have been associated with the Boy Scouts since I was a Cub Scout in the Northeast during the early '70s.

I served on the staff at Treasure Island and am a member of the Scouting Order of the Arrow. My son is an assistant senior patrol leader and I am an assistant scoutmaster in his troop. I proudly refer to myself as a Scout and am honored by the associations I have had with fellow Scouts.

I disagree with State Sen. Gib Armstrong (R, Lancaster) who wrote in The Inquirer on Monday that Philadelphia should forget its anti-discrimination policy and support the Scouts, despite a stance against homosexuals. Boy Scouts of America discriminates.

There are no two ways about it. If you are a homosexual, you're out. No offense - a Scout is kind - but please leave. Scouting is classified as a nonprofit religious organization. It is a convenient legal category that allows a group to determine who its members can be and who they cannot be, without oversight or legal action by the government. This is very much a part of the freedoms we as Americans have in our country, and should not change.

While I love Scouting, the Boy Scouts organization has two serious flaws: its stance on sexuality and its stance on religion. It hides those flaws behind a disguise of morality. If you're gay or agnostic, you are simply not moral enough to be a Scout.

I and many others have chosen to engage the Scouts and work within the system to bring about change. It is a slow process.

I have had several conversations with the local Cradle of Liberty Council leaders and numerous ones with parents and other concerned adults. But they are all powerless individually to make changes to an organization that is ruled from national headquarters in Texas.

(This week the Boy Scouts sued the City of Philadelphia, alleging that constitutional rights had been trampled by the city's effort to force the Scouts to vacate their Beaux Arts headquarters on city land because of the organization's policies prohibiting homosexuals and atheists. The city set a deadline of May 31 for the Scouts to change policies or begin paying market-rate rent of about $200,000 a year.)

When I first heard of the lawsuit, my question to the Boy Scouts was: "What will you do when you lose?" They did not have any answer. Perhaps they hadn't considered a possible loss in the case. The result of a loss in this case could be good for Scouting, though.

The only way to gain attention with the National Council and its discriminatory policies - legal as they are - is to cease having public dollars support this organization. And we can try to inspire those within the Scouts - most of whom do not really understand the discriminatory rules of the group - to stand up and speak out on the policies. This is why the United Way of Southeastern Pennsylvania does not support the Cradle of Liberty Council, but does support its Inner City Program, with different rules.

The United Kingdom has the oldest Scouting group in the world and that group doesn't discriminate against homosexuals. How ironic.

Many say that Scouting is under attack. That could not be further from the truth. Scouting is a wonderful group, full of amazing people almost all of whom donate their time, skill and love so that young boys can learn to grow to be good, moral leaders in society.

All that is being asked of it is to be trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean and reverent, regardless of the race, creed, sexuality or religious preference of its members and of society as a whole.

A Prespective on 'Difficult' Scouts

I have had my share of 'difficult' Scouts. Behavior, attitude and physical barriers are not all that uncommon. Scout aged boys may have any number of difficulties that call for understanding, tolerant and compassionate leadership.

Scoutmasters must educate themselves to meet the challenge of working with boys who are challenged in one way or another. We must especially guard against the isolating and excluding tendencies that are almost always a reaction from 'normal' boys and adults.

I recommend reading this entry at Amanda's Ballsatexistenz blog. Amanda writes from the perspective of one who was excluded and bullied. Her writing opens a world to us that we should understand;

I have read in the past about schools... where children work together to solve problems, and where the kids who learn faster in any particular area, instead of being separated out and told they’re special and above everyone else, end up being taught to use their talents to cooperate with the other children. “Winning” or “getting ahead” isn’t the goal there — and all the children tend to learn more than they do in the more cut-throat style of schools. If schools have to exist that sounds like a much better set of principles to run them on.

Children aren’t born knowing how to behave towards other children.  None of them are, autistic or non-autistic.  They have to learn that everyone’s dependent on everyone else, that people aren’t better than others just by being better at something, and that tendencies to do bad things to other people are things we all have to fight, not give in to, if we want society to be remotely just to anyone.

Scouting is not competitive, not exclusive, not elitist. At its best Scouting is a safe haven for learning to live and work with just about anyone andbenefit from the experience.

Fixing Your Feet - Immersion Foot

Hikers, runners, athletes, backpackers and Scouts all know that one must take care of their feet. Scouts are young enough to bounce back from blisters, strains and twists quickly but not the old Scoutmaster.

It is worth knowing how to maintain healthy feet. Perhaps it is a sign of my ever advancing age (I'm fine with getting older, it is better than the alternative) that I have greater concern for sore feet. Folks generally agree that Fixing Your Feet is the best general reference on the subject.

Your feet uphold you. They're easy to abuse, hard to repair. This book is considered the authority on maintaining feet by those who most depend on them: athletes, dancers, soldiers, runners and hikers. Keep 'em happy with the great advice and proven remedies in this portable foot hospital. No other source is as reliable and complete, or more recommended by pros.
Kevin Kelly at Cool Tools

Fix Your Feet available at Amazon

Tod Schimelpfenig at the OutdoorEd.com blog published an informative  article about Immersion Foot:

In immersion foot, like frostbite, blood vessels constrict in response to cold and damp.  In this case it’s cold enough to impair circulation, but not to freeze tissue. Cells are deprived of oxygen and nutrients.  Nerves are especially sensitive, which accounts for the numbness, pins and needles sensations, itching and pain that often announce the injury.

In the field it’s common to see cool pale extremities, numbness or tingling, itching and mild swelling.  It’s less common to see the textbook appearance of cold, swollen, numb, cyanotic and mottled skin, or the warm, swollen, red and painful skin that surprises the camper after they take their first warm shower.

There isn’t much we can do to treat this in the field.  We need to recognize it, keep the foot dry and warm and go see the doctor.  The pain can be awful and difficult to manage with medications.  Severe cases result in tissue loss.  Moderate cases can be painful and sensitive for weeks, months and even years.

Also known as 'trench foot' this condition was all too common during the first and second world wars. Schimelpfenig explains the dangers, diagnosis and prevention of a common wilderness problem.

Goodbye Oscar de la Renta Hello Supplex

Scouts haven't had a functional outdoor uniform since fashion designer Oscar de la Renta redesigned the Scout uniform in 1980. Perfectly suited to meetings and ceremonies the de la Renta design was next to useless in the out of doors.

Much more suitable for camping Switchback pants were released last year. A shirt was sure to follow and recently it was announced that a new Supplex nylon shirt will be available in August.
Dubbed the 'Centennial Uniform' there are a few other changes. Red shoulder loops will be exchanged for green, troop numerals will be forest green and khaki, no more red topped socks and an updated baseball-style hat.

I am a big fan of Supplex clothing; it is cool, dries quickly and wears well. The new shirt has bellows pockets (one on the right sleeve) and Swiss loops to retain rolled-up long sleeves. I am a little skeptical about the  pocket on the sleeve, but we shall see what we shall see.
By September, if all goes to plan, we will have a less red, more utilitarian uniform that I will be able to wear camping.

The new uniform scheme also offers 'cotton rich canvas' switchbacks and 'cotton rich poplin' shirts. Find out more at the 2008 Scout Uniform page at Scoutstuff.org

One more thing; before anyone tells you different any element of the Scout uniform that was once an official part of the uniform remains so in perpetuity. If you want to wear your old Scout hat from 1952, your shirt from 1987 and a new pair of switchbacks go right ahead. If someone insists that you must wear the latest iteration of the uniform ask them to show you the 'official policy' in writing.

Memorial Day 2008

We will be reminded many times today that Memorial Day is not about picnics, ballgames and the first day of summer.

But it really is.

Picnics, little league, trips to the beach or lake will all happen in a country where most of us are free to breathe and can persue happiness with little fear of our fellow human beings, our government or our neighbors. These heady freedoms are protected, to a large extent, by those who serve or have served in the military.

Scouts and other good people will be placing flags on the graves of the modest men who gave a measure of their lives to secure our lives and families. Ceremonies, parades and celebrations will bring their sacrifice to our memories. If the soldiers, sailors, airmen and marines who have gone on before us can look in on our picnics, cheer a home run or feel a bit of ocean wind on their faces perhaps they will know they succeeded in their mission.

The Rules

From an (anonymous) list of Troop Rules posted on the web:

Troop Chairs chairs are a privilege, not a right. Bringing chairs to a campout will be decided at the discretion of the Scoutmaster. Abuse of this privilege results in forfeiture of a camp chair. Camp chairs are defined as a bag chair, or folding chair. Not a lounge chair with foot rests, recliner, or rocking chair.

I would be curious to know what set of circumstances precipitated this particular 'rule'. Perhaps the Scoutmaster didn't have a rocking lounge chair with foot rests and just couldn't conscience that others did?

When I came across this I had to smile wryly to myself and recall that I once thought that most of my problems could be solved by writing rules or developing forms and procedures.

Most of the problems turned out to be what I call 'the price of doing business'. Scouts are boys, and as Plato said: "Of all the animals, the boy is the most unmanageable."

Rules require enforcement, and enforcement is an unpleasant and un-soutmasterlike task. The Scout oath and law are as close as I would like to come to rules - if everyone strives to achieve those ideals we need nothing else. Except perhaps a rocking lounge camp chair with footrests.

Identifying Trees

If, when in the forest, we know the names of the trees we are more at home.

My well-worn Golden Guide to Trees is a reliable source of information for tree identification. I have a couple of other guides but reach for the Golden Guide first because I find it easier to identify things from illustrations rather than photographs.

The guide features over 730 species of trees grouped in 76 families. Each species description includes characteristics-tree shape, bark, leaf, flower, fruit and twig-for quick identification. As with any guide one must learn how to use it properly. Become familiar with the family descriptions and nomenclature featured in the front of the book and you will be a tree expert in no time.

The Golden Guides have been around for decades and remain popular for their clarity, simplicity and utility.
Available at  Amazon

Getting Parents Excited About Scouting

Scouting Magazine's Front Line Stuff asks the question:

Some parents aren’t as eager to participate in Scouting as others. As a result, their Cub Scout or Boy Scout sons don’t attend as many events as the children of active parents. How do you create excitement about Scouting among your Scouts’ parents?

I am not sure if this is a resolvable situation, or if it should be. One of the key features of Scouting is that Scouts and their families are able to participate at a level that works for them. We leaders may feel like they are 'missing out' but they may be doing all they can, or want, to do.

It seems to me that sports teams, schools and churches are constantly expanding their expectations for attendance and participation; sometimes with little consideration for the other activities in any given community.

We may also, with the best of intentions, be making parental participation more difficult than it needs to be. There are a few things that will encourage attendance and participation from parents;

- Respect their time and commitments. Meetings must begin and end on time and when parents are asked to participate in them be sure that their participation is relevant, engaging and important.

- Be specific and focused when requesting participation. It is much more likely that parents will volunteer for tasks than positions. Tasks have a beginning, middle and end - positions are open ended.

- Be considerate of siblings. If a parent's participation is dependent on bringing other children along see that there is something to engage them. A few crayons and coloring books may be all that is needed.

- Plan and present ceremonies that are brief and meaningful rather than overly long and elaborate.

- To my lights no Pack meeting should last longer than 1 hour, 45 minutes is better. With younger siblings, parents and Cub Scouts in attendance less is almost always more.

Creating Functional Boy Scout Patrols

Scouting Magazine's Front Line Stuff asks the question:

Our troop's patrols are organized by age and don't function well. We  basically have two patrols: the "chaos" patrol of 11- and 12-year old  boys and the "I'm too cool" patrol of older Scouts. How can we create  functional patrols where the older Scouts teach the younger ones?

A.S.
Louisville, Ky

Encouraging older and younger Scouts to interact with each other is simple when we observe the methods and aims of Scouting. Examine the 'chaos' Patrol carefully - what appears to be chaos to an adult may be a highly functioning patrol of 11 and 12 year-olds.

Since the Patrol method is THE method let's examine how A.S. could apply it to resolve the situation. If there is instruction going on ad it isn't coming from the older Scouts where is it coming from?

Assure that responsibility for the Patrols and skill development where it belongs - in the hands of youth leadership. Put a moratorium on all adult instruction (except in mentoring leadership) and reduce adult oversight of the patrols to a minimum. The troop may have to step back and do some youth and/or adult leader training to accomplish this.

A.S.'s fellow adult leaders probably have the common concerns we all have had in taking the plunge with such advice. But when we step back the Scouts step up.

Once there is a clear understanding of leadership roles start asking lots of questions of the Youth leadership:

• What are your goals for Troop and Patrol advancement, activities and involvement in the next several weeks or months?
• Does our current Patrol structure lend itself to reaching these goals? (i.e. does having all the younger Scouts in the same Patrol make sense?)
• What do you plan to change about your Troop so to achieve the goals you have set for yourselves?

The Scouts will surprise you. They will work hard once given the latitude to do so. The short answer to any problem or dysfunction within a Scout Troop is asking the leadership (specifically the youth leadership) if they see it as a problem and then guiding them to discover a solution