Every year millions of children across the United States visit the outdoors with youth groups. It might be the Boy or Girl Scouts, a church, the YMCA, Adventure Quest, Civil Air Patrol, Boys and Girls Club, a school or college, or any other number of groups across America. Sadly every year thousands of children are injured and dozens are killed. Some of the injuries and deaths are tragic accidents, a bee sting that turns into anaphylactic shock, a boulder shifting unexpectedly pinning a teen, or an unexpected lightning strike. However many of these injuries and deaths could be avoided.
Because children's bodies are still developing, and healthy children lack a lot of body fat, they are far more susceptible to several different outdoor related injuries than their adult leaders. Hypothermia, frostbite, dehydration, heat related injuries, and altitude sickness are all points of risk.
Hypothermia is caused when the body can no longer maintain a normal temperature. Just a 1.6 degree change in temperature can have adverse effects, and a 3.6 degree change in temperature to 95 degrees can be immobilizing. Preventing hypothermia is a parental responsibility. If your child is going on an outdoor adventure, be sure they are adequately clothed and they are wearing layers. Hypothermia can happen even on a summer day, and wind and moisture can increase the effect. One of the best ways to help maintain body heat is to wear a hat, and be sure your child understands to wear it. Identifying hypothermia and taking proper action as early as possible is the responsibility of the group leaders. People who suffer from hypothermia typically deny they have a problem, and can even be combative. Hypothermia is not a sign of physical weakness; it is a serious medical emergency that needs to be treated.
Frostbite is caused when the fluid inside the cells of body tissue freeze. As the fluid freezes it expands, rupturing the cells. Frostbite typically starts on the extremities, the nose, earlobes, toes, fingers, cheeks, and moves toward the core of the body. Frostbite typically has a cascading effect. As a part of the body becomes chilled blood flow is restricted in an attempt to save heat and prevent hypothermia, which lowers the temperature further increasing the problem. Frostbite prevention is also the parent's responsibility. Once again making sure your child has the proper clothing is key. Exposed flesh equals frostbite on a cold windy day, so gloves, a hat, and in more extreme environments scarves, ski masks, and even ski goggles to protect the eyes may be needed. Children should be briefed on the symptoms of frostbite, and group leaders should also know how to identify and treat it.
Dehydration is probably the most senseless of injuries that can happen to a child. Proper hydration out in the field is the responsibility of the leaders. When your child goes out for an adventure make sure they will have an adequate water supply. Buying a couple bottles of Avian at the convenience store may save you some time, but it is doing your child a great disservice. Take the time and spend a few dollars on some proper water bottles. One quart water bottles can be found at stores like Wal Mart or Target for as little as two dollars. If your child is hiking or backpacking, seriously consider investing $15 to $25 in a two-liter hydration system. A good rule of thumb is one gallon of water per day, or one quart of water for every two hours, more if you are in extreme hot, cold, dry, or at high altitude. If it is a struggle to get your child to drink water, invest in some powered sports drink mix. Soft drinks, especially caffeinated ones should be avoided.
Heat related injuries are the opposite of hypothermia. Instead of the body not being able to stay warm, the body can no longer stay cool and overheats. Heat exhaustion is a serious problem, and heat stroke is a very serious medical emergency that can cripple or even kill in minutes. Just like hypothermia denial is one of the symptoms so it is up to the leaders to watch for these medical emergencies. Many children who die from heat related injuries were simply pushed too hard, the early symptoms of nausea, dizziness and feeling weak can be ignored as an excuse to want to stop and take a rest. Just like hypothermia, heat related injuries are not a sign of weakness; they are serious, life threatening emergencies.
Altitude sickness also affects children more than adults. Sudden changes in altitude over a very short period of time can bring on life threatening emergencies. Fortunately the most serious condition, HACE or High Altitude Cerebral Edema doesn't typically occur below 18,000 feet, but can. Children need to be watched for AMS, Acute Mountain Sickness, and in elevations over 12,000 feet, HAPE, or High Altitude Pulmonary Edema. It is up to the leaders to watch for these conditions. Once you get over 7,000 feet, elevation change should be limited to 1,000 feet per day, with jaunts of 2,000 to 3,000 feet in change acceptable as long as you return to your starting altitude. Bigger changes than this can bring on illness.