Cardiac Events

Millions of Scouts and adult leaders venture out into the wilderness annually. This outdoor classroom is full of risks and requires preparation including planning, physical conditioning, and a pre-participation conversation with your health-care provider. The Annual Health and Medical Record (AHMR) is a tool to help you identify cardiac and other health risks. Having an adult leader review all AHMRs prior to events should also be a key component of your plan.

As you review these actual cardiac-related incidents, keep in mind that some may have been preventable. Knowing the capabilities and medical issues of all participants is critical to having a great experience.

Incident Review #1

A 38-year-old male Webelos parent suffered a fatal heart attack during an overnight backpacking trip with his son’s Webelos den approximately 1 mile into the hike. This parent had been denied participation in a similar hiking activity one year earlier due to poor physical condition and a BMI greater than 40. The parent did not have a pre-participation physical (AHMR part C).

Key Points

  • The trip was described as a “family trip” because the unit knew that overnight treks are not part of the Webelos program.
  • The Cub Scouting program does not include highadventure activities or treks because of youth-related physical limitations and maturity levels.
  • Health risks, as presented in this incident, are often identified during pre-participation physical exams performed by a health-care professional. The Cub Scouting program does not require pre-participation physical exams except for those attending resident camp but does recommend them for all participants.

“Poor health and/or lack of awareness of risk factors have led to disabling injuries, illnesses, and even fatalities.”

Incident Review #2

A 52-year-old registered male leader collapsed during a Venturing crew hike in a remote mountainous area. CPR was administered immediately by an adult leader and youth member for approximately an hour and a half. Two youth members went back down the trail to find help. Despite receiving CPR, the leader did not survive. It took paramedics two hours to reach the victim due to the remote area.

Key Points

  • Although medical issues can occur during any event with any participant, potential concerns should be identified and discussed with the individual before beginning a trek.
  • Those with the greatest risk for cardiac events are typically the adult leaders. Having youth be prepared by providing training for first aid, wilderness first aid, and CPR is encouraged.
  • Wilderness first aid is recommended for high-adventure treks that take participants into the backcountry. It is appropriate for all adults and youth age 14 and older to be trained in wilderness first aid. Assessing and providing care for injuries and illnesses at the onset, especially in the wilderness, allow for the greatest chance of recovery

“Perhaps the most critical test of your preparedness will be in time of emergency. This is true whether going on a day hike, participating in an overnight or longer troop campout, or engaging in any other activity”

Incident Review #3

During a council camporee, a 67-year-old male pack committee member reported feeling lightheaded after completing a swimming test. He also developed chest pain and shortness of breath but was able to make it back to shore and then to his tent. Later, adult pack members stopped to check on him at his tent and found him to have continued chest pain and difficulty breathing. The camp first-aid officer was summoned and found the victim unresponsive, not breathing, and without a pulse. CPR was begun immediately and emergency responders were called. They were unsuccessful in reviving the victim.

Key Points

  • This leader had stated that he was having symptoms indicating a serious medical problem, and he separated himself from others who could have either provided care or notified the first-aid officer of the problem sooner. Frequently, many people deny they are having a serious cardiac event and refuse help initially.
  • Courses in first aid and CPR train responders to identify a serious illness and provide help early.
  • Medical emergencies can occur anywhere and at any time. Whether it’s a high-adventure trek or a large council event, the key to a successful and safe event is being trained and prepared.

“… the Boy Scouts of America has produced and required use of standardized annual health and medical information since at least the 1930s …”

Discussion Questions

  • Does the camp you are attending have a risk advisory?
  • What types of risks could occur if a unit doesn’t collect an AHMR from each participant?
  • What information in the AMHR could be relevant to potential cardiac issues?
  • Who should review and collect the AHMRs for a unit?
  • How are AHMRs handled in your unit?
  • When should the AHMR be completed?
  • CPR/AED/first-aid training is important, but when is the training mandatory?
  • Based on a review of your unit’s AHMRs, have you identified any potential cardiac issues?

Resources

Annual Health and Medical Record

Council High Adventure Risk Advisory template

CPR course information for Scouts:

Campout safety checklist

Event safety checklist

Scouts BSA Handbook

 

Scouting youth are trained in first aid as they advance in rank and earn the First Aid, Emergency Preparedness, and Wilderness Survival merit badges.