277
Camp Health Services
Table 2. Camp physicians
Family
practice
Pediatrics
Emergency
medicine
Internal
medicine
Other
Don't
Know
Reviews health policy
(N
129)
n
%
(95% CI)
89
69
(61%77%)
13
10
(5%15%)
11
8
(4%13%)
5
4
(1%7%)
2
2
(0%4%)
9
7
(3%11%)
Is ``our camp doctor''
(N
106)
n
%
(95% CI)
77
73
(64%81%)
16
15
(8%22%)
6
6
(1%10%)
4
4
(0%7%)
1
1
(0%3%)
2
2
(0%4%)
Table 3. Ambulance response times and transport times to the hospital
5 min
510
min
1015 min
1520
min
20 min
Don't know
Response time to camp
(N
129)
n
%
(95% CI)
14
11
(5%16%)
50
39
(30%47%)
33
25
(18%33%)
13
11
(5%16%)
5
4
(1%7%)
13
10
(5%15%)
Time from camp to hospital
(N
129)
n
%
(95% CI)
7
5
(2%9%)
24
19
(12%25%)
40
31
(23%39%)
29
23
(15%30%)
22
17
(11%24%)
7
5
(2%9%)
Forty-five percent of the CHOs were registered nurses,
and 6% were physicians.
Larger camps had more highly trained providers. The
mean size of camps with a CHO who had LPN training
or greater was 197 (SD: 229), while the mean size of
camps with a CHO with paramedic training or less was
134 (SD: 103) (t(95)
1.99, P
.05).
CHO SUPPORT
Nearly all (97%) of the CHOs stated that a physician
had reviewed their standing orders for that year (Table
1). However, only three fourths (76%) stated that they
had an established relationship with a camp physician.
Family physicians were most likely to have reviewed the
standing orders and to have agreed to be the camp phy-
sician (Table 2). Of concern, 7% of the CHOs did not
know who reviewed their health service policy, and 2%
did not know who their camp physician was.
Ambulance response times and transport times to the
hospital are presented in Table 3. Overall, 40% (95% CI,
32%49%) of the CHOs reported ambulance response
times of more than 10 minutes. When they called 911,
the CHOs stated that a full-time ambulance crew would
respond half of the time. However, half of the time they
did not know what type of training the arriving crew
would have (Table 1). Once the ambulance crew had
arrived at camp, the transport time to the hospital was
more than 10 minutes 71% of the time (Table 3).
The CHOs were asked to report the name of the pri-
mary receiving hospital for a transported camper. By us-
ing a self-identification system provided by the state of
Michigan,
10
hospitals were divided into those that cate-
gorized themselves as small and rural and those that did
not. The CHOs reported that their campers were trans-
ported to a small or rural hospital more than two thirds
of the time (Table 1).
While it was expected by the state that camps would
provide care through a primary care physician, the
CHOs were much more likely to use an acute care fa-
cility than a primary care office when care was provided
off-site. On average, 41% of that care was provided by
an emergency department and 31% by an urgent care
facility. A physician's office was used only 28% of the
time. Overall, 75% of the CHOs reported taking sick or
injured campers to an acute care facility (emergency de-
partment or urgent care), more than half the time when
they could not be treated in camp.
CHO COMFORT
Using a Likert scale format, the CHOs were asked to
assess their level of comfort with their own skills and
