Wednesday, June 30, 2010

A Youth Activity Ends In Tragedy

Having been involved with youth groups and having been an adult leader on many youth outdoor excursions, I am especially torn about the death of 17-year-old Sophie Barton of Holladay, Utah. (See KSL story.) Barton died on Monday after collapsing while hiking with an LDS Church young women’s group under controlled and well supervised conditions. Barton’s mother was one of the adults hiking with the group.

Barton’s tragic death is no doubt having a stark impact on her family members and friends. The adult leaders that were in charge of the hike must feel terrible. I wish the best for all of these and pray that they will find solace amid their grief.

In the hundreds of youth outdoor adventures I have attended, I have dealt with a variety of medical and first aid issues. Most have been the garden variety injuries that can be expected when engaging in such activities: cuts, abrasions, burns, blisters, hypothermia, sprains, etc. There’s been the occasional illness, such as flu, histamine response, or intestinal distress. More serious injuries, such as broken bones, have been rare. Ditto with serious illnesses, although, these have occurred too. I’ve seen a very few campers end up riding in ambulances and Life Flight helicopters over the years.

I have friends that have dealt with deaths on youth outings. One friend had a seemingly healthy boy die after swimming in a lake at an organized Scout camp. The boy had passed a doctor’s medical exam. A medical doctor that was a few yards away when the boy collapsed on the beach immediately administered treatment, but the boy died anyway. An autopsy revealed a previously undetected rare heart anomaly. It was only by circumstance that the boy died at camp. He might have passed away while sitting at home watching TV.

Another friend had one of his young campers die after being struck by lightning while sleeping in a tent. They figure that lightning struck a nearby tree and traveled through a root that was under the tent. The tree was unaffected. The other boy in the tent was unaffected and was unaware that his companion had been shocked until later in the night.

There is risk involved in any kind of activity. Organizations that sponsor youth groups go to much greater lengths to mitigate unnecessary risks associated with youth activities than at any time in history. We know more about these risks than ever. Medical precautions, training, equipment, and accessibility to qualified professional help have never been better. And yet participants in activities can still be injured, get sick, and even die.

We don’t know for sure why Barton died. KSL reports, “The state medical examiner hopes to have an answer to that within 48 hours.” The Standard Examiner reports that a Sherriff’s deputy “suspected that heat played a role in the death of the girl….” That’s curious, since it wasn’t particularly hot at the time and in the location where Barton collapsed. Perhaps the deputy was referring to heat exhaustion or heat stroke.

Both heat exhaustion and heat stroke begin primarily with dehydration — inadequate fluid intake to replenish the fluids being lost from the body. Naturally, physical exertion and heat — factors inherent in summertime outdoor activities — increase fluid loss. Illness and some medications can contribute to dehydration as well. Simply replacing fluids can remedy mild dehydration, but severe dehydration requires immediate medical treatment.

The layperson may not be able to tell the difference between heat exhaustion and heat stroke. But both conditions require medical attention. Body temperature rises under either condition, but it is generally higher with heat stroke. Body temperature may reach or top 105° with heat stroke because the body’s cooling system has shut down.

Adequate hydration begins well before an activity begins with making sure that all participants start out well hydrated. Activity leaders should carefully consider the condition of those that have (or have recently had) diarrhea, young women that are having periods, and those taking medications such as antihistamines.

Proper planning should ensure that each participant has adequate fluid for the duration of the activity and during the hours afterward. I want to take some of my sons hiking to a nearby mountain peak this summer. I know that there are no water sources past a half mile into the hike, so even my backpacking water filter won’t help. We will have to carry a lot of water. That will add weight to our packs, but it is essential to enjoying a safe hike.

Several years ago, we took a large group of youth to St. George, Utah for several days of activities. We enjoyed hiking slot canyons, games in a city park at night, waterskiing, swimming, and even a service project in 104° heat shoveling silt out of a tennis court that had been damaged by flooding that spring. Throughout the days of the activity, we supplied copious amounts of bottled water. Each adult was assigned to watch several youth during those days to make sure no one got close to dehydration. We had a great time and nobody suffered from inadequate fluids.

Right now nobody knows for sure whether dehydration played a role in Sophie Barton’s untimely death. We don’t even know if her death was preventable. When the medical examiner reveals the cause, perhaps it will serve as a learning experience for those of us that lead, participate in, and help with outdoor activities. Such activities are an important part of life. But everyone involved should enjoy them as safely as is reasonable.


MainTour said...

Did you know that LDS BSA units have a higher casualty rate (deaths, injury, etc) than non-LDS BSA units.

This statistic might also apply to the Young Women programs.

The main factor is commonly believed to be leader training.

Traditional BSA units now require all the scouts to get a physical before they can join in any physical activity.

Scott Hinrichs said...

In fact, I treated that very subject in this June 2009 post.