"First Aid Log - B' oy Scouts of America"

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First Aid
Log
For a council/district activity or event including day camps.
(Resident camps must use No. 33681.)
__________________ ______________
Council name/number:
District: _____________________________
_____________________________________________________________________
Activity/event:
: ________________________________________________________________________
Location
_________________
________________ to
Duration:
____________________
_____________________
Date
Time
Date
Time
Health officers/first-aid providers:
_______________________________
Name:
Scouting position: ____________________________________
Address: __________________________________________________________________________________________
City: ___________________________________ State: __________________________ Zip code: _________________
Telephone: ______________________________ Email: ___________________________________________________
_______________________________
Name:
Scouting position: ____________________________________
Address: __________________________________________________________________________________________
City: ___________________________________ State: __________________________ Zip code: _________________
Telephone: ______________________________
Email: ___________________________________________________
First Aid
Log
For a council/district activity or event including day camps.
(Resident camps must use No. 33681.)
__________________ ______________
Council name/number:
District: _____________________________
_____________________________________________________________________
Activity/event:
: ________________________________________________________________________
Location
_________________
________________ to
Duration:
____________________
_____________________
Date
Time
Date
Time
Health officers/first-aid providers:
_______________________________
Name:
Scouting position: ____________________________________
Address: __________________________________________________________________________________________
City: ___________________________________ State: __________________________ Zip code: _________________
Telephone: ______________________________ Email: ___________________________________________________
_______________________________
Name:
Scouting position: ____________________________________
Address: __________________________________________________________________________________________
City: ___________________________________ State: __________________________ Zip code: _________________
Telephone: ______________________________
Email: ___________________________________________________
FIRST AID LOG
All entries should be made in ink.
Print Name
Time
Unit No./
Complaint / Type of Injury/Activity/Location
(24:00)
Age
and Examination of Findings
Last
First
Date: _______________ to ________________
Activity/event:
Page 2 of 4
Comments
Treatment/Disposition
Treated by
(Activity and Location)
Date: _______________ to ________________
Activity/event:
Page 3 of 4
EMERGENCY TELEPHONE NUMBERS
Fire: ______________________________________________________________
Police or sheriff: ____________________________________________________
Hospital: __________________________________________________________
Rescue squad/ambulance: ____________________________________________
Medical practitioner(s): _______________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Scout executive: ____________________________________________________
Office: ___________________________ Home: _____________________
Cell: ___________________________ Email: ______________________
National Crisis Communication Support
• BSA crisis and communication issues management hotline: 1-855-870-2178
• BSA national office communication specialist: David Burke, 972-580-2280
• BSA public relations email: PR@scouting.org
HOW TO USE THE FIRST AID LOG
• Print the time of day, name of each person seen, a brief summary of injury or complaint of illness, and
pertinent comments. Information should include the nature of the activity engaged in at the time of the injury
or illness and the specific location, such as swimming pool, troop campsite, or dining hall. Each treatment
or disposition must be described and signed by the person rendering aid. Use as many lines as needed
for each entry.
• If a complete page of the First Aid Log is not used on any one day, draw a line through the entire next space
across both pages and enter the next day’s date on the next line. This eliminates the possibility of false entries
at a later date.
• The SOAP formula is recommended for recording in this log.
S—Subjective: what you are told
O—Objective: what you see and measure
A—Assessment: working diagnosis, what you think is the problem
P—Plan: what you did to treat the problem
• IMPORTANT. This record should be kept on file in the council service center, following council retention policies.
Note: All incidents, illnesses, and injuries requiring the intervention of a medical provider beyond basic
Scout-rendered first aid shall be reported via MyBSA. The Incident Information Report, No. 680-016, and
Near Miss Incident Information Report, No. 680-017 (for incidents not resulting in injury or illness, but could
have), are available at www.scouting.org/forms or from Supply Group to aid in your reporting.
680-127WB
2012 Revision
Date: _______________ to ________________
Activity/event:
Page 4 of 4
Page of 4