Letter from the Alaska Crossings Medical Director, Lynn Prysunka
Dear Parent or Guardian,
Your child is soon to embark on an exciting adventure with AICS Alaska Crossings. This program will challenge them both emotionally and physically. As the medical director for Alaska Crossings, I wish for your child to be as physically healthy as possible during the program so that they may get the most out of this experience.
Thank you for taking the time to fill out the medical intake form. It is very important for me to know about any specific medical challenges your child has faced or perhaps continues to deal with. After reviewing this information, we occasionally make recommendations for further medical evaluation to ensure your child’s medical safety before they participate in the program.
When your child arrives in Wrangell they will be seen by me or one of my colleagues at our Primary Care Clinic for a physical exam. With help from the information you have provided, I will be able to address any medical concerns before they head out on their program. If they are found to have an infection or injury that can be treated, you will be informed and we will start treatment.
Alaska Crossings is a behavioral based program. Some of our participants have been prescribed medication to help them cope with behavioral or psychological challenges. You and your child’s regular doctors are the best judges of the medications and dosages that best help your child. During the program we do not adjust long-term medications that your child has been prescribed before arriving, unless there is a clear adverse medical reaction. We do not start children on medications to deal with mental health issues. We feel again that this is best done with your regular doctor.
If medical problems arise during the program, they are discussed with the Medical Control Officer in town and appropriate action is taken. Participants who have illnesses or injuries that cannot be managed in the field will be brought into Wrangell and treated in the clinic or through the emergency department of the Wrangell Medical Center. You will be contacted if this occurs.
If you have any questions about how medical issues are managed in the Alaska Crossings organization, please make us aware so we can respond to your concerns.
Dr. Lynn Prysunka, MD, CCFP
Alaska Crossings Wilderness Program
Medical History Disclosure by Parents/Guardians
Parents/Guardians are responsible for accurately completing the medical history portion of the intake packet. If the history reveals conditions that might pose a risk to your child, other participants or staff in our program, our Medical Director will review the information and make a recommendation as to admission and conditions for participation.
Prescription and Over the Counter Medication policy
When a participant is taking medications we adhere to the following guidelines:
- Prescription Medication
• Prescription medication must be prescribed by a physician.
• Prescription medication must be prescribed to the participant.
• Medication must not be expired.
• Medications prescribed for one participant shall not be used by another participant.
• Participants will self-administer their medications. However, Alaska Crossings staff will retain physical possession of the medication supply and administration directions. Alaska Crossings staff will supervise the taking of medications.
• Prescription medications are kept in a locked container when possible.
• It is not possible to refrigerate medications. Participants taking refrigerated medications must find a medically acceptable substitute that does not require refrigeration.
- Individual records will be kept for any medications taken by participants. This information includes the prescribing physician’s name, the description of the medication and dosage, method of administration, verification in writing by the staff and the participant that the medication was taken and times and dates the medication was administered.
- In the event of a missed medication or medication administration error Alaska Crossings staff are required to notify the Medical Control Officer as soon as possible for further direction.
- At the end of each program, staff will return all medications to the Parents /Guardians. Staff will count the medication, tally the records of use during the program and make sure all the medication is accounted for. Parents/Guardians will be informed of the count prior to the participant returning home. Parents should count the medications once the participant returns to ensure that all medications are accounted for.
- Participants are encouraged to fully inform staff of any medical problems or concerns they may be experiencing. Staff report and record all medical issues. Our program always assumes that a concern is medical until proven otherwise. All staff carry trauma medical kits. The head guides carry advanced diagnostic equipment including a stethoscope, blood pressure cuff, and thermometers. In the event of a concern staff take vitals and complete a medical assessment. Field staff have access to outside medical consultation 24 hours a day. This includes telemedicine where digital photos can be sent via the satellite telephone for review.
- Some prescription medications can cause issues with heat regulation. If your child is on one of these medications they will be placed on a Hyperthermia Watch. Hyperthermia Watches are conducted when the temperature is 80° F or higher. At this point staff are required to take your child’s temperature three times a day and in case of overheating, take immediate action to lower their body temperature.
Informed consent for medical treatment
Participants and their families will be informed about the nature of any medical care, procedures and treatment that they receive.
Confidentiality and Clinical Records
By law, information regarding the identity, clinical records and status of all participants is protected under the Health Insurance Portability& Accountability Act (HIPAA). Protected health information is not and cannot be disclosed by any staff member to any persons other than those who we have, on file, written authorization to disclose or receive this information.
We comply with federal and state law which recognize the following exceptions:
- Information regarding imminent danger to self or others, criminal activity involving program or program personnel, or medical emergency.
- Information regarding suspected child abuse.
- Information about communicable diseases, which have significant public health implications, including HIV/AIDS, is reported to the Wrangell Public Health Department.
- Disclosure of information may be allowed by court order under limited circumstances.
Alaska Crossings Staff Medical Training Requirements
- Alaska Crossings requires that all Field Guide Staff are trained as Wilderness First Responders or EMT’s. All staff must be trained at the professional level of CPR, and certifications must be kept current over their the course of their career with Alaska Crossings.
- Alaska Crossings staff are instructed on specific topics including advanced procedures for wilderness medical response, evacuation procedures, simulation training, medication delivery training, and emergency communication training at the annual Staff Training.
- Before each program, Alaska Crossings staff review client medications and identified health concerns with the Medical Control Officer.
- Staff obtain and maintain a field trauma kit at all times.
- Alaska Crossings conducts on-going risk assessments and collects data on a realtime basis on all incidents in the program. This helps us to respond to issues in a timely manner, and contributes to an in-depth annual review and updating process prior to each new season.