Req 13 — Eyes, Teeth & Strokes

This final medical conditions requirement covers five situations that don’t fit neatly into the previous categories — but that Scouts commonly encounter at campouts, games, and in daily life:

• 13a — Object in the eye
• 13b — Dental injuries (broken, chipped, or knocked out tooth)
• 13c — Vomiting and diarrhea from food poisoning
• 13d — Abdominal pain
• 13e — Stroke

Requirement 13a: Object in the Eye

What it is: Foreign objects — dust, dirt, sawdust, sand, metal chips, or insects — commonly get into the eye. A small, superficial object often comes out with the eye’s own tearing response. An embedded or penetrating object is a serious eye emergency.

Signs and symptoms: Intense tearing; pain or a “gritty” sensation; redness; difficulty opening the eye; blurry vision.

First aid for a small, non-embedded object:

1. Do NOT rub the eye — rubbing can embed the object or scratch the cornea.
2. Blink rapidly several times — natural tearing may flush the object.
3. If blinking doesn’t work, flush the eye with clean, room-temperature water for several minutes. Tilt the head so the affected eye is lower; pour water from the inner corner outward.
4. Gently lift the upper eyelid to look under it for the object; gently pull down the lower lid. If you see the object on the white of the eye or inside the lid, gently remove it with a damp corner of a clean cloth.
5. If the object is on the cornea (the colored part), do not attempt to remove it.

First aid for a penetrating eye injury:

• Do NOT remove any object embedded in the eye.
• Cover both eyes loosely (covering one reduces sympathetic eye movement).
• Do not apply pressure.
• Seek emergency care immediately.

Prevention: Safety glasses for power tools, woodworking, and chemistry; protective eyewear for outdoor activities in dusty or debris-prone environments.

Requirement 13b: Dental Injuries

Chipped or Broken Tooth

Signs and symptoms: Visible chip or fracture; pain (especially with air, cold, or pressure); sharp tooth edge that cuts the tongue.

First aid:

• Rinse the mouth with warm water.
• Apply a cold pack to the cheek to reduce swelling.
• Cover sharp edges temporarily with dental wax or sugar-free chewing gum.
• Save any tooth fragments in milk if possible.
• See a dentist promptly.

Loosened Tooth

Signs and symptoms: Tooth is mobile in the socket; pain; possibly displaced.

First aid:

• Do NOT try to push it back into position.
• Bite down gently on a piece of gauze.
• See a dentist as soon as possible — a loosened permanent tooth can often be saved with prompt treatment.

Knocked-Out Tooth (Avulsed Tooth)

A knocked-out permanent tooth is a dental emergency. It can often be re-implanted successfully if treated within 30–60 minutes.

First aid:

1. Find the tooth; handle it by the crown (top), not the root.
2. If dirty, gently rinse with water or milk — do not scrub.
3. Best option: Reinsert the tooth in the socket immediately and bite down gently on gauze to hold it.
4. If reimplantation isn’t possible: Store the tooth in milk, the patient’s own saliva, or a commercial tooth preservation solution (Save-A-Tooth). Do NOT let it dry out; do NOT store in plain water.
5. Get to a dentist or emergency room within 30–60 minutes.

Note: This applies only to permanent teeth. Baby teeth should not be reimplanted.

Requirement 13c: Vomiting and Diarrhea from Food Poisoning

What it is: Food poisoning results from consuming food or water contaminated with bacteria, viruses, or their toxins. Common culprits: Salmonella, E. coli, Norovirus, and Staphylococcus aureus (the “hours later” type from food left out too long).

Signs and symptoms: Nausea, vomiting, diarrhea, abdominal cramps; sometimes fever; typically begins within 2–48 hours of eating the contaminated food; usually self-limiting (resolves in 24–72 hours).

First aid:

• Rest the stomach: small, frequent sips of clear fluids (water, diluted juice, electrolyte drinks).
• Rehydration is the priority — vomiting and diarrhea can cause significant fluid and electrolyte loss.
• If vomiting is severe, wait 15–30 minutes after vomiting before attempting any fluids.
• Gradually reintroduce bland foods (crackers, toast, plain rice) when tolerated.
• Do NOT force food.
• Oral rehydration salts (ORS) are excellent for fluid replacement, especially for children.

When to seek care: Blood in vomit or stool; high fever (above 102°F); severe dehydration; symptoms lasting more than 72 hours; or any severe abdominal pain that might suggest appendicitis.

Prevention at camp: Proper food storage (cold food cold, hot food hot); prompt refrigeration; thorough cooking; handwashing before food prep and after bathroom use; treat backcountry water sources.

Requirement 13d: Abdominal Pain

What it is: Abdominal pain has dozens of causes, ranging from gas and muscle strain to appendicitis and bowel obstruction. Your job as a first aider is not to diagnose — it’s to assess severity, manage comfort, and recognize when the situation requires professional care.

Signs and symptoms by location and character:

Appendicitis Specifics

Appendicitis is the most critical cause a Scout should know. It begins with pain around the navel, then migrates to the lower right abdomen. It worsens over hours and is accompanied by fever, nausea, and loss of appetite. It is a surgical emergency — an untreated appendix can rupture, causing peritonitis (widespread abdominal infection), which is life-threatening.

Warning signs requiring emergency care:

• Worsening pain unrelieved by any position
• Fever with abdominal pain
• Rigid abdomen (board-like stiffness — suggests peritonitis)
• Vomiting with inability to keep any fluids down
• Worsening over hours, especially if pain starts centrally and moves to the right lower quadrant

Basic first aid:

• Rest in a comfortable position.
• Do not give pain medications unless directed by a healthcare provider (pain masking can complicate diagnosis).
• Do not give laxatives.
• Monitor and seek care if pain doesn’t resolve quickly or shows any warning signs.

Requirement 13e: Stroke

What it is: A stroke occurs when blood supply to part of the brain is cut off — either by a clot (ischemic stroke, 87% of cases) or by a burst blood vessel (hemorrhagic stroke). Every minute without treatment, approximately 1.9 million brain cells die. “Time is brain.”

Types:

• Ischemic stroke: Blood clot blocks an artery supplying the brain.
• Hemorrhagic stroke: An artery bursts, bleeding into or around the brain.
• TIA (Transient Ischemic Attack): A “mini-stroke” — symptoms resolve within 24 hours. It is a warning sign that a major stroke may follow; always seek emergency care.

Recognizing a Stroke: FAST

The FAST acronym is the standard public recognition tool:

Other stroke signs: Sudden severe headache with no known cause (“the worst headache of my life” — a classic sign of hemorrhagic stroke); sudden vision loss or double vision in one or both eyes; sudden loss of coordination or balance; sudden confusion.

First aid:

1. Call 911 immediately — stroke is a time-critical emergency. Note what time symptoms started.
2. Keep the person calm and lying down.
3. Do NOT give anything by mouth — they may have difficulty swallowing.
4. Do NOT leave them alone.
5. Prepare to perform CPR if they lose consciousness and stop breathing.

You’ve covered the full spectrum of medical emergencies. Now for a requirement that’s completely different — teaching.