01 Jan College EMS systems provide education, opportunity
During my 20-plus years working in pre-hospital healthcare, I wore patches in Texas, New York, North Carolina and Kansas. I wore patches for a service in Texas, Wimberley EMS, that I helped to found. I wore a patch for a service in North Carolina, Cary Area EMS, that grew form having one full-time ambulance to having five in about a decade. But the patch I was perhaps the most proud of was the patch for Syracuse University Ambulance, the student emergency medical service for which I worked while working on my master’s degree in public administration.
I was only there a year. And maybe I ran my first CPR call in Wimberley and got my first code-save there. Maybe I got about a dozen saves in Cary. But in Syracuse, I worked with some of the most committed, most talented and most committed medics — students — who spent time learning, teaching and saving lives.
During my tenure at Syracuse University, I wrote some articles about college-based EMS systems. I reprint them here so that they are available for historical purposes but also to remind myself of the talent these students and their successors possess.
Readin, Ritin’ and Responding
EMS on College Campuses
Story and photography by Bradley Wilson, EMT-D, -I
Originally printed in the June 1997 issue of JEMS, the Journal of Emergency Medical Services
For EMT Cragin Greene, it was a rather typical Sunday at Syracuse University in New York. He was at home working on his 20-page genetics lab, culminating six weeks of breeding fruit flies and observing mutations. Having agreed to respond to ambulance calls, and wanting a break from studying, he jumped up when a drug overdose came in at around 10 p.m.
“Sunday night’s generally a slow night, and I wanted to keep the ambulance in service,” he said. “I didn’t have any problem spending a couple hours here and there on a call. I knew I’d be up all night anyway working on the lab. It’s like a good break.”
A good break until the electrical power went out at three of the largest dormitories and the Department of Public Safety’s radio communications tower and emergency telephone lines, forcing student medics and dispatchers to scramble to coordinate resources.
“The power outage lasted two or three hours , and we had a high volume during that time keeping us very busy,” Greene said, noting that he and his partner responded to a sickle cell anemia attack, a standby for people trapped in an elevator, a general illness and an injured ankle, as well as several other emergencies. “Even after that power outage ended, we ran calls until like four in the morning.”
Meanwhile, not much work got done on the gene-mapping lab that was due Tuesday. “Monday was tough,” Greene admitted. “I was exhausted. I came in from the calls and went straight to the lab. I spent a lot of time in my professor’s office trying to get help. I just wasn’t counting on having a power outage, a flu epidemic and an unforecasted snowstorm all at once.”
Luckily for Greene, however, dealing with the power outage and medical emergencies wasn’t the only learning taking place — he got the second highest grade in the class on his gene-mapping exercise. His lab partner , who did get to sleep, beat him by one point.
For student medics at some 150 college EMS services nationwide, rushing to a drug overdose or a twisted ankle is as much a part of student life as final exams and 20-page papers . Yet despite the obvious similarities that result from working in a college environment, these services are as varied as the schools at which they are based. For example, some services staff their ambulance all day, every day, while others only run calls when school is in session. Most offer only BLS service, but others provide ALS care on MICU-capable ambulances. Most operate strictly on a volunteer basis, but a handful are paid. Most respond and transport, some respond on bicycle and call the local EMS service for transport. In any case, student volunteers opt for training and experience rather than a paycheck.
“Besides developing valuable medical training, I also learned a lot about responsibility, respect and communication,” said Scott Savett, an EMT-B with Clemson University’s EMS system in South Carolina and a director-at-large with the National Collegiate Emergency Medical Services Foundation (NCEMSF), a professional society for university- and college-based organizations. “To know that someone is relying on you to save his life is a heavy load on a 19-year-old.”
David Flores, a senior psychology major, EMT and driver, said that his experience with Syracuse University Ambulance (SUA) goes way, beyond what most student groups do for their members and the campus. “SUA is full of good people who are willing to [volunteer) eight hours a day and go into unknown situations,” he said. “I like knowing that I’ve done good.”
Besides doing good for others, student EMS providers do a lot of good for themselves. Jim Schaferling, a paramedic and senior at Texas A&M University majoring in community health, said his service has three goals: providing quality patient care, training the student staff and developing friendships. “We take freshmen medics and train them from the ground up, how to work on an ambulance and to work with other medics,” he said. “(They) also learn how to run an EMS service.”
But They’re Just Kids
The biggest problem student medics face, according to students at campuses all over the United States, is being seen as “stupid kids playing with their flashing trucks,” said Dustin Roberts, an EMT-B majoring in biomedical science at Texas A&M.
Bob Audet, EMT-CC with Rural/Metro and EMS manager for Syracuse University, said he can easily imagine what people were saying when SUA began in 1975: “You can’t match the professionalism of a paid service. Leave it to the pros. You’ll never be more than a group of students with a first aid kit.”
Stephanie Ayer, a medic with SUA today, acknowledged that perception still exists despite more than 20 years of service. “Because we’re college EMS, obviously we’re not paid professionals,” she said. “We have to know our stuff better than the next guy.”
Syracuse isn’t alone in facing a perception problem. Stuart Rosenhaus, an administrator with New York’s Brooklyn College, said students in his service constantly battle the misplaced notion that they are “just a bunch of kids playing ambulance.”
David Kingdon, a junior at Bates College in Lewiston, Maine, majoring in English, agreed that student EMTs work hard despite little recognition. “(Our volunteers) make the best of their slow-growing funds, offering nonalcoholic-involved entertainment events and education for all of the campus as well as serving with no material reward,” he said. “And we love it.”
At Texas A&M EMS, enthusiasm and dedication has helped improve relations with neighboring services, but what really made the difference, said student medics there, was becoming an ALS service, one of the few ALS student-run services in the nation.
At Harpur’s Ferry Ambulance, a student-run ALS system in Binghamton, N.Y., respect also came with the development of a quality assurance program that now is being used as a model for other county EMS systems. Under this QA program, every Prehospital Care Report (PCR) is evaluated based on an objective set of criteria, including completeness, response times and adherence to a professional standard of care. Executive Director Bill Bodeker, a senior majoring in biology, said the QA program, like many other programs his service has developed, is an assimilation of ideas brought in by students from all over the United States. “We try to take all the best ideas and make them our own,” he said. “(The QA program has) helped to improve our level of care.”
Mom, Dad … Send Money
Most campus services receive their funding from a university department, such as public safety, or from the student health center that receives student fee monies from every student enrolled. Only a few charge for their services or pay their medics for the day-to-day staffing of the station.
“Our biggest problem is, and probably always will be, funding,” said Julie Glaser, a senior majoring in illustration who works for Rowan College EMS in New Jersey. “We’ll be sending mailers to the home addresses of most of our students telling them who we are and asking for donations. We do not want to do the typical fund-raisers that other clubs do because (they don’t) generate the kind of funds we need.” Glaser said her group’s funding comes from the Student Government Association with some financial support from the Department of Public Safety, but that they supplement that with donations and are trying a direct-mail campaign to solicit donations.
Dan Kaniewski, a George Washington University freshman in the EMS degree program and public relations liaison for the Emergency Medical Response Group, said his service saves money by being very careful who it transports. “Our service prevents unnecessary patient costs — including unnecessary use of an ambulance,” he said. “We transport nonemergent, ambulatory patients via University police cars, with one of our EMTs accompanying the patient to the ER. We do not charge for our service, nor do we get any compensation.”
Other college EMS programs, such as that at Clemson University EMS, are self-funded through patient billing. “If the county-run local EMS system took charge of campus calls, the average ambulance bill would jump from $150 to over $300,” said Clemson’s Saven, adding that Clemson is considering discontinuing the campus EMS service. “Imagine the backlash when parents start getting ambulance bills from the county for $300 to take (their children) to the hospital.”
But It’s Friday Night
Funding issues aside, collegiate EMS offers a special social charge that many professional EMS operations do not. At New York’s Binghamton University, for example, trainees and experienced members travel to a nearby lake once a year for a weekend of training and bonding, according to Justin Davis, a senior majoring in anthropology.
“The nights you’d be hanging out, and the days you’d be training,” he said of the group’s trip to Echo Lake. “We made it mandatory for our new members.” Davis said the more than 50 student volunteers sit around the heater on the final evening and talk about dealing with death and the harder things that medics must deal with. “As soon as that’s over, we’d go outside and build a big campfire,” he said. “We’d roast marshmallows. It’s a big bonding experience.”
He also said other events, such as Midnight Madness (where team members try to follow clues left around campus to solve a puzzle), a spring banquet (which includes members of neighboring EMS agencies), and a picnic the weekend before finals (complete with sand volleyball and barbecue), bolster the group’s morale.
At other services, something as simple as watching television together serves as a bonding experience. “We are a close group like many other services,” said Aris Craven, director of the Lakehead University Emergency Response Team in Ontario , Canada. “For fun, many of us get together each Thursday night and watch ER and, of course, critique it. We also plan special events that are for team building and volunteer appreciation.”
Time for Training
While there is certainly a social aspect to campus EMS systems, particularly those run solely by students , the social aspects are almost insignificant in comparison to the continuing education, inservice and training , which varies greatly in content and depth.
“This semester, many of the senior medics have been putting in 80- to 100-hour weeks. We strive to keep the service running constantly, but this requires sacrifices at times,” said Texas A&M senior Aaron Segal, EMT-P. In fact, after working a 120-hour week, he said with a definite sense of pride, “We haven’t gone out of service in two years.”
The need for displaying professionalism has made managers of campus EMS systems develop rigorous guidelines for familiarizing newcomers to their local protocols, especially since students may come from other states or even other countries.
Most campuses work with local fire departments, private EMS agencies or medical schools to provide continuing education training. At Syracuse, for example, the student training coordinator invites local medics in every Sunday afternoon to teach drills on everything from driving in the snow to diabetic emergencies. Every volunteer must attend seven drills per semester.
At Binghamton University, even the first level of training includes CPR classes, up to six hours of attendant training class per week, dispatching, driving drills, observing calls and even watching a video of a simulated call and writing the prehospital report. Further training includes simulated drills and lots of critique.
At SUA, Ayer said this rigorous training takes a level of commitment beyond what some people are willing to give. “Because our training is so rigorous, we don’t have a crew chief to fill some slots,” Ayer said, acknowledging that it also includes giving up some of the things college students accept as normal. “It’s a Friday night, and (sometimes I have to say) I’m not going out because I might have to go on an ambulance call.”
Because it is difficult to keep people trained in a system that loses all of its members every four years, SUA’s manager Audet said one of his goals is to have a person training on every run.
“I don’t think we are successful unless at least one person is training up to another position,” he said. Medics in Syracuse’s system, which is similar to many college systems, work their way up through a system designed to familiarize new people with local protocols. All calls require a qualified driver and state-certified EMT. Trainees for both medic and driving positions serve as third/fourth members of the crew.
Building confidence in handling emergency situations is what the training is all about. But for the more active members of the student groups, this training goes beyond being a medic or dispatcher. It may include managing a fleet of vehicles, writing and implementing policies, attending board meetings, applying for grants, requesting funding from campus legislative bodies, and dealing with personnel issues, including hiring and firing student staff members.
Texas A&M’s service, a Division of Health Services, is entirely student-run. Students serve not only as medics and dispatchers but also as administrators answering to the Health Center director.
Josh McClain, an EMT-B and junior at Texas A&M majoring in community health, said, “This is probably one of the few places you can truly be an in-charge paramedic under the age of 21 (and learn) about the operations of an ambulance service.” SUA’s Audet agreed: “We have also taught them how to think under pressure, how to communicate, how to document, and how to see the big picture.”
In addition to teaching students about finances, administration and handling medical emergencies, Audet notes, a campus EMS system promotes real-life discussion of issues, such as the impact of HIV on the health care system, alcohol or child abuse.
Jennifer McGuire, a second-year doctoral student in geophysics and a dispatcher, said this training has really taught her how to learn fast and how to teach others those skills she had just learned.
“There’s no place, I’ve ever worked that taught me as much about working with people and focusing and getting a job done,” she said.
But Do They Graduate?
Because of the skills, both tangible and intangible, that these students learn, some campuses award academic credit for EMT courses. Trinity College in Hartford, Conn., for example, counts the EMT course as an internship for which students receive credit. At Pennsylvania State University, students earn four credits in health education for the EMT-B course that can be applied toward any major. At George Washington University, students can major in prehospital care. Such credit helps solve a perpetual problem for campus systems — recruitment — since it gives students another incentive to get involved .
Paramedic Jeff Jarvis, director of education at Scott & White Hospital in Temple, Texas, said this recruitment and exposure to EMS may be the most beneficial role college EMS systems play for the profession. “Collegiate-based services, in general, are very important in the development of our profession. They are able to recruit very bright and ambitious students and, at a minimum, expose them to EMS.”
Lou Rotkowitz, a member of the University of Delaware Emergency Care Unit, said most students don’t get involved to get course credit. “People on UDECU do it because they have it in their blood. The credit is irrelevant,” he said.
And once they get EMS in their blood, sometimes it’s hard to get out. Some student medics graduate and move straight into the front lines working for city fire departments and private ambulance services. For example, Jarvis got his start within the Texas A&M system. “I can’t begin to express how much I got from my four years with TAMU EMS,” he said. “When I arrived at college, I was, like many freshmen, completely clueless about a direction for my life. I took a first aid class from a TAMU EMS instructor and fell in love with EMS. I developed a severe EMS addiction and soon found myself very involved with the service.
“I have serious doubts as to whether I would have remained in college, much less received a master’s degree without the support of the fine people in that organization,” he said.
Despite the benefits college-based systems offer to their respective communities and to the profession in general, college medics still have to deal with everything from concerned parents to budgets to committees to new attendees and trying to provide patient care while training an entirely new staff every few years. All this has convinced managers of college-based EMS systems of one thing — they’re going to have to fight for their existence as much now as they did almost 30 years ago.
Still, when the electricity goes out at 10 p.m. and they have research projects due the next day, you can bet they’ll be ready to provide emergency services to the students under their care.
Back in 1996 and 1997, the internet was still young. Websites weren’t common. But one company, MERGInet — the Medical Emergency, Rescue and Global Information Network, got started to bring news to the pre-hospital healthcare community on the “electronic frontier.” This article appeared in Vol. 2, No. 1. MERGInet has subsequently gone out of business.
by Bradley Wilson
Originally published online at MERGInet in 1996.
It seems that some 30 years ago when metropolitan governments and rural areas were starting their own emergency medical systems, colleges and universities had the same idea. Shorter response times, an opportunity to provide real-life experiences for their students, and lower costs provided all the necessary reasons for such services. One or two student activists and a catalyst were all the campuses needed.
According to Scott Savett, an EMT-B with Clemson University’s EMS system, all of those things came together when Clemson’s EMS system started in 1976.
“A student was struck by an auto on campus in 1976, and it took 40 minutes for the local ambulance to arrive,” Savett said, noting that the service was first actually formed in 1971, re-established in 1976 and moved under the jurisdiction of the university’s fire department in 1979.
Bob Audet, EMT-CC with Rural/Metro in Syracuse and EMS Manager for Syracuse University, said Syracuse University Ambulance started in 1975 when he said students were concerned about the cost of an ambulance ride and about response time. He also said the stabbing of a student on campus may have served as a catalyst for the movement.
“It was a student activist type of movement. Students wanted to get involved. They did not have an easy fight.”
After more than 20 years, Syracuse now operates two ambulances, one on call with medics 24 hours a day every day that the Health Center is open and one available as a backup. Standby crews also work large campus events and events at the Carrier Dome. SUA also operates a Medical Transport Service to help students who need transport to or from campus or local medical facilities and maintains a computerized dispatch service. And Syracuse is only one of some 150 campus-based EMS systems according to the National Collegiate Emergency Medical Services Foundation (NCEMSF).
At other universities, the number of different types of student EMS services is almost as varied as the campuses themselves.
George Washington University in the District of Columbia, for example, dispatches BLS medics on mountain bicycles 24 hours a day, Thursday – Monday.
“We begin patient care long before any DCFD units arrive. It can take 20-60 minutes for a DCFD ambulance to respond),” said Daniel Kaniewski, EMT-B, public relations liaison with George Washington University’s Emergency Medical Response Group. “Our bikes allow us quick response times (1-3 minutes) and also our service prevents unnecessary patient costs.”
Kaniewski also said this saves the students a minimum of $200 for unnecessary ambulance rides. The University Police transport non-critical patients to the emergency room accompanied by an EMT.
In contrast, Texas A&M University operates a 24-hour MICU-capable service and provides mutual aid to surrounding towns.
“Since we are entirely a volunteer service, the University must only pay for equipment and operating costs,” Aaron Segal, TAMU Director of EMS and student majoring in Computer Science. “Our ambulances, in addition to providing 911 service to the University, also provide non-emergency and emergency transfer service from the student Health Center.”
Segal admitted that it’s sometimes difficult to find volunteer paramedics and that they’ve been short-staffed on occasion this year forcing senior medics to work long hours.
“We strive to keep the service running constantly,” he said, “but this requires great sacrifices at times.”
Regardless of the type of service students say the education they get is worth the commitment and effort.
“There are few things I could have done which would better prepare me for the ‘real world,”‘ said Jean O’Connor, NREMT-I with Emory University First Responder Unit in Atlanta. “With the campus group, I get exposed to how EMS works, in sort of a scaled down version, and with the county I get to run serious calls with a paramedic. It also provides an incredible opportunity to not only see emergency medicine but to be exposed to people that I otherwise never would have met.”
Audet says this exposure to how HIV affects health-care, to child abuse and to alcohol abuse is an eye-opener for many medics.
“EMS is a real-life application of what is sometimes only a moral discussion,” he said. “You learn a lot about how people live.”
This training to work with people and to deal with unexpected situations is, according to Audet, one of the benefits of EMS at the college level.
“We have also taught them how to think under pressure, how to communicate, how to document, and how to see the big picture,” Audet said.
Further, he said student leaders in his organization, learn a lot about running an EMS system well-beyond running calls, including how to maintain a fleet of vehicles, how to maintain a personnel roster, how to conduct performance reviews, how to do a budget and even how to sit through a meeting.
Savett, a graduate student in chemistry, says students at Clemson are learning all that and more especially since administrators are considering discontinuing or privatizing the campus EMS service.
“Imagine the backlash when parents start getting ambulance bills from the county for $300,” Savett said.
Of course, who knows what will happen when a few student activists get together behind a cause.
About the Author: Bradley Wilson is a Texas-certified EMT-I and former member of Wimberley EMS near Austin. Mr. Wilson is an EMT and volunteer with Syracuse University Ambulance where he is enrolled in the Maxwell School of Citizenship and Public Affairs at Syracuse University and is planning on receiving his master’s degree (MPA) in June.
The master’s in public administration program is tough and time-consuming. I have no doubt that if I were there now, I’d have a lot more photos. And EMS calls don’t exactly come on a schedule. But I realized that there was one more limiting constraint — film. Digital cameras might have come from Kodak in 1975, but they weren’t widely available until the turn of the century. As a consequence, I shot far fewer pictures than I would have now. Nevertheless, here are some.