EMS on College Campuses by Bradley Wilson

TEXAS A&M ERSITY EMERGENCY MEDICAL SERVICES

1:AtTexas A&M. JimSchaferting. paramedic andsenior majoring incommunity health . andAaron Segal practice theirskills . 2: InTexas A&M's training room . JoshMcClain . anEMT-B andjuniormajoring in community health. andAaron Segal paramedic andsenior majoring incomputer science . practice IVandintubation skills . 3.JoshFrancis dispatches a medical transport runforSyracuse (SUA) . 4. KellyHirsch . president ofSUA student organizaUniversity Ambulance tionandanEMT -D.works withtheSyracuse FireDepartment atasimulated DWI accident oncampus.

Reodin Ritin' EMS on College Campuses ST O RY AND PHOTOGRAPHY WILSON. EMT-D BRADLEY

By - I

espond n OR EMT CRAGINGREENE, IT WAS A RATHERTYPICALSUNday 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.

Campus Life 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 Âˇsystem 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 provid~rs do a lot of good for themselves. Jim Schaferling, a paramedic and senior at Texas A&M University majoring in community health, said hisservice has three goals: providing quality patient care, training the stuJ U N E 1 9 9 7 jEMS

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dent 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 slowgrowing 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 stud ents 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

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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."

ButIt'sFriday Night Funding issues aside , collegiate EMS offers a special social charge that many professional EMS operations do not. At New York's Binghamton Univep;ity, 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 volleyballand 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 forTraining? 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 cam puses work with local fire departments, private EMS agencies or medical schools to provide continuing education training. At Syracuse, for example, the stud ent training coordinator invites local medics in every Sunday afternoon to teach dri lls 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'smanager 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

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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 legislativebodies, 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-Band 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-lifediscussion 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.

ButDoThey Graduate? Because of the skills , both tangible and intangible , that these s tudents 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 re.ceive 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 help s .solve a perpetual problem for campus sys tems-recruitment- since it gives students another incentive to get involved . Paramedic Jeff Jarvis, director of edu-

cation 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 . "Co llegiate-based services, in general, are very important in the developm ent 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 con cern ed parents to budgets to committee~ to new attendees and trying to provid e 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. Bradley Wilson, EMT-D, -I, is a graduate student in publi c administration at Sy racuse University 's Maxwell School of Citizenship and PublicAffairs.