Collegiate EMS System In The Works

[Guest]

So, I need some advice... excuse the length of the post...

I'm the Director of Operations for a collegiate EMS system in Massachusetts that has been in operation for over 50 years now. There are approximately 12,000 students living on campus, spread out over a fairly large area. The local fire department provides 911 EMS response to the students at an ALS level as well as the members of their (fairly large) response area.

The collegiate EMS unit has always functioned as a non-transporting entity that only works details/stand-by's at football games, hockey games, concerts, etc. While it is impractical for us to look into obtaining an ambulance, the thought of getting a first-response vehicle seems plausible.

As it stands right now, if you dial 911 for a medical emergency on campus: you speak to the university PD, who then dispatches a cop and relays the info to the local FD, who then dispatches their own ambulance, who then mobilizes and responds. We are proposing to implement a first response unit on campus (volunteer) that will be dispatched along with university PD. We feel this will reduce the time between the 911 call and on-scene medical care.

I love the idea and theory behind it all, but I know there's more to it than just buying an SUV and listening to a scanner. The Executive Director and I have made a list of things we think we need to research (listed below):

-Vehicle (insurance, registration, inspection)

-Dispatch protocols

-Staffing

-SOG's

-Line Officers/Crew Chiefs/Member Qualification

-Liability Insurance

-Response Area

-Fuel/Misc. Costs

-Funding in general

-Support from the local FD

I'm not sure what else we really need to look at... that list alone is enough to tie up our hands, but I'm sure we're missing things. I've checked the NCEMSF site and have done some research with them as well.

So basically, here are my questions: what else do we need to research? Does this seem like a plausible system? How do you suppose we tackle the obstacles listed above?

Thanks for reading!

[xfirefighter484x 234]

My suggestion:

Talk to EMSJunkie712. He was involved with the up and running of a College EMS service down in Florida.

http://www.emtbravo.net/index.php?showuser=172

[Guest]

Is the fire dept volunteer? I think the first response vehicle is a great idea, is University PD dispatched to EMS calls on campus if it is called in a cell phone and they don't talk to University dispatch? I would suggest having University PD dispatch the EMS calls for your fly car, probably just on their freq if they allow it, this will eliminate any problems with licensing a freq and all that entails, and they can both be dispatched simultaneously. Also, for staffing, although you aren't doing transports, if you can, you might as well put two EMT's on board, or if the call volume could justify it, having two staffed vehicles could be a good approach. Maybe you could try and tie this in with the police dept for the registration and vehicles if that makes it simpler, I'm sure they either have some spare vehicles or one of the fleets on campus has spare vehicles. For response area, I'm sure directly on campus would be a good start, and after seeing the effectiveness and demand, see if you could expand to some off campus areas. I don't know if that helped at all, but that's just what I could think of now. Also, for funding, I know that at my school they nickel and dime us for everything, so I'm sure if you could get it approved, a small 'emergency response' fee tacked on like an activities fee might not be out of the question, since you can't bill for transports.

Edited February 22, 2009 by Slayer61

[OoO 24]

How long is the average response time from the FD? If they will respond in about the same amount of time as you would, you won't really get to do much except respond and then drive back. Why rule out transporting?

Edited February 22, 2009 by OoO

[Guest]

The FD's response time is decent; however they are severely understaffed and are often (sometimes more than 10 times in a month) unable to send an ambulance and must call for mutual aid, which obviously takes longer. We're ruling out transporting because the FD gets somewhere around $1000 per transport, and we'd be taking an enormous amount of calls from them.

The local fire department has a paid force, a call force, and a student force that operates their own engine. They are completely unaffiliated with our EMS system. I believe PD is dispatched to every call regardless of method of alarm--cell phone, landline, smoke signals....

[OoO 24]

If they are understaffed and often go to mutual aid, they may be willing to let you take some calls off of their hands. I would think contacting them is worth a try.

[helicopper 1,050]

So, I need some advice... excuse the length of the post...

I'm the Director of Operations for a collegiate EMS system in Massachusetts that has been in operation for over 50 years now. There are approximately 12,000 students living on campus, spread out over a fairly large area. The local fire department provides 911 EMS response to the students at an ALS level as well as the members of their (fairly large) response area.

The collegiate EMS unit has always functioned as a non-transporting entity that only works details/stand-by's at football games, hockey games, concerts, etc. While it is impractical for us to look into obtaining an ambulance, the thought of getting a first-response vehicle seems plausible.

As it stands right now, if you dial 911 for a medical emergency on campus: you speak to the university PD, who then dispatches a cop and relays the info to the local FD, who then dispatches their own ambulance, who then mobilizes and responds. We are proposing to implement a first response unit on campus (volunteer) that will be dispatched along with university PD. We feel this will reduce the time between the 911 call and on-scene medical care.

I love the idea and theory behind it all, but I know there's more to it than just buying an SUV and listening to a scanner. The Executive Director and I have made a list of things we think we need to research (listed below):

-Vehicle (insurance, registration, inspection)

-Dispatch protocols

-Staffing

-SOG's

-Line Officers/Crew Chiefs/Member Qualification

-Liability Insurance

-Response Area

-Fuel/Misc. Costs

-Funding in general

-Support from the local FD

I'm not sure what else we really need to look at... that list alone is enough to tie up our hands, but I'm sure we're missing things. I've checked the NCEMSF site and have done some research with them as well.

So basically, here are my questions: what else do we need to research? Does this seem like a plausible system? How do you suppose we tackle the obstacles listed above?

Thanks for reading!

I'd add these to your list:

- Support of the University

- Massachussetts Health Department (or agency that oversees EMS) approval

- Dispatch services (who's actually going to do it if the University PD will not or can not)

- Equipment and Supplies

You need to seriously crunch the numbers and show the University why this is a great idea. FD response times vs. your response times, number of calls that go mutual aid (longer scene time), total call volume, projected staffing, etc. Get your medical director (assuming that you have one) involved as an advocate for your cause. I'm sure a couple more members will pop in here with some other ideas too.

Consider approaching the UPD about one of their retired vehicles. Perhaps they can arrange to turn one over to you so you don't have to invest in a new vehicle. Start small and grow big. If you come in with a 100K budget in this economy you're probably just going to get shot down. But if you can arrange to start it with very modest start-up costs, you have a much better chance of gaining University support.

Good luck and keep us posted!

[dxn8388 0]

I am also involved in a Collegiate EMS System in Rochester, NY where we have an ambulance and a BLS flycar. We are directly tied into the Student Health center so that is where we get most of our money. One of the main supporting factors for keeping us around is that it gives students free transports to hospitals if it is a BLS call.

I have attended 2 Collegiate EMS Conferences and I have also seen some ideas for getting money. Since your campus has a moderate student population there probably exists large scale events on campus. These events include concerts or track meets or even graduation. All of these events involve money and therefore have an EMS budget built in. At least in New York, there exists a DOH requirement which I think is called Part 18. It requires per the amount of people in an event, for there to either be an ambulance, doctor, ALS, or other types of first responders. So, if you have a good number of members and can run a first aid room and first response for these events, they will give you the money that was budgeted into the event. Then you take that money and work it into your agency to get vehicles and what not.

I hope this is helpful, if you have any questions, I will try to check back this thread to answer them.

-dxn8388

[bartman884 0]

Another issue to look at is staffing. During my college days I was involved with the BLS service at SUNY Albany which provided 2 BLS ambulances and was staffed 24/7 while the dorms were open. Conversely when speaking to other collegiate agencies I found that many were not staffed during the daytime becuase they couldn't get the staffing during class times. Although we had a fairly ample stable budget from the university student association, training people to be crew chiefs or drivers took time and most of these people would end up being upperclasmen. For this reason scheduling coverage 24/7 between the 10 or so drivers and 12 or so crew chiefs was very difficult. In my opinion 3 of the best college EMS services to look at and get information from would be Harpurs Ferry at Binghamton, Five Quad at Albany and the University at Stony Brook's ambulance service. Speaking to other services at the NCEMSF conference can also get you some great information.

[NWFDMedic 58]

Just as a base for further questions, what is your level of certification and authority as an agency? Since you do standbys at events, I'm assuming you must have Mass. certification, which would likely include a medical director, completion of patient care reports, a QA/QI system, etc. Does the University pay for the service of the ambulance that is on standby for events such as football or hockey games (the two sports I know that the NCAA requires an ambulance on standby)? Do you guys work well with the local FD/EMS services when you are at the standby details?

All in all, I would think that the best option would be to sit down with the local town department and discuss the options. They may be more than receptive to your assistance and may even be interested in adding your providers into their system. They might be willing to support your student service and maybe even enter into an agreement to allow your providers to tend to patients in their ambulances (which might better response times, get their ambulance out more, and get money for them in the process). It could be a win-win situation for their department, your agency, the patient, and the University as a whole.

The other side of the coin would be if there's an adversarial reltionship... if so, good luck.

[ny10570 745]

I'd go straight to other groups that operate on their campus. In NY I know of Fordham, Columbia, Oneonta, and Albany.

[NJMedic 96]

Have you seen this website: http://www.ncemsf.org/

[Future Fireman 4]

Contact the Massachusetts Office of EMS (OEMS for short). If you set up a Emergency Medical Response agency and you don't take care of the proper paperwork for them, you can bet that your (butt) will be hunted down and fined!

Mike

[Guest]

Thank you all for your replies! We're slowly getting on our way and researching more material for the idea. I'm sure that I'll be posting more in the future for suggestions and such... feel free to PM me if you have any further suggestions or ideas!

[JohnnyOV 2]

So I've been waiting a while to get back to you, but basically our problems have been summed up in an article that came out in our school newspaper today actually...I'll let you all read:

http://media.www.avionnewspaper.com/media/...s-3643755.shtml

prepare to be astounded...and go ahead and ask any questions you want, I'll be happy to answer any.

[JackEMT 77]

Lots of good comments. My thoughts:

- What are current average response times from your agency, the Univ PD and the transporting agency?

- Are the Univ PD officers medically trained? Will they initiate treatment? If the patient is getting care in a matter of two to three minutes and transport within eight, what does the response vehicle offer? (Obviously it can carry more equipment/supplies than any person can carry around campus attending classes.)

- Would having the vehicle centrally located require a driver to respond to the vehicle and increase his response time to the scene for equipment that might or might not be needed?

- Campus layout, is a vehicle around campus be feesible, or is most of campus walkways?

- How likely are you to get an increase in funding? In terms of budget, budget some money each year towards a replacement vehicle. That way when the vehicle needs to be replaced, it's not one big expense, you will have money set aside already.

- On the plus side, having a vehicle with supplies will be nice at stand-bys like football games, or anything outdoors.

Good luck!

[Guest]

Holy cow Alex, it sounds like that place is worse off than mine... I love how the general public thinks that if someone calls 911, a CPR card will come and save the day!

Jack, thanks for your reply:

As it stands right now, our agency doesn't have a "response time" since we don't respond to 911s on campus. We solely operate at details and events. UPD's response time is fairly good, and I know they can be there for several minutes... it's difficult to say how long, although I'm definitely going to do some research on that. Part of the problem is that the FD is understaffed: in Sept. 08, they had to call a mutual aid ambulance 12 times (the highest yet). This happens anywhere between 3-7 times a month on average...

UPD will arrive on scene with a defibrillator, and although some of them are EMTs they do not usually render care. Would cutting down 5 minutes on a response time for medical attention not be worth it?

The vehicle would be staffed, so once a call is received there would already be people either in the rig or right next to it. The vehicle is definitely practical for maneuvering around campus... after all, the ambulance has to get there too.

Definitely going to look into budgeting, thank you for those suggestions. And yes, we'd love it for stand by's as well!

[medic25 0]

If you are interested in running a first response service, you could try talking to the EMS service at SUNY Geneseo (Geneseo First Response). It's where I got my start in EMS, and since I left (all the way back in the mid 90's) I believe they are now fully integrated into the county 911 system, providing BLS first response with an SUV. You can check out their website at http://www.geneseo.edu/~esquad/index.html

Edited February 24, 2009 by medic25

[JohnnyOV 2]

Holy cow Alex, it sounds like that place is worse off than mine... I love how the general public thinks that if someone calls 911, a CPR card will come and save the day!

Yeah, basically right now, the entire safety department is in a crapstorm from our legal department now.

Some quick facts for you all

-Our organization provides a first response, non-transport, basic life support operation, that has a maximum of 3 min. response time to anywhere on campus from when our safety department is notified.

Daytona Beach is served by a highly professional group of career firefighter/Paramedics and a commercial ambulance service that is the sole provider of transportation for the entire county. Now I am not knocking either department or wanting to start a response time debate, but on average, the average response time for the first unit on scene for our campus is anywhere from 10-15min from the 911 dispatch (this is documented through many cad reports)...this will come into play in my next point.

-Its drilled into every students mind from the first day on, that if ANY emergency happens on campus, call safety, this is from a fire to medical emergency to gunman on campus. What they do not tell the student is that once you call, they will send a safety officer to check out the situation before doing anything more. And anything more is the dispatcher (who have absolutely NO EMD/emergency 911 training) actually picking up the regular land line phone, and dialing 911 themselves and giving all information second hand. So when a student calls for a true emergency such as a dorm room fire, or heart attack, Saftey will dispatch an officer, which takes anywhere from 3-5 min to get to the scene. Once they make a determination of whats going on (through the VAST training that none of them have [notice the sarcasm]) they will then notify the "dispatch" center to call 911, which takes another 2-3 min to gather all the information, and then the 911 center will dispatch the appropriate units. So you're looking at an actual response time of an ALS unit of somewhere between 15-25 minutes...well beyond the 10 min. golden rule for getting treatment to a patient

-My partner and I have had numerous times a safety officer try and forcefully tell us to stop our care and wait for the ambulance to get there to do anything further, which we all know would be abandonment, negligence yadda yadaa and charges on the officer for his actions as well.

-There have been cases of students falling and hitting their head on concrete, vomiting, dizzy, in and out of consciousness, all the classic signs of a traumatic head injury, and while we were in service, dispatch only sending a safety officer to check it out, and the officer determined that it was fine if a friend drove the injured student to the hospital, then told us about the incident hours after it occurred. There are numerous stories such as this one, and each hads been documented in an extensive after action report on our side.

If anyone has any other questions please feel free to ask.