College campuses are an interesting place to practice EMS.
Much like in a small community, campus EMS providers often know their patients. But these EMS providers aren’t just their neighbors—they’re also their classmates, teammates and friends.
Rice University Emergency Medical Services (REMS) serves an urban campus set on 300 acres in Houston, TX, across the street from the world's largest medical center. Total undergraduate enrollment at Rice University is about 4,000, with an additional graduate student population of more than 2,500.
Since 1996, Rice EMS has operated as an advanced life support first responder organization with a staff of 53 undergraduate volunteers, 20 alumni members, six volunteer physicians and one staff person.
“For an undergraduate student, being involved in a collegiate EMS agency as a young person is a tangible way they can participate in service to the university community, while learning and applying skills of working with a team, the challenges of caring for peers and balancing volunteering with their rigorous academic loads—skills that help build them into community leaders no matter what their majors or future educational plans,” says Lisa Basgall, EMS director for REMS. And, she notes, the volunteers become a tight-knit family.
“Rice EMS has a team of six physician medical directors, five of whom are graduates of Rice EMS who returned to provide medical leadership and mentoring to the undergraduates currently participating in the program,” explains Basgall. “This is an invaluable resource for our service. The physicians all assist with providing online medical command, and each helps in additional ways. Two physicians are involved with supervising the students in the research course; one assists with EMT & AEMT class instruction; one regularly comes to campus to help with continuing education for the ongoing staff; one oversees quality assurance and chart review for the service. All of these amazing physicians work with students in the program when they come to the ER for clinical rotations through the EMS courses. The student leadership team all participate in ongoing clinical rotations at the ER, taking a shift at least once a month to keep clinical skills sharp.”
And those skills are definitely put to the test. In the 2013–14 academic year, REMS responded to 590 campus emergencies, provided 1,968 hours of special event coverage at 170 events, offered 39 CPR classes to almost 500 people—at no charge—and offered three EMS certification courses.
Continuing education is a vital component of all EMS services, but for REMS, being set on a college campus provides ample opportunities for ongoing educational opportunities.
“Rice EMS offers EMT and Advanced EMT certification courses annually,” says Basgall. “These are offered as undergraduate science elective course at the university. All courses are run in compliance with Texas Department of State Health Services standards, and Rice EMS is recognized by DSHS as an agency allowed to offer advanced life support certification courses. Offering the AEMT course as a hybrid course has ensured the undergraduates enrolled in the course are able to fit more than 130 hours of clinical rotations into the semester concurrent with the didactic portion of the course. The robust clinical rotations allow for increased competency in patient care upon completion of the certification, and better prepared providers for service within Rice EMS.”
According to Basgall, this year REMS also offered an undergraduate EMS research course, partnering undergraduate students with physician faculty from Baylor College of Medicine to participate in prehospital and emergency medicine research. The projects the students were involved with helped increase the students’ insight into the process of evidence-based medicine and protocol development, and allowed for greater collaboration between the EMS service and the faculty physicians at the EMS agencies where they serve, as well as in hospital.
“The research course was a big step for EMS to take,” Basgall says. “Many people enter college hoping to attend medical school in the future, but participating in prehospital and/or emergency medicine research as an undergraduate is an opportunity we hope will help our service—and others—in the understanding and development of evidence-based protocols for the future.”
Because of frequent turnover in the student population, REMS has had to get creative in order to stay consistent in its level of service. “The need for consistency in training, efficiently welcoming and orienting new members, and thorough record keeping, is essential for any collegiate EMS agency where the most experienced and proficient staff graduate and leave annually,” Basgall explains. “Rice EMS has worked to meet these challenges through working with the university’s Information Technology Department, developing shared storage options that allow student administrators to collect and store job descriptions, training manuals, resources, and other key information to pass on to the next student who will be taking on leadership positions in the same functional area in the future. Implementing electronic medical records has increased exponentially the access the medical director team has to patient care records, and allows them to give prompt feedback to the EMS providers. While these steps may seem elementary, they have made a large impact in our organization in reducing the need to design a training program, or make public education materials, for instance, allowing more time for the personal connections involved in the ongoing recruitment and training of new members essential for collegiate EMS agencies to flourish.”
And the campus setting is beneficial in a number of other ways. Basgall says REMS works in collaboration with personnel from the university’s Environmental Health & Safety Department when responding to all calls involving lab accidents. And its unique access to other departments makes for some excellent partnerships. The Rice Counseling Center provides a program on QPR—Question, Persuade and Refer—a suicide-prevention program for all EMT students. Leaders from the counseling and wellbeing offices are also willing and able to provide drop-in times for EMS staff who have been on a high-stress call.
“Another thing that makes this collegiate EMS program unique is that the EMS providers live in residential colleges with hundreds of other people,” says Basgall. “Living in close proximity to people who may be REMS patients, and may have an infectious condition, raises the importance of the need for prudent measures for cleaning and illness prevention.”
All REMS members are offered a flu shot annually; TB testing and meningitis vaccinations are mandatory. When infectious illness is suspected in one of the residential colleges, or a trend is identified through several patients having similar signs and symptoms in a 24–72 hour period, REMS partners with the Housing & Dining officials on campus. A procedure is in place for enhanced cleaning of common areas such as restrooms and common rooms, and Housing and Dining staff are diligent about tracing any possible food-borne illness. “As first responders on a college campus, we are often the first ones to identify areas of concern or risk for potential future illness or injury, and having relationships with campus partners helps us appropriately share information as needed,” Basgall notes. “For instance, last summer a fire ant infestation in several campus fields during orientation week for new students caused 10–15 calls for emergency services. Contacting the orientation week leadership allowed for activities to be moved to a different area of campus, reducing calls.”
Rice EMS also actively helps raise awareness of local health resources available to students, how to access the best resource for the type of medical condition, and when to use emergency services. REMS provides low cost CPR and First Aid classes on campus for any student, faculty and staff interested in learning these skills. In the 2013–14 academic year, 39 classes were offered with 498 participants. In addition, Rice EMS maintains the Public Access Defibrillator program on campus, with 45 PAD sites on campus.
“Amazingly, this service is run by young adults—college students who join together to maintain the proud history of the service, and help it grow for the future,” Basgall says. “Collegiate EMS is a unique niche in the EMS community, but provides unparalleled opportunities for new EMS volunteers to attain proficiency as care providers and learning what it means to be a community volunteer and leader.”