BY RICHARD JAMESLEY, MATTHEW PALMISANO, ROB LAWRENCE
University-based EMS systems have existed for decades. There are currently 243 collegiate-based EMS systems in the U.S. and 16 more in Canada.They are represented by the National Collegiate EMS Foundation.
In Virginia, the University of Richmond, recently declared by U.S. News & World Report the No. 1 up-and-coming liberal arts schools in the country, has a student-led EMS group that has now completed a 15-year journey to become an efficient and effective EMS organization.
In 1998, a group of students led by undergraduate Patrick Oliver, an EMT, noticed that the ambulance response times to 9-1-1 calls on campus were excessively long, even in high-priority cases. The campus was split between two jurisdictions, which created dispatch uncertainty, and the constantly renovated campus roads presented a challenge to responding units unfamiliar with the university's layout. Dozens of already-qualified EMTs lived on campus, yet their skills, proximity to medical emergencies and knowledge of the campus went unutilized.
Oliver and his group seized the opportunity to remedy the situation. They established an all-student EMT group called the Spider Advanced Volunteer Emergency Rescue Squad, or SAVERS, to initiate care to patients on campus while waiting for ambulances to arrive.
During the group's infancy, its operations were anything but advanced; its responders relied on the tools and resources of university police officers.
"The extent of the communication instruments owned by SAVERS," recalls Oliver, "included two pagers to direct the on-call responders to emergency scenes. Without radios, they could not give responding units patient updates or directions around campus. The EMTs also transported themselves to emergencies, either by driving their own cars or by putting one foot in front of the other all the way across campus."
In time the program's budget expanded, and response bags were acquired, but the EMTs were still required to rely on what they could carry on their backs. "Improvise, adapt and overcome" was an often-used phrase. Through the 10th anniversary of SAVERS, responders continued to be dispatched through pagers and carried minimal equipment in small response bags.
Ultimately, however, SAVERS became affiliated with the Richmond Ambulance Authority (RAA), which is responsible for all EMS operations in the city of Richmond and frequently worked with SAVERS to treat patients on the University of Richmond campus.
In 2009, RAA, also undergoing a renaissance after it severed ties with its ambulance contractor and became a self-operated public utility model, began to fully mentor the college program. At the same time, SAVERS restyled itself as the University of Richmond Emergency Medical Services, or UREMS.
RAA's CEO, Chip Decker, played a major part in transforming the organization; as chief of a local volunteer rescue squad and an EMT instructor, two decades earlier he'd run the first EMT courses on campus—classes that ultimately led to formation of the university squad.
The partnership with RAA brought with it more advanced equipment, such as duty cell phones to replace the pagers and two-way radios to communicate with responding units and dispatch personnel.
RAA also brought guidance from its medical director, prominent emergency physician Joseph P. Ornato, MD. In 2012, growing relationships with the university police department were cemented into what has now become a seamless working partnership.
Squad Receives New Delivery
In 2013, UREMS has grown far beyond its roots. Original student leader Oliver, now an MD, recently lent his successors some support in the form of a quick response vehicle (QRV) to allow UREMS providers to respond to calls faster and carry more equipment.
"I would never be able to teach my mentors much," says Oliver. "I will never be able to give them as much as they gave me, but I can do that for others who come after me."
The 2013 Ford Escape SE with an EcoBoost engine was purchased in partnership by Oliver, the university and its police department, and was outfitted by RAA as a nontransport BLS emergency vehicle with state-mandated road safety and communications systems. A roof-mounted solar panel keeps battery-powered equipment charged without plugging in.
UREMS is currently composed of 20 student volunteers, who respond to all medical emergencies on campus while classes are in session, totaling about 10,000 hours of volunteer service each academic year. Most of these EMTs are trained in UREMS-sponsored classes, and the resources to provide such classes are another mark of the organization's success. UREMS's budget allocated by the university this year is $14,000, more than 90 times the initial fund given to SAVERS.
With a maximum four-year term for undergraduates, recruitment is a major effort, and UREMS recruiters use word of mouth, the Web and social media to attract new members. Says UREMS Operations Chief Matt Palmisano, "We attempt to target younger students so we can get more years out of them, but we encourage anyone of any college year to apply."
Members must be an EMT-B or higher in Virginia, possess CPR certification and have completed NIMS 100, 200 and 700. New recruits complete three 12-hour ambulance ride-alongs with RAA and a further 12-hour shift in which half the time is spent with a field operations supervisor and the other half in the communications center. On completion of their training, EMTs undergo a clearance process via skills evaluation, a review of SOGs and an overview of how UREMS, URPD and RAA work together.
Post clearance, new EMTs must have 17 weeks' experience and have completed their UREMS Field Training Guide Book and received call evaluations from a UREMS FTO before they are eligible to become a UREMS 1, which is UREMS lingo for AIC. Ongoing professional development maintains skill levels and currency.
UREMS continues to function as a nontransport response group, with the main priorities of initiating care and directing responding transport units to the proper locations on campus. With each new year, members and student leaders contribute more time, energy and ideas, growing a collegiate EMS organization they believe in, and the effort has clearly paid off. The continuing success of UREMS is owed to the members' constant commitment to work with the materials at hand, however limited or abundant, and push hard to build the organization one step at a time.
There is a distinct advantage to having university clubs deliver EMS first response on campuses that can be difficult to navigate and off the beaten track. The longer-term advantage of these clubs is that they are rapidly becoming an inspiration for a new generation of emergency physicians, who may eventually go on to become EMS medical directors. This is a healthy circle of life. Full-time services would do well to visit the NCEMSF website and see if there is a collegiate EMS organization in their locality. The benefits could be life changing for both patients who receive their care and the students who deliver it.
For more on UREMS, visit http://police.richmond.edu/urems/index.html.
Richard Jamesley is president of UREMS, as well as a field operations supervisor. He is a Business Administration major with a concentration in Finance and a minor in Pre-Health Studies. He is the NCEMSF's 2013 National Collegiate EMS Provider of the Year.
Matthew Palmisano is chief of operations and a field operations supervisor for UREMS. He is pursuing a double major in Leadership Studies and PPEL (Politics, Philosophy, Economics and Law), with a concentration in Economics.
Rob Lawrence is chief operating officer of the Richmond Ambulance Authority and a regular contributor to EMS World. He was recently appointed to the EMS World Editorial Advisory Board.