A loud snap, followed by two screams: one from a player, the other from a ref. While working as a supervisor during an indoor soccer game last spring, one of my referees frantically yelled for BCPD. A player had just broken his leg. BCPD, along with Boston College EMS, responded within minutes, following necessary protocol for the traumatic situation. Given that BC does not have an ambulance capable of transporting the patient, BCEMS contacted an outside ambulance company to take the patient to an emergency room. This presented a multifaceted problem: a delayed arrival to the emergency room combined with conflicting opinions between BCEMS and outside EMS personnel, causing the patient more pain, and costing him more money.
According to its website, BCEMS is a “student-run, all-volunteer, quick response, emergency medical service” serving the BC community. In 2012, BCEMS added a non-transporting ambulance that only responds to medical emergencies on campus. Its inability to transport patients to a hospital has proved to be detrimental to the functionality of the emergency response system and to the patients themselves.
During the 2014-2015 academic year, 172 BC students were transported to an emergency room, which incurs an expense of over $1,000. Given that part of a student’s annual tuition funds the supplies used by BCEMS, one would think that this charge would be covered. Unfortunately, because outside agencies—ambulances—are performing the transport, that is not the case
There have been numerous times when outside medical personnel have either undone or redone BCEMS’ work on a patient, as happened in the above case last spring. When the ambulance finally arrived, EMS personnel attempted to redo the splint already provided by BCEMS, which would have added to the cost incurred by the patient. Luckily, the splint was left on as BCEMS advocated for the patient—saving him time, money, and pain.
The comparison of response times really highlights the need for a BCEMS ambulance in order to transport students to emergency rooms. According to Kevin Zirko, BCEMS president and LSOE ’16, BCEMS’ average response time to a medical emergency is approximately 2 to 3 minutes. This is quite short compared to the 7 to 15 minutes that it takes an outside organization’s Basic Life Support (BLS) unit to respond, not to mention that, if the emergency is severe enough, it takes an Advanced Life Support (ALS) unit approximately 15 to 25 minutes—time that could be extremely consequential when treating a patient, leading to additional morbidity or even mortality.
If a medical emergency occurred under our current system, it would take 2 to 3 minutes for BCEMS to arrive, another 5 minutes for personnel to assess and contact an ambulance, and another 10 minutes for that ambulance to arrive. Add on another 15 to 20 minutes for them to treat, load, and transport the patient, and the patient could be 30 to 45 minutes away from an emergency department. The inefficiency is appalling. With St. Elizabeth Medical Center a little over a mile away from the main campus, getting a patient to the emergency department should take responders less than 15 minutes—maximum. It’s only going to be a matter of time before our EMS system comes under scrutiny because of its inability to get emergency transport help to a student in a timely manner. Is it really going to take a serious injury, or even a death, for changes to be made?
If BCEMS had its own transport unit, it would eliminate the need to contact an outside ambulance, cutting down on both time for patient transport and out-of-pocket costs, thereby increasing the system’s efficiency. Transport via BCEMS, however, should not be completely free, as the expenses associated with an ambulance can be quite costly. Not only would BC have to purchase the vehicle (with an approximate cost of $250,000), but it would have to insure and stock it as well. I am proposing that we charge students $500 instead of the $1,000 typically charged by an outside agency, covering the unit’s cost in a little less than three years.
BCEMS needs this transport unit. It will ultimately save patients money and provide necessary and more efficient emergency care for the student body.
Featured Image by The Associated Press