This article was published while I was a journalism student at Boston University's College of Communication, in about 1975 or 1976. It appeared in the university magazine, Commonwealth Monthly Magazine, and reflects my early interest in emergency service!
Last year in Seven Hundred the guest of a BU student awoke with the classic symptoms of a heart attack. Seven Hundred Resident and Emergency Medical Technician (EMT) Jim Mattatall went to the room and called the Infirmary, advising the nurse to summon an ambulance immediately.
Forty-five minutes later, a taxi arrived and took the patient to Beth Israel Hospital.
In another emergency last year, a West Campus student became seriously ill from an overdose of barbituates. His condition was aggravated by drinking alcohol. "Very little first aid was administered before the ambulance arrived," according to a report by Mattatall and another BU EMT, Carl Glidden.
The ambulance did not arrive for at least one half hour.
Summing up the quality of emergency medical care on the BU campus, Mary Eaton of the Office of Residence Life said it all: "We've been very lucky."
Situations requiring life-support first aid have been uncannily sparse in the 15,000-person BU community.
Of over 200 medical calls logged by the BU Police last year, few were of the severity of those already described.
"The lifesaving business is pretty small," said Dr. Samuel Leard, Director of BU's Medical Services.
"There aren't too many true emergencies."
"I see such a potential for things that could happen," countered Mattatall, an SMG sophomore. 'It's a wonder more doesn't go wrong."
BU requires neither those responsible for the 6,000 dorm residents nor the BU police to know advanced first aid, although at the beginning of second semester all full-time Senior Staff members received a one day course in the basics of first aid.
"I can name five people in this dorm who are adequately trained in first aid," said Karl Schneider, a Seven Hundred R.A. “Even if there are other people, the fact that I don't know says something."
"There's no reason why an R.A. shouldn't be ready to save someone's life,' added John Smythe, also a Seven Hundred R.A. “You want to see the first aid kit they gave me?" he asked, as he pulled out a 4" by 6" Johnson and Johnson's Compact First Aid Kit — "and a thermometer," he added.
An overview of responsibility within the dorms at night shows that the duties of the Dorm Directors and R.A.s are spread thin. In Seven Hundred, for example, one R.A. is officially on duty in each of the three towers, while one Senior Staffperson is available to the 1,650 residents. An identical situation is true in the West Campus complex of 1,200 persons.
On Bay State Road, one R.A. is on duty in Shelton Hall, in Myles Standish Hall, and in Towers, while one Senior Staffperson from one of those three dorms must cover the five block area.
Within the small dorm system, clusters of dorms on Bay State Road and the Buswell Street area have one person on duty for each cluster.
Therefore, although off-duty R. A.s and Directors may be available in an emergency, those on duty are the only persons guaranteed to be in the dorm.
When a person stops breathing, he has three to five minutes before irreparable brain damage from lack of oxygen begins. If the R.A. on duty is five floors away and no one present knows first aid, precious minutes can be lost finding help. And yet, although time is a crucial factor in many emergencies, no lists of those R.A.s and other students who do know first aid have been compiled and distributed for posting on R.A. doors.
Right now, emergency procedures are, at best, unorganized and full of red tape. "People generally use their common sense in an emergency," said Lee Giles, Co-Director of Myles Standish Hall.
An R.A. is usually the first "responsible" person on the scene. He or she must evaluate the situation to the best of his or her ability, and then call the Clinic. The Clinic must then decide whether or not an ambulance is needed based on that information.
Until this year, the Clinic would not accept calls from R.A.s; first a Senior Staffperson had to be notified, and that person then had to call the Clinic. This required more time, and more distance was often placed between the patient and help, since the Senior Staffmembers sometimes called the Clinic without seeing the patient.
“This third party business of getting a phone call from a person who hasn't seen the patient drives me right up the wall," said Leard. Yet, according to Bill Gaine, Director of Claflin Hall, "It was a big hassle to get calls from R.A.s accepted.”
"Letting R.A.s call the Clinic directly is a vast improvement,” said Steve Tiernev, Director of Seven Hundred.
The BU Police are usually also notified of a medical emergency. They used to transport some less seriously ill or injured patients to the Clinic or hospital themselves. "The BU Police are now very reticent to do anything like that," said Eaton.
Their “first responder" status has been severely limited by a stringent Massachusetts law governing medical emergencies (Mass. General Law, chapter 111C). “First responders" are people such as police, firemen, and ambulance workers who are the first to reach an emergency.
“If the BU police insist on transporting sick people," said Mattatall, "They'll need to be trained as emergency medical technicians and have an ambulance.”
Two patrolmen have now reportedly taken the 80-hour EMT course, and will be teaching first aid to other BU police.
First aid is among several “specialty" courses offered to R.A.s during their pre-semester and in-service training. Other courses include such topics as sexuality training and career counseling, and R.A.s choose to learn one of these specialties.
“These 'brush' sessions are a joke," said Mattatall, who taught the 6-hour pre-semester course. "You can't teach someone first aid in a few hours.”
“I'd like to see R.A.s take an established first aid program such as the Red Cross Standard First Aid course so there would be a common base of ability," he said. “This way, the university would know that all R.A.s have a certain level of first aid knowledge under their belt."
Sentiments among Dorm Directors, however, vary concerning a need to improve BU's emergency medical system. Some feel confident in the ability of their staff to handle an emergency; others say the lack of training makes them nervous.
"I don't think most of the staff is competent in first aid," said Tierney, whose 42 R.A.s and 5 Senior Staffpersons are responsible for the 1,650 Seven Hundred residents. "There is no organized network of people who know first aid that we can call in an emergency," he said.
On the other hand, Joyce Valesquez, Director of Sleeper Hall, feels confident about her 11 R.A.s in that dorm of 460 students. "They're pretty good kids," she said. "They know what to check for and when not to move someone. She could not say, however, what training her R.A.s have had other than one first aid lecture last fall.
In Rich Hall, has a student-to-R.A. ratio similar to Sleeper's, Director Pam Cleghorn said, "l feel fairly confident there are enough R.A.s trained that one of them would be around. However, she has no list of trained people and their telephone numbers available to call for help before the ambulance arrives.
“The lifesaving business is pretty small, there aren’t too many true emergencies.”
"A lot of R. A.s from other floors feel their training is inadequate," said Claflin Hall R.A. and nursing student Linda Collins. "They say they'll be down in my room quick if something does happen." But what if she is not there?
Some directors said they do not like to think about the possibility of an emergency. They say they have had good luck getting outside help on time in the past.
Anita Tripodi, Director of Longfellow Hall's 250 students and nine R.A.s, said, ' 'I'm sure R.A. training is minimal. Most things only need common sense in what to do." Asked what she would do in an emergency, she said, "Hopefully, I won't get in a position where I would need to make a judgement."
"We've always been able to get help," said Jackie Baxter, Co-Director of Towers. "I would be hesitant and hard-pressed to take care of an emergency," said the woman in charge of 500 students and eight R.A.s.
What can be done to improve BU's emergency medical care system? One obvious solution is to require advanced first aid training of the people responsible for dormitory students.
Cleghorn agrees with the need for required training. "l would like it, and I know my R.A.s would, too,' she said. "They should develop something relevant to the unique nature of a dorm."
A beginning has been made in this direction. This semester Mattatall, a qualified Red Cross instructor, is teaching the 16-hour Standard First Aid course plus several hours of in-struction in cardio-pulmonary resuscitation (CPR) to a group of R.A.s who represent many of the dorms. He said the course will stress injuries most likely to occur in the dormitories.
Gaine draws the line at required training for Dorm Directors. "I'm not convinced that Directors should be required to have training," he said. "The Dorm Director is seldom the first one there.”
A second solution to the problem, according to Mattatall, is to organize various awareness programs within the dorm communities. "Residence Life is aware of the situation, and is working on it," he said. According to him, their biggest concern is to find the best balance between informing people of what to do in an emergency and the cost involved.
“It’s a wonder more doesn’t go wrong.”
Some other proposals include giving R.A.s better first aid equipment and setting up first aid stations in the large dorms.
Dr. Leard supported the community awareness program idea. He said, "I've said it before and I'll say it again, but it won't do any good. If there were a first semester required course for Freshmen on accident prevention and health care, it would be the best way to get the community involved in the problems that exist."
A third solution to BU's emergency medical situation is in their prevention by eliminating various physical difficulties and dangers now present. One tragic example was last fall when freshman Collin White fell to his death from the Seven Hundred escalator.
Mattatall pointed out additional problems. He said that if someone in Seven Hundred had to be carried out lying flat, he would have to be carried down the stairs, since the elevators are too short for a fully-extended ambulance stretcher.
Another proposal written last spring by Mattatall and Glidden dealt with instituting an on-campus ambulance. Right now, BU contracts the services of two private ambulance companies. The hope is that either Fallon Ambulance Service or Reagan Ambulance Service, both operating out of the Allston/Brighton area, will be available if the other is on another call.
The average wait for these ambulances ranges from 15 to 20 minutes, although, as in Collin White's case, they can arrive within five minutes. Traffic along Commonwealth Avenue is a large factor.
“I've had it take up to 45 minutes to get from one end of BU to the other," said Leard. "It doesn't really matter where you're coming from.”
Emergency Medical Technician Jim Mattatall
Another delay factor is the intra-university red tape. "One flog in the system," said Shelton's Graduate Assistant David Kennedy, "is that sometimes BU police will send a car to assess the situation, and then they'll call an ambulance. That strikes me as unnecessary.”
An on-campus ambulance is not inconceivable, since many communities smaller than the BU dorm population run them. Other colleges, notably the Universities of New Hampshire and Vermont, have their own campus ambulances, run by volunteers with financial assistance from the universities.
“There is no organized network of people who know first aid that we can call in an emergency.”
Reactions to the BU ambulance proposal varied. Kennedy responded positively. "Absolutely. I think it's an excellent idea," he said.
In a thoughtful reply, Tierney said, "Of course the more you can do the better. I'm not sure a university ambulance system is warranted. If it could be done, it would be marvelous. But there are a lot of considerations."
Some of the considerations include whether a BU ambulance crew would be paid workers or student volunteers, how people could get the required EMT training, and how an ambulance would be funded. According to law, the ambulance would have to be available 24 hours a day, seven days a week.
Most people interviewed were concerned with whether an ambulance staff would be paid or volunteer. "If you get something going," says Leard, ' 'of course people will be interested if there's pay involved."
“The emergency medical services at Boston University are grossly inadequate.”
"One of the problems with volunteer situations is that it's fine, until things like exams and school work become more important," said Cleghorn.
At any rate, according to Mattatall, ' 'Carl Glidden and I have had no official feedback from the university." And Mary Eaton, who supports the idea, said that the proposal will probably not go through. ' 'It's too expensive," she said.
According to the proposal, it would cost $14,750 to start a full-service and purchase a fully equipped ambulance, and $1,700 in annual expenses if the service was staffed by volunteers.
Director of BU’s Medical Services Dr. Samuel Leard
As it stands now, BU is still unorganized and unprepared for emergencies. In the introduction to their ambulance proposal, Glidden and Mattatall wrote, ' 'In our professional opinion, the emergency medical services at Boston University are grossly inadequate."
Many of these inadequacies could be easily amended with little cost to the university. One improvement would be to post the names and numbers of trained first aiders on R.A. doors and dorm offices.
All this is especially important to the well-being of the University because, as Leard pointed out, "the number one cause of death for people under 36 in America is accidents."