Medical incidents on board trains

[dk1]

Of all the (good) reasons for not offering the course, how typical of the railway to choose that one!

Clerical & station staff still went on it. It didn’t surprise me if I’m honest.

Nothing to stop you doing it in your own time.

Couldn’t be bothered. Lost interest after that.

 

[Adam Williams]

There are good reasons why not. From the risks of something going wrong to the possibility of staff being accused of assault, you can imagine any number of unpleasant scenarios. Generally it’s always going to be best to get the emergency services to someone asap. DOO only makes that harder of course.

No, I don't think there are any good reasons not to attempt to perform CPR and/or try to use an AED (in e.g. a public space - appreciate most trains don't carry them, which is a shame) when there's been a cardiac arrest and the patient is unresponsive. Should the priority be to alert the emergency services? Absolutely! Should that preclude any intervention whatsoever? No.

Bystanders performing timely CPR is one of the best predictors of a positive outcome in a cardiac arrest. This should be common sense.

Regarding liability/concerns of getting sued for assault/battery: this is the exact reason the Social Action, Responsibility and Heroism Bill was passed - to try and protect good samaritans. This isn't America where everyone is sue-happy and the courts are often unreasonable.

 

[LancasterRed]

Also if this was a longer distance service rather than a more local one I presume the driver would seek permission to be able to make a stop at an earlier station on route if possible rather than waiting until the next scheduled station?

Absolutely, have travelled on an Avanti service when it was still Virgin that was forced into making an unscheduled call at Stafford to allow an ambulance to meet a passenger.

Believe similar happened at Euxton Balshaw Lane in the Virgin days.

 

[43066]

No, I don't think there are any good reasons not to attempt to perform CPR and/or try to use an AED (in e.g. a public space - appreciate most trains don't carry them, which is a shame) when there's been a cardiac arrest and the patient is unresponsive. Should the priority be to alert the emergency services? Absolutely! Should that preclude any intervention whatsoever? No.

Bystanders performing timely CPR is one of the best predictors of a positive outcome in a cardiac arrest. This should be common sense.

Regarding liability/concerns of getting sued for assault/battery: this is the exact reason the Social Action, Responsibility and Heroism Bill was passed - to try and protect good samaritans. This isn't America where everyone is sue-happy and the courts are often unreasonable.

The reasons are as I’ve set out above. You are entitled to disagree or course, but that doesn’t make them invalid. As @Skymonster said it’s perfectly reasonable for people not to want to get involved beyond calling an ambulance. Bystanders choosing to get involved are in a different position to railway staff on duty who are not medical staff and cannot reasonably be expected to take this responsibility on. There is absolutely a risk of allegations being made, especially in the situation of a lone male guard and a female passenger. That alone would be enough to put me off! The social action bill you mentioned isn’t a complete get out of jail free card.

99 times out of a hundred when people are ill on trains it’s self inflicted and they’ve taken drugs and/or drunk themselves into a stupor.

 

[LowLevel]

Last night I departed my train and as I was walking away from the station heard a bit of a commotion around someone being ‘passed out’ but didn’t think anything much of it at the time (just thought it was a bit of Friday night drama as to someone who may have had a little too much to drink)

Looked on Railboard later on and it showed ‘delayed due to ambulance crew attending a situation’ and it eventually departed around half an hour late

It got me thinking are train crew trained in any form of first aid as depending on when and/or where such an incident occurs an ambulance could be quite a while away, or are they just expected to call 999?

Also if this was a longer distance service rather than a more local one I presume the driver would seek permission to be able to make a stop at an earlier station on route if possible rather than waiting until the next scheduled station?

In an emergency you don't seek permission to stop, you come to an informed decision with all parties and you stop where you need to. The traincrew will always have the final say though.

I don't really get the idea that someone might see another person or animal in distress and not do their best to sort it out - these things have a habit of just falling on you to sort out without warning.

Just before Christmas one of our drivers got stopped at a red signal at a rural block post and they couldn't raise the signaller. Control asked them to investigate and they walked forward to the box where they found the signaller who had collapsed having had a heart attack.

Between the driver, the MOM who was dispatched and the signaller from the next box who locked up and drove over they have been credited with saving the bobby's life - you just can't plan for these things.

I've dealt with all sorts of silly stuff over the years and I find it easiest just to get on with it and worry about the consequences later.

 

[jmh59]

Nothing to stop you doing it in your own time.

It needs to be backed by insurance really rather than just something you do yourself in order to be a first aider in a work context. I did the 3-day course several times over the years while at work (office based) and was insured to act. First aid can go horribly wrong and, regardless of intention someone 'abusing' (effectively!) someone else can end up in court, or, worse coroners court. If acting you really also need witnesses and say what it is you are doing etc.

 

[Dai Corner]

Isn't the best course of action to phone the ambulance service and follow whatever first aid instructions they give? Nobody should ever be criticised for doing that, whatever the outcome.

Trains should certainly carry AEDs (Automated External Defibrillators). Even my regular pub has one, and I hope somebody uses it if I suffer a cardiac arrest there. I have had one before but fortunately I was in hospital at the time with plenty of highly trained people around so I'm still here to tell the tale.

 

[Runningaround]

Totally agree… Because of these risks, in my workplace there is no way I’d go near getting involved these days especially when it involves interfacing with the public.

The myths of helping someone is just that they are myths attend a first aid course and they'll blow a lot of fake news out for you. including ''The risk of an assault charge'' , not one person has ever been convicted for assault while attempting to save another's life and I guarantee even a saving a life from an attempted suicide you will not be done for preventing the outcome.
And do you think the training will be only of use on a train or in work? Just think your relative collapses in front of you the first aid course can be the difference to you just watching helplessly or saving them.

 

[43066]

The myths of helping someone is just that they are myths attend a first aid course and they'll blow a lot of fake news out for you. including ''The risk of an assault charge'' , not one person has ever been convicted for assault while attempting to save another's life and I guarantee even a saving a life from an attempted suicide you will not be done for preventing the outcome.

In this day and age the risk of being accused of sexual assault is not a myth or fake news at all. As for “I guarantee…” how can you possibly make such a statement?

 

[Runningaround]

The reasons are as I’ve set out above. You are entitled to disagree or course, but that doesn’t make them invalid. As @Skymonster said it’s perfectly reasonable for people not to want to get involved beyond calling an ambulance. Bystanders choosing to get involved are in a different position to railway staff on duty who are not medical staff and cannot reasonably be expected to take this responsibility on. There is absolutely a risk of allegations being made, especially in the situation of a lone male guard and a female passenger. That alone would be enough to put me off! The social action bill you mentioned isn’t a complete get out of jail free card.

99 times out of a hundred when people are ill on trains it’s self inflicted and they’ve taken drugs and/or drunk themselves into a stupor.

I hope your not in a position where you need First Aid and if any are around they don't just pass it off you being drunk. Would you be happy if your wife/child was in trouble and all stood around watching them suffer, worried incase they got sued for assault.

In this day and age the risk of being accused of sexual assault is not a myth or fake news at all. As for “I guarantee…” how can you possibly make such a statement?

You won't get sued for attempting to save a life.

 

[43066]

I hope your not in a position where you need First Aid and if any are around they don't just pass it off you being drunk. Would you be happy if your wife/child was in trouble and all stood around watching them suffer, worried incase they got sued for assault.

You’re still ignoring the risk of allegations being made - this is part of the reason why staff do not provide first aid. That’s the world we live in today unfortunately.

If I was in a supermarket or a restaurant and had a heart attack would I expect the staff to be trained in first aid and take responsibility for assisting me? Of course not. It would hardly be fair to expect them to. The railway is no different. The best thing for staff to do is alert the emergency services and/or ask if there’s anyone on board who is medically trained and knows what they’re doing.

You won't get sued for attempting to save a life.

With all due respect that’s a baseless statement. You can’t possibly predict what might happen in any given situation.

 

[RailWonderer]

I was on a VT service back from Manchester a few years ago and it was Crewe non stop to MK but they made an emergency stop at Tamworth to release a passenger onto an ambulance who was very ill. Guard and driver kept quiet about the whole thing until we had departed, so no one knew why we were stopping. I was in first so had no idea what was going on and chatter didn't spread.

 

[Runningaround]

You’re still ignoring the risk of allegations being made - this is part of the reason why staff do not provide first aid. That’s the world we live in today unfortunately.

If I was in a supermarket or a restaurant and had a heart attack would I expect the staff to be trained in first aid and take responsibility for assisting me? Of course not. It would hardly be fair to expect them to. The railway is no different. The best thing for staff to do is alert the emergency services and/or ask if there’s anyone on board who is medically trained and knows what they’re doing.



With all due respect that’s a baseless statement. You can’t possibly predict what might happen in any given situation.

Can you wear a badge declaring ''I will not help you'' so I can decide whether to you should be helped by me. I mean if this is how you think my time would be better used carrying on incase you sued me for giving you a kiss of life.

You’re still ignoring the risk of allegations being made - this is part of the reason why staff do not provide first aid. That’s the world we live in today unfortunately.

If I was in a supermarket or a restaurant and had a heart attack would I expect the staff to be trained in first aid and take responsibility for assisting me? Of course not. It would hardly be fair to expect them to. The railway is no different. The best thing for staff to do is alert the emergency services and/or ask if there’s anyone on board who is medically trained and knows what they’re doing.



With all due respect that’s a baseless statement. You can’t possibly predict what might happen in any given situation.

Attend a first aid class they'll explain, there are no financial benefits to being trained, but I'd rather risk being sued than seeing someone die.

 

[jmh59]

I hope your not in a position where you need First Aid and if any are around they don't just pass it off you being drunk. Would you be happy if your wife/child was in trouble and all stood around watching them suffer, worried incase they got sued for assault.


You won't get sued for attempting to save a life.

If someone has fallen ill and caught and broken their neck on their way to the floor and you helpfully drag them back to their seat paralysing them for life, rest assured you will be sued.

OTOH if someone is lying with no pulse the situation is different because whatever you do you're (probably) not making it worse. But do you know how to check for a pulse, do you know how to elicit a response from someone just messing about, do you know how to put someone in the recovery position?

Personally I think that basic life saving should be taught to everyone regardless of whether they ever use it... (having said that my first aid training and involvement is decades ago now so what do I know)

 

[Dai Corner]

If someone has fallen ill and caught and broken their neck on their way to the floor and you helpfully drag them back to their seat paralysing them for life, rest assured you will be sued.

Citation needed

 

[Gloster]

You won't get sued for attempting to save a life.

It may not have happened, although I have my doubts about that (*), but who wants to be the first? I know of one case where somebody was arrested by the police for attacking an elderly man and hauled off to the police station. It was only when CCTV on a nearby property was examined (this was in the days when such CCTV was much less common) that it became clear that the old man was the attacker. The sick (who may not be sick) person may not be able to give an accurate account or, for good or ill reasons, gives an inaccurate one and/or a third party does the same and the helper may be in trouble. They may avoid legal consequences, but in this day and age there will be a big black mark against them with their employer.

* - At least to the extent of an actual criminal conviction.

EDIT: Just to be clear: I am not advocating not helping. I think you should always help, but I think that this country is still moving towards a USA style litigious culture and you need to be careful.

 

[43066]

Can you wear a badge declaring ''I will not help you'' so I can decide whether to you should be helped by me. I mean if this is how you think my time would be better used carrying on incase you sued me for giving you a kiss of life.

This is a little childish and still not addressing the points I’ve raised. It’s not about being uncaring but simply recognising that staff would be put into an impossible position if they were expected to provide medical treatment. That’s what we have ah ambulance service for after all. As I said before you wouldn’t expect restaurant or supermarket staff to be first aid trained would you!?

Attend a first aid class they'll explain, there are no financial benefits to being trained, but I'd rather risk being sued than seeing someone die.

I’m pretty sure they won’t explain that first aid training disapplies the civil and criminal law. If they do they’ll be talking nonsense.

It may not have happened, although I have my doubts about that (*), but who wants to be the first?

Quite!

 

[Runningaround]

This is a little childish and still not addressing the points I’ve raised. It’s not about being uncaring but simply recognising that staff would be put into an impossible position if they were expected to provide medical treatment. That’s what we have ah ambulance service for after all. As I said before you wouldn’t expect restaurant or supermarket staff to be first aid trained would you!?



I’m pretty sure they won’t explain that first aid training disapplies the civil and criminal law. If they do they’ll be talking nonsense.



Quite!

You'd stand watching or walk away on seeing a child having a fit or bleeding because you might get sued if you touch them. Tell me when anyone has been sued for helping?

This is a little childish and still not addressing the points I’ve raised. It’s not about being uncaring but simply recognising that staff would be put into an impossible position if they were expected to provide medical treatment. That’s what we have ah ambulance service for after all. As I said before you wouldn’t expect restaurant or supermarket staff to be first aid trained would you!?



I’m pretty sure they won’t explain that first aid training disapplies the civil and criminal law. If they do they’ll be talking nonsense.



Quite!

The myths your alluding to do get brought up in First Aid courses by the instructor, its to counter nonsense like yours. But then you wouldn't be at one. Yet I would certainly be annoyed should it was you I helped a child wouldn't have been given any considerations should they need help off you, I mean they might sue you.

It may not have happened, although I have my doubts about that (*), but who wants to be the first? I know of one case where somebody was arrested by the police for attacking an elderly man and hauled off to the police station. It was only when CCTV on a nearby property was examined (this was in the days when such CCTV was much less common) that it became clear that the old man was the attacker. The sick (who may not be sick) person may not be able to give an accurate account or, for good or ill reasons, gives an inaccurate one and/or a third party does the same and the helper may be in trouble. They may avoid legal consequences, but in this day and age there will be a big black mark against them with their employer.

* - At least to the extent of an actual criminal conviction.

EDIT: Just to be clear: I am not advocating not helping. I think you should always help, but I think that this country is still moving towards a USA style litigious culture and you need to be careful.

I'd gladly go to court for helping someone out. What would the charge be ''Guilty of assault'' you stopped them bleeding to death by touching them?Should I put in a counter claim for my blood stained T-Shirt?

 

[Ashley Hill]

. As I said before you wouldn’t expect restaurant or supermarket staff to be first aid trained would you!?

From what I’ve seen most supermarkets have a least one first aider in the store. Given sharp knives and hot things in the kitchen I’d be surprised if a restaurant didn’t have a person with first aid knowledge (doesn’t mean they do though).
Also a little knowledge could be dangerous and make things worse. It’s been 35yrs since I had to attend a FA course and so much has changed,you need to keep up to date.

 

[Runningaround]

When a call for ''A Doctor'' gets made and they attend do they get there fare reimbursed or at least a significant goodwill gesture off the company.
In that matter do Police Officers get any rail travel benefits they do help out if off duty on board? I see the military get benefits from travelling in uniform or by showing some i.d.

 

[Ashley Hill]

When a call for ''A Doctor'' gets made and they attend do they get there fare reimbursed or at least a significant goodwill gesture off the company.
In that matter do Police Officers get any rail travel benefits they do help out if off duty on board? I see the military get benefits from travelling in uniform or by showing some i.d.

I’ve always taken the names and addresses of people who have answered such a call and aided. The two off duty nurses who attended an awful incident on my train both received a complimentary 1st class ticket from the company.

 

[SCDR_WMR]

My TOC does not do first aid courses for train crew based, according to them, on insurance grounds. They have been requested many times.

We are expected to attend, call for help (signaller/control/medical assistance onboard) and go from there. I have given minor first aid treatment as I am happy with how to do it.

If a passenger needed urgent help that I wasn't sure what to do, I would absolutely call 999 first (have done previously) and do what they tell me. It doesn't not fall under Duty Of Care to administer first aid without knowing what to do/not to do. We also have St Johns App on our work phones which are fairly useful for minor and major injuries.

I would feel great guilt causing somebody harm through my actions or lack of, regardless of intent.

I do think AEDs onboard would be brilliant as cardiac issues are somewhat common.

 

[Dr Hoo]

Back in BR's day First Aid training was generally voluntary in my experience. I attended my first 'railway' course in my own time. The instructors were volunteers too. I well remember the competitions. Obviously you need to keep skills refreshed and up to date and later on some of this was allowed for in work time when I had an office job.

I 'had to' (chose to?) use my skills on a number of occasions, on station and on train. Also outside the railway - road accidents and in social settings. Never regretted it. Never been criticised for it.

First Aid isn't a magic bullet. I've had two people still 'die on me' despite administering CPR but you've got to try. Other interventions have had a happier outcome.

Things like mobile phones and availability of AEDs have improved the general nature of response in many ways.

My personal view is that training (and competency) should be a job requirement for front line customer contact staff including 'guards' and at least someone on shift at stations. For single-staffed stations this would obviously mean 'everybody'. Nevertheless I do realise that this would significantly constrain the talent pool and that this is the sort of thing where you can't really force people to intervene.

Just my two-penn'oth.

 

[Gloster]

To my mind there is unlikely to be a problem if the person is clearly sick or injured, either then in the presence of witnesses or later. The difficulty is if they are not, they might be drunk, for example, and there are no other witnesses able to back you up. Other witnesses, if there are any, may only have seen half the story and could even give an embroidered version of it. We know that people will often stick to seriously damaging (to others) lies out of a wish not to be seen to have made a mistake.

You are on a train and the only other passenger in your coach is a young woman who suddenly gasps, falls to the floor and lies still. You go to help, realise that she is drunk, but stay to help her get up again. As you are helping her she suddenly loses it and starts screaming at you and calls you a pervert, etc. This attracts passengers from the next coach and she gabbles out an accusation of molestation. What happens next?

 

[Llanigraham]

It needs to be backed by insurance really rather than just something you do yourself in order to be a first aider in a work context. I did the 3-day course several times over the years while at work (office based) and was insured to act. First aid can go horribly wrong and, regardless of intention someone 'abusing' (effectively!) someone else can end up in court, or, worse coroners court. If acting you really also need witnesses and say what it is you are doing etc.

This sort of "question" comes up on every First Aid Course I have done and is totally incorrect, even for an untrained person.
As long as the person has used common sense and has acted reasonably they cannot and will not be taken to Court. That has been tested and advice gained by ALL the major First Aid suppliers in the UK. As has been stated this is saferguarded under the legislation mentioned previously.

 

[SCDR_WMR]

To my mind there is unlikely to be a problem if the person is clearly sick or injured, either then in the presence of witnesses or later. The difficulty is if they are not, they might be drunk, for example, and there are no other witnesses able to back you up. Other witnesses, if there are any, may only have seen half the story and could even give an embroidered version of it. We know that people will often stick to seriously damaging (to others) lies out of a wish not to be seen to have made a mistake.

You are on a train and the only other passenger in your coach is a young woman who suddenly gasps, falls to the floor and lies still. You go to help, realise that she is drunk, but stay to help her get up again. As you are helping her she suddenly loses it and starts screaming at you and calls you a pervert, etc. This attracts passengers from the next coach and she gabbles out an accusation of molestation. What happens next?

You'd back off, speak to control and do a report before end of shift. Call BTP if really needed. The onboard CCTV should show fairly clearly what you did.

 

[Gloster]

You'd back off, speak to control and do a report before end of shift. Call BTP if really needed. The onboard CCTV should show fairly clearly what you did.

And if you are in a CCTV blind spot?

 

[SCDR_WMR]

And if you are in a CCTV blind spot?

There are very few, toilets being the main one. I would get my driver to assist, or platform staff if we're at a staffed station. Or, if not classes as an immediate risk, get BTP to assist at next station but that could be a long wait.

 

[Runningaround]

And if you are in a CCTV blind spot?

Do you honestly think like you do in an emergency? First thought ''Will I get sued for helping'' Do you consider the worst of others at first, stand watching, contemplating, wondering ''will I get in trouble'' for doing the right thing. If we all were like you and stood around or ignored you or your partner/child would you be happy.
I'd sooner take the chance and help first. I wont stand contemplating what to do you might need to act quickly.
If I become the only person to ever get arrested for giving first aid and charged i'll deal with this extremely unlikely scenario. If the parent sues me for sexual assault after giving there child the kiss of life. I still won't be wishing i'd left them in agony and failed to help.

 

[Gloster]

Do you honestly think like you do in an emergency? First thought ''Will I get sued for helping'' Do you consider the worst of others at first, stand watching, contemplating, wondering ''will I get in trouble'' for doing the right thing. If we all were like you and stood around or ignored you or your partner/child would you be happy.
I'd sooner take the chance and help first. I wont stand contemplating what to do you might need to act quickly.
If I become the only person to ever get arrested for giving first aid and charged i'll deal with this extremely unlikely scenario. If the parent sues me for sexual assault after giving there child the kiss of life. I still won't be wishing i'd left them in agony and failed to help.

Now you have got that off your chest, read the last sentence of #46.