GTR TL disruption 9/2/18

Due to passenger being taken ill with a 'spinal' injury whilst ON a train at STP?

90 minutes Block for the core and chaos ensuses.

One wonders what on earth went on here....

I won’t go into too much detail about the nature of the passenger injury, but the injury was probably the worst-case scenario in terms of its type and the timing.

Not that this is any excuse for any flaws handling the disruption, of which there were some, which could actually become quite valuable learning points (should there be any energy to do the learning - and there should be).

For example, it turned out to be a bad idea to end up blocking up Farringdon-Kentish Town northbound by terminating trains at Kentish Town, which caused fairly lengthy queues whilst platforms were cleared. In turn, this meant that it took ages to implement bidirectional working on the Northbound line through St Pancras (due to trains being in the way), which otherwise should’ve worked reasonably well.

But another root cause of that congestion was that the first train stranded behind the train with the ill passenger was sent back to Kentish Town to terminate - but the driver expected to go back through the Core, as they hadn’t been advised to terminate the train, so they ended up changing ends twice at Kentish Town as well.

It was also apparent that London Ambulance were well out of their depth when it came to having a plan to respond properly - no appropriate resources turned up to move a potentially seriously injured person from a busy railway line for a very long time indeed. Once the necessary resources did arrive, it took them a grand total of about 10 minutes to actually assist the casualty.

Did the passenger fall within the train or on the platform?

Or did they fall at all?

There will be have been circa 100,000 people severely disrupted last night and I think some explanation is due for those who missed flights and connections at STP.

For 24TPH to work then for the core stations surely STP, Farringdon and City can't rely on the 999 service to arrive, are there not emergency first aiders present?

Downthelane said:

Did the passenger fall within the train or on the platform?

Or did they fall at all?

There will be have been circa 100,000 people severely disrupted last night and I think some explanation is due for those who missed flights and connections at STP.

For 24TPH to work then for the core stations surely STP, Farringdon and City can't rely on the 999 service to arrive, are there not emergency first aiders present?

Click to expand...

I am a first aider at work and the advice I was given during my recent requalification was if your not comfortable or unsure how to deal with an injury make the person comfortable and await professional help ie an ambulance - so your answer is there may well have been first aiders present but they didnt know how to deal with the injury.

That's quite understandable and I am not suggesting that anyone without a paramedic qualification would be responsible. However for a station the size of STP and KGX next door are both relying on emergency first aiders rather than FULL TIME paramedics? In that case it's always going to be a 999 call.

Do also remember that if it is a spinal injury, and they are responsive, you do not move the casualty - you keep their head still and wait for an ambulance (with a spinal board) to turn up. If they are unresponsive, it is slightly different, but still much the same effect in that you aren't going to be doing much operationally until the ambulance arrives.

Granted but there is still the mystery of how you can have a "passenger taken ill on a train" situation when it's stated as a spinal injury.

Spinal injuries are caused by an accident, it's unlike a heart attack or aneurism.

So was it a fall in the train? If so why the mystery?

999 was called straight away. Medical assistance was there very, very quickly but the individual could not be moved. Took a while for the full crew with necessary kit to get there due traffic etc. It was Friday night of half term, one of the busiest of the year. Without going into too much detail, it was a pre-existing condition which deteriorated whilst on board. Nothing to do with the 700 seats.

I would be interested to understand how LU would have handled such a situ, so if any members with knowledge of LU practice for dealing with spinal injuries could PM me, that would be great.

Bald Rick said:

I would be interested to understand how LU would have handled such a situ, so if any members with knowledge of LU practice for dealing with spinal injuries could PM me, that would be great.

Click to expand...

If the person was on the trains and the doors able to be closed, the train would have been worked forward to a sidings (or other station where it can be moved out of the way). However, if the ambulance service were said to only be a few min away then the train would stay where it is. Also worth mentioning that LU has a Network Incident Response team that is comprised of a BTP Medic and senior operational manager that are “blue lighted” to incidents affecting the train service. In their vehicle they carry things such as the “Vac mat” that can be used to safely remove people from trains.

It also depends on where the source of information about someone with a spinal injury came from; staff receive training on challenging people who claim to have medical qualifications.

Typical risk-averse reaction by a corporate body fearful of being sued in case they make the condition worse. Why does the train have to stop dead when somthing like this happens? Run it non-stop to KT or Elephant where access is better and there's a route round for other services. Given the time it takes the London Ambulance Service to get to a passenger "taken ill" they could just as easily be sent to KT or Elephant whilst the train continues. Isn't it better to move the ill passenger quickly on the train to meet up with the ambulance rather than maroon everyone plus the ill passenger on a train in a sub-surface station?

It strikes me that there are a lot of people commenting here who have no first aid training or experience.

It is quite possible to fall less than 6" and potentially have a spinal injury. If there is ANY doubt then the casualty is NOT moved until all the correct equipment and personnel are present. And I'm afraid a "vac mat" may not be the correct item to deal with a potential spinal injury; you need a spinal board.

As far as I can see there are very few work places that require staff to be trained to Paramedic standard, and certainly not railway stations. Considering that to train a paramedic takes several years I cannot see any railway company paying for that, and there is no legal requirement for them to do so. The standard 5 day full First Aid At Work course covers spinal injury training in the detail that is required in most instances.

As for moving the train, yes it may be applicable in some circumstances, but since we don't have the full details here it is not correct to question why it was not done. I can certainly think of situations where I would think it unsuitable. If it delays Joe Public tough, someone's life and mobility is at stake and that takes precedent.

And for information, I have had extended first aid training including spinal injuries and vehicle extraction in the motor sport agenda, where the potential of this injury is common.

The Box Photter said:

Typical risk-averse reaction by a corporate body fearful of being sued in case they make the condition worse. Why does the train have to stop dead when somthing like this happens? Run it non-stop to KT or Elephant where access is better and there's a route round for other services. Given the time it takes the London Ambulance Service to get to a passenger "taken ill" they could just as easily be sent to KT or Elephant whilst the train continues. Isn't it better to move the ill passenger quickly on the train to meet up with the ambulance rather than maroon everyone plus the ill passenger on a train in a sub-surface station?

Click to expand...

A paramedic was there very quickly. They are the qualified individual, and what they say rules in these circumstances. Would you overrule a paramedic?

The Box Photter said:

Typical risk-averse reaction by a corporate body fearful of being sued in case they make the condition worse. Why does the train have to stop dead when somthing like this happens? Run it non-stop to KT or Elephant where access is better and there's a route round for other services. Given the time it takes the London Ambulance Service to get to a passenger "taken ill" they could just as easily be sent to KT or Elephant whilst the train continues. Isn't it better to move the ill passenger quickly on the train to meet up with the ambulance rather than maroon everyone plus the ill passenger on a train in a sub-surface station?

Click to expand...

I don’t think that’s necessarily fair to say; we don’t know where this person fell ill and what the initial response was from first responders. It’s most likely one of those things where everyone involved has tried to do what they believe to be best for the person involved, and without any clear guidance from the operator in question as what to do, decided it’s best to stick with what they thought to be the safest option.

The Box Photter said:

Typical risk-averse reaction by a corporate body fearful of being sued in case they make the condition worse. Why does the train have to stop dead when somthing like this happens? Run it non-stop to KT or Elephant where access is better and there's a route round for other services. Given the time it takes the London Ambulance Service to get to a passenger "taken ill" they could just as easily be sent to KT or Elephant whilst the train continues. Isn't it better to move the ill passenger quickly on the train to meet up with the ambulance rather than maroon everyone plus the ill passenger on a train in a sub-surface station?

Click to expand...

I don't think it's fair to say access is better at Kentish Town, let alone Elephant and Castle with it's narrow curved stairs..! Sadly in incidents like this sometimes it can be very difficult to predict just how long the Emergency Services will take, and it appears in this case everyone has indeed stuck with the safest option. For the record there is a route round at St Pancras too using Single Line Working which it appears was used. Yes, it caused disruption but sometimes hindsight is a wonderful thing...

As a side question: would you want to be responsible for making the call to send the train further down the line like you've suggested, and then find out something has happened as a result that has made the ill person worse?

I'm currently suffering from a condition that might cause me to "fall ill" on a GTR train (or tube) without warning. So, I've taken th decision not to attempt to travel for the moment, having discussed the situation with my (very understanding) employer. As Spock so famously said, "The needs of the many outweigh the needs of the few, or the one". 100,000+ people disrupted v 1 "spinal injury" which could have been avoided had that person been more thoughtful.

It's not a question of expecting railway staff to overrule a paramedic, its a question of common sense.

Your point is the one I was trying to make yesterday, although in hindsight not as succinctly as you have put it.

Apologies to anyone who I offended.

The Box Photter said:

I'm currently suffering from a condition that might cause me to "fall ill" on a GTR train (or tube) without warning. So, I've taken th decision not to attempt to travel for the moment, having discussed the situation with my (very understanding) employer. As Spock so famously said, "The needs of the many outweigh the needs of the few, or the one". 100,000+ people disrupted v 1 "spinal injury" which could have been avoided had that person been more thoughtful.

It's not a question of expecting railway staff to overrule a paramedic, its a question of common sense.

Click to expand...

But that presumes the person knew they were "ill" before they set out on their journey, or even if they were "ill" at all. Their injury could have been as a result of tripping over something.
As we do not know any details of the casualty or the incident your comment is still unfounded.

Bald Rick said:

A paramedic was there very quickly. They are the qualified individual, and what they say rules in these circumstances. Would you overrule a paramedic?

Click to expand...

A number of hypotheticals here. I wasn't there, but I do know the details of the incident, (and I'm certainly not saying that the paramedic was wrong) I'd have moved the train. At low speed, with persons on board to control the movement of the passenger, as there is a greater risk to the '000s of passengers stuck or potentially going to be stuck, for precisely the reasons you outlined it was the worst possible time - a busy Friday evening. Thursday lunchtime? Leave it where it is. It's not about overruling a paramedic and telling them that they're wrong, it's about the whole system view. As far as I'm aware, that procedure has come from reviewing metro style procedures elsewhere that work on a similar basis - move the person or move the train.

Turning attention to the specific details of TL core at this time, you can't send it to E+C as there's no lifts. LBG is the way to go, and as you can work around, its marginally less worse than Blackfriars. Of course, Driver may not have had knowledge until its reopened, so in which case you're really stuffed!

tsr said:

It was also apparent that London Ambulance were well out of their depth when it came to having a plan to respond properly - no appropriate resources turned up to move a potentially seriously injured person from a busy railway line for a very long time indeed. Once the necessary resources did arrive, it took them a grand total of about 10 minutes to actually assist the casualty.

Click to expand...

Although there's certainly that. From the recent gubbins coming out of the IRB, TfL are finally acknowledging that the Core will be the north-south Crossrail, and should be treated as such. Hopefully that will extend to prioritising whole system responses, such as these.