Medical incidents on board trains

mpthomson · 20 Apr 2022

43066 said:
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.

Nobody in the UK has ever been sued for giving first aid to a patient, or accused of assault. As long as you act within your training and in good faith you are completely fine legally. It's not a risk unless you try to do something that you've never been trained to. There is legislation in place that specifically covers this.

jmh59 said:
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.

No first aider in the UK has ever ended up in civil or criminal court for acting within training, or Coroners except as a witness to describe what occurred either and there is no need to have witnesses. The only reason you say what you're doing is to reassure the patient that you're helping them, it's not to protect yourself against anything. There's no need to be insured. This is not the US.

43066 said:
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?

Because it's never happened and never would if you can show that you're acting within training and in good faith, as above.

jmh59 said:
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)

No you won't. as above it has never happened. Noone who knows what they're doing would attempt to move them

Pseudonym said:
I am an Emergency Medicine consultant and have found some of the responses on here either terrifying, funny (we do a lot of very black humour) or occasionally sensible (thanks for those).
Few points....
1. In our department (full of emergency medicine docs and nurses) we have to have a nominated number of first aiders! These are mostly health care assistants - hugely valuable but the least qualified members of the team, who will immediately ask someone else what to do - quite rightly, given where we work. I am astounded that the same rules that apply in offices, shops, airports (as I understand) and hospitals re: first aiders don't apparently apply on the railways. There should be first aiders on the railway.
2. As there are automated defibrillators on most, if not all, major stations and others too I wonder if railway staff would really wait for a passenger to get on and attach/use it should someone collapse? Surely basic training is given to station staff??
3. You will never be convicted in a British court if you are an untrained bystander trying to save a life. Clearly if that involved obviously inappropriate behaviour that would be different. If I tried to intervene however after an evening in the pub and made a cock up - then that would be different - as I would be deemed to have the knowledge to know when it was appropriate to intervene and when not to.
4. Sometimes you have to do something even if it seems unwise in other circumstances (someone earlier mentioned a neck injury and paralysis). Extreme example - drag someone off the track with a potential neck injury or let them be sliced up by an approaching train. Possible bad things vs certain death???
5. You are more likely to be criticised by a judge or coroner for doing nothing rather than trying your best to do something.

Happy Easter (I can now enjoy a few glasses of red having worked all weekend)

As a fellow professionally qualified person I can't like this post enough compared to some of the ill informed nonsense in this thread.

thejuggler said:
112 is the worldwide emergency number and will connect from mobiles even if there is no signal on your network.

Last year we were chatting to an RNLI rep and she said to use 112, especially on coastal areas where mobile signal can be patchy as it is better at locating where the call is coming from.

When I called 999 at Christmas the call handler gave the coordinates of where I was calling from as it was from a mobile. Useful to locate a caller if its a fake call, but also good to locate where the incident is happening.

Having the What Three Words app on your phone is incredibly useful to blue light services too, it's much quicker than trying to describe somewhere out of the way.

RailUK Forums

nickswift99 · 20 Apr 2022

mpthomson said:
Having the What Three Words app on your phone is incredibly useful to blue light services too, it's much quicker than trying to describe somewhere out of the way.

W3W has been debunked by a significant number of researchers and has been strongly advocated against by Mountain Rescue organisations in the UK after a number of incidents (45 in 1 year).

Mountain rescue organisations will send you an SMS with a URL. Follow it and it will provide your location in Lat/Long. This, along with Eastings and Northings, are the definitive location mechanism in the UK, especially in rural areas. They are easier to communicate and less likely to be misunderstood.

As I mentioned above, emergency control rooms that have integrated with AML already know your location - these are in the majority in the UK. The same is true for calls from landlines.

ainsworth74 · 20 Apr 2022

jmh59 said:
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.

If you've completed first aid training with St Johns Ambulance then they will cover you if you put into practice the skills you've been trained in and no other insurance is applicable:

We believe it is vitally important that people have the confidence to use their first aid skills without hesitation, wherever and whenever an incident occurs.

We provide all students who successfully pass one of our approved first aid courses with ‘Good Samaritan’ insurance cover for the duration of the validity of their training qualification. This insurance covers students against claims arising from first aid they may have delivered outside of their workplace, club or association and not covered by any other insurance.

This insurance is offered at no extra charge, as we are so confident in the standards of our first aid training delivery.

To qualify, you must hold a current St John Ambulance certificate for one of the following courses:

First Aid at Work

Emergency First Aid at Work

Automated External Defibrillation

Sports First Aid

Anaphylaxis First Aid

Paediatric First Aid

Schools First Aid

Professional Drivers First Aid

*A Good Samaritan is someone who voluntarily renders first aid to another in distress.

What to do now
You don’t need to do anything. You are automatically covered as soon as you gain your qualification. Your St John Ambulance certificate doubles as your proof of cover. Keep it safe, as you will need to quote the unique reference number on your certificate in the event of a claim.

Associate Membership Insurance - Guidance

Discover more from St John Ambulance about Associate Membership Insurance for participants that hold a first aid certificate from one of our first aid and health and safety training courses, such as our First Aid at Work, Paediatric First Aid and Anaphylaxis First Aid training courses.

www.sja.org.uk

Though as the trainer on my course pointed out no-one has ever needed to use it because getting sued criminally or civilly for rendering first aid just isn't a thing no matter how much people may protest otherwise.

43066 · 20 Apr 2022

mpthomson said:
There is legislation in place that specifically covers this.

Is there?

Can someone please cite the legislation that guarantees there’s no possibility of being prosecuted under criminal law or sued under civil law for actions taken administering first aid in a good faith attempt to save someone’s life?

I’ll wait.

ainsworth74 said:
getting sued criminally or civilly for rendering first aid just isn't a thing

In which case why is insurance against it available?

ainsworth74 · 20 Apr 2022

43066 said:
In which case why is insurance against it available?

Because:

We believe it is vitally important that people have the confidence to use their first aid skills without hesitation, wherever and whenever an incident occurs.

And lots of people, falsely, are afraid of using their skills for fear of being sued.

Re 4/4 · 20 Apr 2022

W3W has been debunked by a significant number of researchers and has been strongly advocated against by Mountain Rescue organisations in the UK after a number of incidents (45 in 1 year).

Mountain rescue organisations will send you an SMS with a URL. Follow it and it will provide your location in Lat/Long. This, along with Eastings and Northings, are the definitive location mechanism in the UK, especially in rural areas. They are easier to communicate and less likely to be misunderstood.

W3W on my android phone has an option to show the UK grid reference for your location. I advise finding this in te settings if you're a UK user, as you don't want to be looking for it in an emergency.

43066 · 21 Apr 2022

mpthomson said:
As a fellow professionally qualified person

Since you (rather snobbishly) brought qualifications up, for the record, I’m also professionally qualified. Not in first aid, but as a solicitor. Which of us do you think is better qualified to discuss legal matters?

ainsworth74 said:
And lots of people, falsely, are afraid of using their skills for fear of being sued.

Not “falsely”. Look, I accept we are going down a bit of an irrelevant legalistic rabbit hole here.

I accept the risk is low, to the point where it could plausibly be described as theoretical. That is not the same thing as *no* risk. Anyone making statements like “I can guarantee you won’t be sued” fundamentally misunderstands how the law works. I do hope there aren’t first aid instructors making such statements.

Statements like:

mpthomson said:
It's not a risk unless you try to do something that you've never been trained to. There is legislation in place that specifically covers this.

Are also factually and legally incorrect. For example you could be trained in first aid, but be held to have administered it negligently. As per my question in post #124, which will remain unanswered in perpetuity, there is no legislation nor legal precedent that disapplies the law of negligence or the criminal law in relation to first aid.

Of course, in the context of railway staff, of far more concern than these admittedly low risks would be the risk of an accusation being made. However spurious such an allegation might be, as we all know, mud tends to stick.

D821 · 21 Apr 2022

43066 said:
Since you (rather snobbishly) brought qualifications up, for the record, I’m also professionally qualified. Not in first aid, but as a solicitor. Which of us do you think is better qualified to discuss legal matters?

Snobbish? How?
Whilst you're engaging in a bit of hypocrisy, what type of law do you specialise in? Presumably, you'll be able to cite some cases of people getting prosecuted or sued for first aim attempts, with your professional qualifications?

philthetube · 21 Apr 2022

Can't say nobody, but until I retired nobody on the underground had been sued, if it was going to happen then that is where it would,

43066 · 21 Apr 2022

D821 said:
Snobbish? How?

I don’t want to engage in a fight over qualifications. Being highly qualified (as I am, for the record) doesn’t make people intrinsically better. I’m more interested in peoples’ personalities and how they can enrich my life that way.

D821 said:
Whilst you're engaging in a bit of hypocrisy, what type of law do you specialise in? Presumably, you'll be able to cite some cases of people getting prosecuted or sued for first aim attempts, with your professional qualifications?

I specialised in corporate tax advice to financial services clients such as Goldman Sachs. Not sure how that’s relevant when being a solicitor is a general qualification. I had to sit through criminal and tort law at uni.

What are your legal credentials? Are they better than mine?

I don’t have have to cite any cases to establish that being sued/prosecuted for negligently delivered first aid is (at least) a theoretical risk under U.K. law.

If you can’t accept that, that’s fine.

headshot119 · 21 Apr 2022

@43066 I would assume as someone working in the legal field you can get access to old cases and such like. In fact if you know of a way I could get hold of them to read I'd certainly be quite interested.

Cattley v St John’s Ambulance 1988, Leonard v Girl Guide Association 1995, Loyley v St John’s Ambulance, may all be of interest to you and others. The latter of which was settled out of court, the former two were unsuccessful cases.

There is certainly a small risk (The fact I can only find three cases between 1988 and present day) of someone bringing a case against you, whether or not they'd be successful in doing so seems even less likely, though certainly not impossible.

BayPaul · 21 Apr 2022

With any risk, there is an opposite risk. Does anyone know of legal cases in the opposite direction, where organisations have been sued for not providing adequate first aid training for example, or people have been taken to court for not attempting cpr.

43066 · 21 Apr 2022

headshot119 said:
@43066 I would assume as someone working in the legal field you can get access to old cases and such like. In fact if you know of a way I could get hold of them to read I'd certainly be quite interested.

I *used* to work in the field. We had access to various websites giving access to legal cases, LexisNexis, for example.

headshot119 said:
There is certainly a small risk (The fact I can only find three cases between 1988 and present day)

Thanks. That’s three more cases than I managed to find from a quick Google search

. There is indeed a small/theoretical risk.

BayPaul said:
people have been taken to court for not attempting cpr.

That’s impossible under UK law (unlike various European countries). In the UK you could observe a baby drowning in a puddle, step over it and walk on by with no criminal or civil liability. Sounds harsh but there are some pretty good policy reasons why that’s the case.

Once you start administering first aid, on the other hand, you assume a duty of care…

Pakenhamtrain · 21 Apr 2022

Ken H said:
Surprised TOC's dont encourage traincrew to get 1st aid cert. Staunching bleeding straight after an accident can be a life saver. Surprised its not a legal requirement TBH

It's a requirement down here.
Certainly drivers and, members of rollingstock have to have it.

al78 · 21 Apr 2022

If you are too frightened of the extremely remote possibility of legal consequences of administering first aid, why did you bother going on a course? The whole point of learning how to do it is to be able to administer it in an emergency situation to buy time before the professionals arrive.

I have first aid training periodically at my workplace, and I would administer first aid as long as it was a situation where I was confident I knew the correct proceedure.

43066 · 21 Apr 2022

al78 said:
If you are too frightened of the extremely remote possibility of legal consequences of administering first aid, why did you bother going on a course?

Well quite. I have no intention of ever going on a first aid course.

My original point was to say that first aid courses shouldn’t be compulsory for traincrew, just as they aren’t currently.

michael74 · 21 Apr 2022

What should be offered for train crew, school kids, adults, everyone.... Is BLS, as I have said before even just putting someone in the recovery position can make a difference between life and death, even just performing a head tilt chin lift can be enough ( especially if you fear touching a member of the opposite sex either below the neck line or above the ankle).

As for compulsory, yes absolutely, some trains may have a long run to the next station and the guard may be the only other competent person on board, if they feel they are able to undertake some (BLS) actions they could possibly save a life. If they undertake the course (its only 2 hours once a year) and if they find themselves unable to undertake what they have learned in a future situation then they do not do it.

Ediswan · 21 Apr 2022

al78 said:
The whole point of learning how to do it is to be able to administer it in an emergency situation to buy time before the professionals arrive.

Also to be able to deal with minor incidents without needing to involve the professionals. In my personal experience, that is far more common.

Horizon22 · 21 Apr 2022

nickswift99 said:
W3W has been debunked by a significant number of researchers and has been strongly advocated against by Mountain Rescue organisations in the UK after a number of incidents (45 in 1 year).

Mountain rescue organisations will send you an SMS with a URL. Follow it and it will provide your location in Lat/Long. This, along with Eastings and Northings, are the definitive location mechanism in the UK, especially in rural areas. They are easier to communicate and less likely to be misunderstood.

As I mentioned above, emergency control rooms that have integrated with AML already know your location - these are in the majority in the UK. The same is true for calls from landlines.

What3Words is in extensive use on several railway routes and is incredibly useful, especially if you are at a railway location rural where the running line is in the middle of fields and the nearest access point is some distance. It's not used in in isolation of course (postcode, chains & miles etc.) which is helpful. The "debunking" you refer to was more a note of caution regarding user error and words being misheard/mispronounced and similarities to other words.

D821 · 21 Apr 2022

43066 said:
I don’t want to engage in a fight over qualifications. Being highly qualified (as I am, for the record) doesn’t make people intrinsically better. I’m more interested in peoples’ personalities and how they can enrich my life that way.

I specialised in corporate tax advice to financial services clients such as Goldman Sachs. Not sure how that’s relevant when being a solicitor is a general qualification. I had to sit through criminal and tort law at uni.

What are your legal credentials? Are they better than mine?

I don’t have have to cite any cases to establish that being sued/prosecuted for negligently delivered first aid is (at least) a theoretical risk under U.K. law.

If you can’t accept that, that’s fine.

None whatsoever, unless once working in the IT dept of a solicitor's firm counts for anything!
I was curious if you had experience in this particular field given how strongly you were making your point.

I don't disagree with you that there's a theoretical risk, I just don't think it's worth not helping someone over.

pinkmarie80 · 22 Apr 2022

dk1 said:
The ones that craze me are the bloody diabetics who don’t properly control their medication thus requiring urgent attention & messing the rest of the passengers, crew & NHS about unnecessarily in the process Grrrrr!!!

I assume you mean those who are on insulin?! There are many types of diabetes medication, some even when taken correctly and the rules followed to the letter can cause unexpected problems. I’m type 2 and although I’m now diet controlled only, I used to be on a tablet that caused me to have pretty constant hypos. These could strike without warning (and often did) but I always carried my testing kit and jelly babies with me. It’s not always a case of poor control- even with the best control unexpected emergencies can strike.
We don’t exactly do it just to hold people up!

dk1 · 22 Apr 2022

pinkmarie80 said:
I assume you mean those who are on insulin?! There are many types of diabetes medication, some even when taken correctly and the rules followed to the letter can cause unexpected problems. I’m type 2 and although I’m now diet controlled only, I used to be on a tablet that caused me to have pretty constant hypos. These could strike without warning (and often did) but I always carried my testing kit and jelly babies with me. It’s not always a case of poor control- even with the best control unexpected emergencies can strike.
We don’t exactly do it just to hold people up!

The two instances it occurred on my train causing significant delay where confirmed by the paramedics who attended that the patient had failed to take or carry their correct medication.

GodAtum · 22 Apr 2022

I once witnessed an epileptic seizure on train at Maidenhead. The train waited at the station for the ambulance to arrive.

stj · 23 Apr 2022

What is the procedure,is it stop at next station? I have witnessed 2 emergencies at Severn Tunnel Jn which has involved the Ambulance attending which due to the location has taken a long time.It would have only taken another 10 minutes to get to Newport which is closer to Ambulances/Hospital.

Ken H · 23 Apr 2022

stj said:
What is the procedure,is it stop at next station? I have witnessed 2 emergencies at Severn Tunnel Jn which has involved the Ambulance attending which due to the location has taken a long time.It would have only taken another 10 minutes to get to Newport which is closer to Ambulances/Hospital.

I would have thought somewhere an ambulance can get on the platform. You dont want to be carting your patient through a busy station.

Dai Corner · 23 Apr 2022

Ken H said:
I would have thought somewhere an ambulance can get on the platform. You dont want to be carting your patient through a busy station.

Severn Tunnel Junction Down platforms are only accessible via steps or ramps and the footbridge. Newport Platform 1 on the Down Relief has level access to the street.

Llanigraham · 23 Apr 2022

It can also depend on what is reported wrong with the patient!

And I am sure I can remember one emergency where the train was asked to stop at a level crossing to meet an Ambulance (Possibly on the Cambrian Coast?)

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