Discussion on panic attacks and general first aid training at work

[Haywain]

If the ticket inspector isn't a qualified medical practitioner, they're putting themselves at risk by acting as a diagnostician.

It sounds as though a diagnosis of sorts might have been made, and that it was that the OP was angry and could become violent. If that was the case, the action of walking away was very sensible. Otherwise, without appropriate training, the best any person can do is try to make a judgement as to whether someone is ill and needs help, and they can quite easily get that wrong. The reason for getting it wrong is not lack of care, but lack of qualification and/or training. As those with years of training can get things wrong on occasion, it is extremely harsh to blame someone in a job which did not require those years of (medical) training for not recognising a medical condition.

 

[Bletchleyite]

It isn't? I did it at school, albeit back in the late 1980s.

I have no idea if it was part of any curriculum or just something our school chose to do though.

Some schools do it, some don't, I think. When I do it with my Scouts about 1/3 of them seem to have encountered it before.

Neil

 

[pethadine82]

RPI to an important job and i guess they suffer abuse on a daily basis.
Its not a pleasant job, and I don't think they gain satisfaction fining people, but they have a right not to be abused.
Sometimes when the general public gives you so much flack its human nature to become defensive and cut off hence the reaction you got.

 

[as1981]

As someone who suffers from panic attacks I would say the following:

1. If getting caught caused the attack then that's not the RPI's fault. If the RPI caused it by dealing with the issuing of the ticket in an incorrect manner then that would be of concern just as it would be with anyone else irrelevant of the affect on the individual.
2. As a non medically trained person, it can be very difficult to diagnose an attack for two reasons:
a) Someone having an attack can appear to be rational when there mind state is far from rational especially if the person experiencing it isn't used to attacks and doesn't know how to recognise them.
b) The symptons can match other things. one of the symptoms can be shaking. I saw someone else having, what I think, was an attack but as shaking can come from other things such as epilepsy I didn't advise them of the techniques I use, during an attack, as if it's not a panic attack I have no idea of the harm I could do.
3. Could a person having an attack become violent? I don't but it's a state of panic and people react in different and irrational ways when they panic so maybe they could.
4. As for people faking an attack to avoid a ticket. I doubt I could fake an attack but others may be able to and I certainly wouldn't put it past some members of the public (please note I make no reference to the op or other individual.).
5. Could I, genuinely, forget to buy a ticket and travel during an attack. Probably not now but in the past, yes. However that's not the RPI's fault. They would have to use their judgment, as in other cases, as to whether it's a 'genuine error' or someone taking the..



Andrew

 

[sarahj]

While I was first aid trained at the Hotel I used to work at, I am not first aid trained at the job i do now. If someone is ill we are asked to find a person with medical training eg nurse, doctor and phone for a ambulance. We are not to treat them ourselves in anyway, even to the point of, we are almost told to go here is a first aid kit, there you go.

Reasons. I can only speculate.

A one or two day course can never cover everything.
Compensation Culture. I can imagine the lawyers having a field day. Poorly trained railway first aider made it worse.

I will not add any more comments to that matter.


Meanwhile. The walk away method for angry passengers is common practice. While person A walked away, seemed like others were on hand very quickly. Perhaps they sensed that trying to get someone to calm down who had taken getting a P fare, by doing whatever they did, would be counter productive. so person A walks away so the passenger can vent about person A with person B

 

[DelayRepay]

Maybe the inspector felt his presence was causing more anxiety, and that the best thing to do was to remove himself from the situation in the hope that it would help the OP to calm down? Unless he left her on her own I'm not sure this is irresponsible.

Two other officers took over from him and offered help. These people must have been near by. It may have been better for them to take over as they weren't involved in the original situation and could therefore sympathise with the OP and suggest she appeal the ticket to try to calm her down. I suspect they ended up calling an ambulance so they could have the passenger removed from the tram (make it someone else's problem) and avoid any liability if anything were to happen.

My only other comment is about the inspector being "nasty" - why would he do this? The OP needs to remember that it's his job to deal with passengers without tickets, it will be a run of the mill situation to him, the lack of a ticket won't have hurt him personally so there would be no need to be "nasty".
--- old post above --- --- new post below ---

Reasons. I can only speculate.

A one or two day course can never cover everything.
Compensation Culture. I can imagine the lawyers having a field day. Poorly trained railway first aider made it worse.

This is interesting because when I've done first aid courses, they've always said that provided you follow the training and don't do anything completely stupid, you are unlikely to be successfully sued. I am not sure if there are any documented cases of people being sued for first aid attempts but I do think this is probably another myth.

Having said that, the one time I've seen a passenger taken ill on the train, it was a DOO only service. So it was left to me as a fellow passenger to assist while two of the other passengers argued about whether or not to use the alarm to alert the driver on the basis it might delay the train...

 

[Pumbaa]

Thoroughly dismayed by some of the responses on here.

I agree that there is no point or reason to appeal the Standard Fare issued.

However, if this case crossed my desk, I'd have the member of staff in for a chat without biscuits to get their version of events, as I would consider that they had neglected their duty of care to the public. If they did not realise it was a panic attack, why not(?) if their colleagues did, and if they did realise and took deliberate action to walk away, then it would become a little more serious than just re-training.

Of course everyone is human, mistakes are made and nobody likes being caught out. Guards and Inspectors are routinely complained against in their conduct, but something like this is (on the face of it) entirely different.

 

[Llanigraham]

Picking up the penultimate paragraph above from DelayReplay;
As a First Aid trainer as well as extended training, what DR says is quite correct. There have been no prosecutions of an aiding person. As long as the basic protocols are followed you are perfectly safe, and the basic protocols are all really common sense. Even broken ribs under CPR are considered "normal". Although officially we don't have a "Good Samaritan" law like France, the same concept exists.

By-standers; sometimes it works being forceful and ordering them to do something as what they want is a "leader".

Pumbaa, when did you last do a First Aid course?

 

[Flamingo]

Don't forget, we only have the OP's side of the story, and if they were so angry and upset (for want of a better word) at being caught fare-evading that they required ambulance attention, are they really in a position to give a reasoned and impartial analysis of the situation?

I had somebody turn up yesterday with a bike, after the doors were locked and I had taken the tip (four minutes late), and I said to them "Sorry, you're too late, I can't take the bike on here, you'll have to get the next train".

I heard from the guard on the next train they were demanding my name as I had rudely shouted at them, and refused to let them on board for no reason!"

If they came on here with that story, I'm sure there would be posters demanding my immediate dismissal - despite only hearing one side of it.

 

[Greenback]

Thoroughly dismayed by some of the responses on here.

I agree that there is no point or reason to appeal the Standard Fare issued.

However, if this case crossed my desk, I'd have the member of staff in for a chat without biscuits to get their version of events, as I would consider that they had neglected their duty of care to the public. If they did not realise it was a panic attack, why not(?) if their colleagues did, and if they did realise and took deliberate action to walk away, then it would become a little more serious than just re-training.

It sounds as though you are half way to deciding that the member of staff is at fault, even without hearing their version of events, which may be quite different to the OP's.

While I am in agreement with getting their version of events, I would definitely approach it with more of an open mind.

 

[Pumbaa]

Don't get me wrong, I've not automatically assumed fault with staff. I suppose the implied condition in my post is that the events detailed by the OP are largely accurate. That's what having that chat with the staff member is for.

I approach any situation like this as taking both sides at face value. Just as assuming that the staff member is de facto in the wrong, I think it's wrong to second guess or dismiss part of the customers side of the story just because they've been told something they may not have wanted to hear.

Llanigraham - why is that relevant?

 

[Greenback]

Don't get me wrong, I've not automatically assumed fault with staff. I suppose the implied condition in my post is that the events detailed by the OP are largely accurate. That's what having that chat with the staff member is for.

I approach any situation like this as taking both sides at face value. Just as assuming that the staff member is de facto in the wrong, I think it's wrong to second guess or dismiss part of the customers side of the story just because they've been told something they may not have wanted to hear.

Fair enough, but still have biscuits with the chat!

 

[Pumbaa]

Budget cuts tea only comes free from the shop next door after smiling nicely!

 

[Greenback]

Lol! If I had to pay for biscuits it would definitely be the 29p packets from my local Home Bargains!

 

[Tetchytyke]

Something nobody else has mentioned: if the RPI is the one who "caused" the panic attack (by being a big meanypants jobsworth) is s/he the appropriate person to treat the panic attack? I'd have said leaving the passenger for a colleague to attend to was quite probably far more sensible. It sounds as though the colleagues were there and could assist very easily. It's not as though RPIs hunt alone or that the M5000s are a billion carriages long, is it?

 

[Greenback]

Something nobody else has mentioned: if the RPI is the one who "caused" the panic attack (by being a big meanypants jobsworth) is s/he the appropriate person to treat the panic attack? I'd have said leaving the passenger for a colleague to attend to was quite probably far more sensible. It sounds as though the colleagues were there and could assist very easily. It's not as though RPIs hunt alone or that the M5000s are a billion carriages long, is it?

Good point. Although it isn't really clear from the post that it was the RPI that caused the attack by virtue of their actions (other than correctly issuing the standard fare) I'd guess that in most similar cases the RPI giving assistance would be more likely to make matters worse.

 

[Clip]

However, if this case crossed my desk, I'd have the member of staff in for a chat without biscuits to get their version of events, as I would consider that they had neglected their duty of care to the public. If they did not realise it was a panic attack, why not(?) if their colleagues did, and if they did realise and took deliberate action to walk away, then it would become a little more serious than just re-training.

Of course everyone is human, mistakes are made and nobody likes being caught out. Guards and Inspectors are routinely complained against in their conduct, but something like this is (on the face of it) entirely different.

If this crossing your desk was the first you had heard about the incident then I would be very surprised. Given there was 3 members of staff allegedly involved Im pretty sure any revenue manager wouldve heard about it before the complaint had come in.

Therefore no need for tea and biscuits(or not)

 

[455driver]

Thoroughly dismayed by some of the responses on here.

I agree that there is no point or reason to appeal the Standard Fare issued.

However, if this case crossed my desk, I'd have the member of staff in for a chat without biscuits to get their version of events, as I would consider that they had neglected their duty of care to the public. If they did not realise it was a panic attack, why not(?) if their colleagues did, and if they did realise and took deliberate action to walk away, then it would become a little more serious than just re-training.

Of course everyone is human, mistakes are made and nobody likes being caught out. Guards and Inspectors are routinely complained against in their conduct, but something like this is (on the face of it) entirely different.

Well if it is your attitude that a complaint like this (without further investigation) warrants tea with no biscuits I am glad you are not my manager!

 

[Flamingo]

Well if it is your attitude that a complaint like this (without further investigation) warrants tea with no biscuits I am glad you are not my manager!

They are out there, though fortunatly in a minority.

 

[reb0118]

Compensation Culture. I can imagine the lawyers having a field day. Poorly trained railway first aider made it worse.

This is interesting because when I've done first aid courses, they've always said that provided you follow the training and don't do anything completely stupid, you are unlikely to be successfully sued. I am not sure if there are any documented cases of people being sued for first aid attempts but I do think this is probably another myth.

I was told at my last first aid course that there have been only two cases brought to court in the UK and that both were dismissed - I believe that in one of the cases the judge was not best pleased and went to town on the claimant's legal team.

Having said that, the one time I've seen a passenger taken ill on the train, it was a DOO only service. So it was left to me as a fellow passenger to assist while two of the other passengers argued about whether or not to use the alarm to alert the driver on the basis it might delay the train...

It is probably best not to use the "pass comm" as stopping the train "in the middle of nowhere" is very often not good for the casualty. To be fair this depends on the type of train, but, it is normally best to use a call for aid alarm, if fitted or try to contact the driver at a station where it should be easier to arrange professional help for the casualty. Much easier if there is a guard on board - but then I am biased!

 

[Bletchleyite]

This is where I quite like the German approach. You have a red "Notbremse" which is an emergency brake and stops the train *now*, to be pulled in case of something needing the train stopping like a derailment or an open door, and a green "Notruf" to call for assistance e.g. for medical reasons or a small fire. Ironically in the UK it's the green door release handle that might cause the former on newer stock...

Neil

 

[Llanigraham]

I was told at my last first aid course that there have been only two cases brought to court in the UK and that both were dismissed - I believe that in one of the cases the judge was not best pleased and went to town on the claimant's legal team.

I have heard of the case, and it didn't actually get to Court, but was heard in Chambers, and indeed the Judge was "displeased"!!
I understand they ended up paying the costs.

 

[sarahj]

While I was first aid trained at the Hotel I used to work at, I am not first aid trained at the job i do now. If someone is ill we are asked to find a person with medical training eg nurse, doctor and phone for a ambulance. We are not to treat them ourselves in anyway, even to the point of, we are almost told to go here is a first aid kit, there you go.

Reasons. I can only speculate.

A one or two day course can never cover everything.
Compensation Culture. I can imagine the lawyers having a field day. Poorly trained railway first aider made it worse.

I will not add any more comments to that matter.


Meanwhile. The walk away method for angry passengers is common practice. While person A walked away, seemed like others were on hand very quickly. Perhaps they sensed that trying to get someone to calm down who had taken getting a P fare, by doing whatever they did, would be counter productive. so person A walks away so the passenger can vent about person A with person B

Please note the words I have highlighted. I have not said thats the official reason. I dont know why, it was just a guess.

 

[Flamingo]

I was told recently that the reason that TM's don't get more than a very basic first aid training is that our job is not to give first aid, our job is to manage the situation, and the big picture. If we are down on our knees beside a casualty, then we are not looking at the rest of the train, and all the other things we need to do to organise care for the casualty and the safety of the train and other passengers. So our main role is to recognise that somebody needs assistance, shout for help. and organise further assistance at the next stop.

Stations have trained first aiders, and by ringing 999 we can have an ambulance waiting for us by the time we reach the next stop. I have had situations where I have taken people on a few stops as we would have been sitting at an unmanned station waiting for an ambulance otherwise (I was happy that the person was going to be OK to do so in every case).

Personally, I will ring control and find out which stop it makes more sense to arrange for an ambulance to meet the train at, and take it from there.

 

[DelayRepay]

It is probably best not to use the "pass comm" as stopping the train "in the middle of nowhere" is very often not good for the casualty. To be fair this depends on the type of train, but, it is normally best to use a call for aid alarm, if fitted or try to contact the driver at a station where it should be easier to arrange professional help for the casualty. Much easier if there is a guard on board - but then I am biased!

Sorry, maybe I used the wrong word. I meant the "speak to the driver in an emergency" device. I wanted them to ask the driver to arrange for help to be waiting at the next scheduled stop and also that an ill passenger would be getting off. I didn't want the train to stop in the middle of nowhere. One of the people was worried that this would delay the train at the next station and mean everyone would be late home.

As you say, it would have been much easier if there was a guard on board!

 

[Llanigraham]

I was told recently that the reason that TM's don't get more than a very basic first aid training is that our job is not to give first aid, our job is to manage the situation, and the big picture. If we are down on our knees beside a casualty, then we are not looking at the rest of the train, and all the other things we need to do to organise care for the casualty and the safety of the train and other passengers. So our main role is to recognise that somebody needs assistance, shout for help. and organise further assistance at the next stop.

Stations have trained first aiders, and by ringing 999 we can have an ambulance waiting for us by the time we reach the next stop. I have had situations where I have taken people on a few stops as we would have been sitting at an unmanned station waiting for an ambulance otherwise (I was happy that the person was going to be OK to do so in every case).

Personally, I will ring control and find out which stop it makes more sense to arrange for an ambulance to meet the train at, and take it from there.

Excellent and very true.

 

[Greenback]

I was told recently that the reason that TM's don't get more than a very basic first aid training is that our job is not to give first aid, our job is to manage the situation, and the big picture. If we are down on our knees beside a casualty, then we are not looking at the rest of the train, and all the other things we need to do to organise care for the casualty and the safety of the train and other passengers. So our main role is to recognise that somebody needs assistance, shout for help. and organise further assistance at the next stop.

Stations have trained first aiders, and by ringing 999 we can have an ambulance waiting for us by the time we reach the next stop. I have had situations where I have taken people on a few stops as we would have been sitting at an unmanned station waiting for an ambulance otherwise (I was happy that the person was going to be OK to do so in every case).

Personally, I will ring control and find out which stop it makes more sense to arrange for an ambulance to meet the train at, and take it from there.

That makes a lot of sense to me, and I have seen exactly the same approach from an ATW conductor during a medical emergency at Bridgend. The member of staff is better off seeking help, arranging an ambulance, and assisting or reassuring other passengers than to be performing first aid duties, particularly if the emergency appears to be non life threatening.

 

[Llanigraham]

Exactly. It only needs a quick "Are there any First Aiders or Doctors on board?" over the tannoy and I am sure a response would be forthcoming.
There was a time that some ATW trains were fitted with AED's, but no staff trained to use them. Is that still the case?

 

[Bletchleyite]

Excellent and very true.

Except for that there are (mostly) two members of staff on the train, and once the train has been stopped safely at a suitable location, e.g. at a station, one of them could certainly render assistance.

Neil
--- old post above --- --- new post below ---

There was a time that some ATW trains were fitted with AED's, but no staff trained to use them. Is that still the case?

AEDs are simplicity itself to use - you switch it on and it tells you what to do and decides whether a shock is appropriate. The only thing it requires the operator to do is fit the pads in the places shown in the diagram on the machine, and to get people to stand back before pressing the button for the shock.

TBH I think they should be available for EVERYONE to use, not just trained people. It is difficult to do genuine harm with one, unlike say doing CPR on someone whose heart is beating which can cause serious damage.

Neil

 

[Flamingo]

I once had a train where somebody was collapsed at the buffet, and the customer host put out an "Is there any doctors on board?" announcement. He didn't know that there had been a dermatology conference in Cardiff, and a few dozen Dermatologist's turned up!

Given that dermatologist is the Greek for "Not a real Doctor", they all stand around wondering if the casualty had a rash while an anaesthestist who also turned up sorted the patient out. I handed the phone over to the most senior dermatologist to answer the questions from the 999 operator about the patients inside leg measurements after I had arranged for the ambulance at the next station.

The experience has made me wary of the "Is there a faith-healer on board?" type announcements!