Delay waiting for ambulance

[trainophile]

This is a new one on me - on a LNR just outside Runcorn, heading for Liverpool, and apparently there’s a passenger on an Avanti in front requiring an ambulance, so we have to wait until the passenger is put on the ambulance.

Oh, we’ve just been informed that it has now arrived at Runcorn so we shouldn’t be too much longer. But it made me wonder whether situations like this get ambulance priority, given the horror stories of people having to wait several hours for one.

Thankfully on the move again.

 

[skyhigh]

But it made me wonder whether situations like this get ambulance priority, given the horror stories of people having to wait several hours for one.

They tend to, yes.

If someone has sustained a head/neck injury on board there is little you can do. I for one would certainly not try to get them off the train without professional medical assistance.

 

[LowLevel]

This is a new one on me - on a LNR just outside Runcorn, heading for Liverpool, and apparently there’s a passenger on an Avanti in front requiring an ambulance, so we have to wait until the passenger is put on the ambulance.

Oh, we’ve just been informed that it has now arrived at Runcorn so we shouldn’t be too much longer. But it made me wonder whether situations like this get ambulance priority, given the horror stories of people having to wait several hours for one.

Thankfully on the move again.

Not unusual. It is usually attempted to arrange a rendezvous somewhere as convenient as possible for both the ambulance and avoiding disruption to the train service but that isn't always possible.

Ambulances are allocated based on clinical need and there have been waits for hours for them to trains before - though they do best to get there ASAP.

 

[SCDR_WMR]

This is a new one on me - on a LNR just outside Runcorn, heading for Liverpool, and apparently there’s a passenger on an Avanti in front requiring an ambulance, so we have to wait until the passenger is put on the ambulance.

Oh, we’ve just been informed that it has now arrived at Runcorn so we shouldn’t be too much longer. But it made me wonder whether situations like this get ambulance priority, given the horror stories of people having to wait several hours for one.

Thankfully on the move again.

If it's an emergency then it will be treated as such, no priority over other emergency calls as far as ambulances as concerned. I'm my experience, control often try and force train crew to remove the passenger from the train and allow station staff to take over so as to keep trains moving however it's not always possible.

 

[800001]

It will be treat on exactly the same basis as any other ambulance 999 call.
Just because they are on a train makes no difference in that call being given preference.

I’ve known trains say for over 3 hours blocking a line awaiting an ambulance.

 

[Mojo]

It will be treat on exactly the same basis as any other ambulance 999 call.
Just because they are on a train makes no difference in that call being given preference.

Whilst this is partly true, in that the ambulance service call handler will triage the call accordingly dependent on the clinical need, the location of the casualty is partly important as it determines what resources will be allocated. If there are multiple highly-loaded trains stuck between stations this can quite quickly escalate causing a bigger problem for the ambulance service and hence officers of a differing skill set may be dispatched more quickly.

This is partly why, particularly in London, it has been the policy of many ambulance services and Tocs, to ensure that ill customers are removed from the train into the care of staff on the platform, if they are safely able to be. London Ambulance Service have been working to this guidance for nearly ten years now: https://www.whatdotheyknow.com/requ...erations 18March2013.pdf?cookie_passthrough=1

 

[Bletchleyite]

Whilst this is partly true, in that the ambulance service call handler will triage the call accordingly dependent on the clinical need, the location of the casualty is partly important as it determines what resources will be allocated. If there are multiple highly-loaded trains stuck between stations this can quite quickly escalate causing a bigger problem for the ambulance service and hence officers of a differing skill set may be dispatched more quickly.

This is particularly relevant to the Tube, where on a very hot day people can start getting medical issues in the heat on board/from standing for a prolonged period and potentially start fainting. A bit less so for a mainline train with the aircon running and toilets still in use.

 

[800001]

Whilst this is partly true, in that the ambulance service call handler will triage the call accordingly dependent on the clinical need, the location of the casualty is partly important as it determines what resources will be allocated. If there are multiple highly-loaded trains stuck between stations this can quite quickly escalate causing a bigger problem for the ambulance service and hence officers of a differing skill set may be dispatched more quickly.

This is partly why, particularly in London, it has been the policy of many ambulance services and Tocs, to ensure that ill customers are removed from the train into the care of staff on the platform, if they are safely able to be. London Ambulance Service have been working to this guidance for nearly ten years now: https://www.whatdotheyknow.com/request/154195/response/383204/attach/4/A E Operations 18March2013.pdf?cookie_passthrough=1

1E25 in platform north of Edinburgh a few weeks ago for over 3 hours awaiting an ambulance as person couldn’t be moved, category 1 priority call, but still over 3 hours, another catergory 1 at edinburgh Waverley with customer on board for nearly 2 hours awaiting ambulance an unable to be moved off train.

I have multiple other examples of trains stopped for hours awaiting ambulances.

 

[najaB]

I'm my experience, control often try and force train crew to remove the passenger from the train and allow station staff to take over so as to keep trains moving however it's not always possible.

"Force" or "request"/"ask"'?

 

[800001]

"Force" or "request"/"ask"'?

Always a request, control in no situation can ever force anyone off the train.

 

[norbitonflyer]

This is partly why, particularly in London, it has been the policy of many ambulance services and Tocs, to ensure that ill customers are removed from the train into the care of staff on the platform, if they are safely able to be. London Ambulance Service have been working to this guidance for nearly ten years now: https://www.whatdotheyknow.com/request/154195/response/383204/attach/4/A E Operations 18March2013.pdf?cookie_passthrough=1

Two incidents near Waterloo illustarte this. I was stuck, along with manyn other people, on tarins between waterloo and vauxhall because someone had pulled thew cord on a train because a passenger was taken ill. This caused considerable delay because that section of line is on a viaduct and the train had to be moved to vauxhall to extricate the passenger.

So, when a year or so later a fellow passenger collapsed in an eplileptic fit as our train left Waterloo, I had no hesitation in stopping the train before it could clear the platform - I really did not want someone stopping the train on the viaduct. A paramedic was with us in five minutes (it does help that LAS HQ is just round the corner) and only four platforms were blocked by the stopped train

 

[Flying Snail]

If it's an emergency then it will be treated as such, no priority over other emergency calls as far as ambulances as concerned. I'm my experience, control often try and force train crew to remove the passenger from the train and allow station staff to take over so as to keep trains moving however it's not always possible.

Moving an incapacitated person sounds like an exceptionally stupid request, both for the possibility of causing further harm and the exposure to civil or even criminal liability from doing so.

 

[najaB]

Moving an incapacitated person sounds like an exceptionally stupid request, both for the possibility of causing further harm and the exposure to civil or even criminal liability from doing so.

Which is why I was wondering if control were actually forcing or making a request. There's a big difference between "Can the person be detrained safely?" and "You need to get them off the train".

 

[Flying Snail]

Which is why I was wondering if control were actually forcing or making a request. There's a big difference between "Can the person be detrained safely?" and "You need to get them off the train".

Of course what may be worded as an instruction could easily tun into a question if an accusation of impropriety resulted, are calls to/from control centres recorded?

As an aside, the first thing I'd be installing on a work phone would be a call recorder for my own protection.

Either way the only people in distress that I could imagine being detrained without emergency services personel present would be those able and willing to remove themselves.

 

[Purple Train]

Many years ago, I was travelling back from Lincoln to Mansfield, planning to (as was my custom) go back via Worksop, having made the outward journey via Nottingham. Unusually, a class 150/1 was in charge (instead of the usual Pacer). Before departing Lincoln, a fellow passenger had a medical episode (drug-related I suspect), and the driver and guard moved all passengers into the rear coach, made various calls, and arranged for an ambulance to meet the train at Gainsborough Lea Road, where we were held for a while (20 minutes or so) to allow for the transfer. The train was further delayed for a few minutes at Retford while a passenger on the platform sought assistance from the guard, having dropped their phone on the line. Inconvenient it may have been for my connection, but both driver and guard handled the situation impeccably.

 

[800001]

Of course what may be worded as an instruction could easily tun into a question if an accusation of impropriety resulted, are calls to/from control centres recorded?

As an aside, the first thing I'd be installing on a work phone would be a call recorder for my own protection.

Either way the only people in distress that I could imagine being detrained without emergency services personel present would be those able and willing to remove themselves.

All calls in all control rooms to best of my knowledge are recorded

 

[Mojo]

Moving an incapacitated person sounds like an exceptionally stupid request, both for the possibility of causing further harm and the exposure to civil or even criminal liability from doing so.

We have had this discussion a few months ago (https://railforums.co.uk/threads/medical-incidents-on-board-trains.230511/page-5#post-5624130). There is no chance that someone would face either criminal or civil action if they are acting reasonably and trying to help someone else. In fact, a law change in 2015 (the Social Action, Responsibility and Heroism Act 2015) sets out the situation quite clearly.

If anything I would say it would be exceptionally stupid NOT to move someone, but of course this depends on a variety of situations such as reported injury, the support available at the station, the person's size and so on. The likelihood of causing further harm by not acting in the majority of situations is much greater than the likelihood of causing harm by acting. There are a very small number of situations where moving someone could put you, or yourself at risk. I have moved dozens of ill customers from trains over my relatively short career. I never have to be asked because the facts of the situation, given by my training is quite clear when this is the right thing to do it.

 

[stj]

I have seen this several times at Severn Tunnel Jn where an inter city train has made an emergency stop, to then wait a long time for an ambulance.I often wonder why the trains did not carry on to Newport 10 mins away and closer to Hospital.

 

[dk1]

It’s a very regular occurrence. If the patient cannot be moved & other trains cannot get passed then it’s unfortunate but nothing moves.

 

[The North Briton]

Moving an incapacitated person sounds like an exceptionally stupid request, both for the possibility of causing further harm and the exposure to civil or even criminal liability from doing so.

In my experience, the pressure to move someone comes more often from the Controllers' senior managers, rather than the Controllers themselves. There seems to be a mistaken belief that those at the sharp end are 'not trying hard enough' to get an ambulance on site within an acceptable period of time.

 

[TEW]

Two incidents near Waterloo illustarte this. I was stuck, along with manyn other people, on tarins between waterloo and vauxhall because someone had pulled thew cord on a train because a passenger was taken ill. This caused considerable delay because that section of line is on a viaduct and the train had to be moved to vauxhall to extricate the passenger.

So, when a year or so later a fellow passenger collapsed in an eplileptic fit as our train left Waterloo, I had no hesitation in stopping the train before it could clear the platform - I really did not want someone stopping the train on the viaduct. A paramedic was with us in five minutes (it does help that LAS HQ is just round the corner) and only four platforms were blocked by the stopped train

SWR also pay for private paramedics at a few stations at key locations near London in peak hours so that assistance can be available much quicker.

 

[Falcon1200]

I'm my experience, control often try and force train crew to remove the passenger from the train

Not force, request.

Always a request, control in no situation can ever force anyone off the train.

Indeed. If the Traincrew say no, end of story, they stay on the train.
(We once had a passenger collapse on a platform at Haymarket (Edinburgh) during the evening peak, they could not be moved for a long time, even after paramedics arrived. Station staff deemed it unsafe for trains to use the platform so the line was blocked; No quibble.

Moving an incapacitated person sounds like an exceptionally stupid request,

Does a medical emergency requiring an ambulance always mean that the patient is incapacitated and cannot be moved under any circumstances?

As an aside, the first thing I'd be installing on a work phone would be a call recorder for my own protection.

Control phone calls are recorded already.

 

[BJames]

Yesterday we had someone who needed medical attention who the TM moved to the first class section (I wasn't sure exactly the nature of the medical concern) - but it was agreed by control and TM and the passenger's own judgement that the best course of action was to have a taxi waiting at St Pancras to take him to A&E. The TM did come back through regularly to check on the passenger and offered a number of times to have a transfer waiting at Kettering instead, but the passenger chose to remain onboard to London.

SWR also pay for private paramedics at a few stations at key locations near London in peak hours so that assistance can be available much quicker.

This is interesting - I suppose it makes sense but at how many stations I wonder?

 

[185]

Not force, request.

Disagree. Force.

Some desperate people in Controls trying to protect their PPM related bonuses by breaking every common sense rule in the book. Big mistake offering any performance incentive.

 

[Inthewest]

Moving an incapacitated person sounds like an exceptionally stupid request, both for the possibility of causing further harm and the exposure to civil or even criminal liability from doing so.

I don't think anyone has been procecuted for this sort of thing.
It's not The Incredibles!

 

[swt_passenger]

This is interesting - I suppose it makes sense but at how many stations I wonder?

[SWR paramedics]
Googling various SWR PR stuff from around 2019/2020 suggests Waterloo, Clapham Jn, Wimbledon, Vauxhall, Woking. No idea if it continued through the pandemic though.

 

[alxndr]

I was involved in a slightly different incident where a colleague was injured trackside and, although they were in the cess and clear of the line, they could not be moved.

I was able to keep trains running until the paramedics arrived 40 minutes later, at which point I arranged for all lines to be blocked (despite later requests to reopen the furthest away one, which I wasn’t comfortable doing with 5 non-PTS paramedics wandering around). After a while of trying to figure out the best way of getting the casualty to the waiting ambulance without causing further pain or putting ourselves in danger the decision was made to draw the nearest waiting train up, load the casualty on, and then offload them at the access point onto the ambulance. The offer was made by the train driver to take them to the station, which has the hospital, but the paramedics turned it down as there was no guarantee that they would be able to co-ordinate another ambulance to meet the train there and they preferred to travel by ambulance where they had equipment available.

All in all I think trains were stopped for 1hr 20mins. A large part of that was co-ordinating the plan to get the casualty onto the train and make sure everyone understood exactly what the train was to do.

 

[Horizon22]

Always a request, control in no situation can ever force anyone off the train.

Indeed. The request is always "is the passenger able to be moved off the train". Sometimes there's some uncertainty and it is best to check again and they can confirm they can. But any sort of neck / back damage, broken bones, or fitting of some description normally means stay put. It also may depend what the 999 call handler advises.

 

[noddingdonkey]

1E25 in platform north of Edinburgh a few weeks ago for over 3 hours awaiting an ambulance as person couldn’t be moved, category 1 priority call, but still over 3 hours, another catergory 1 at edinburgh Waverley with customer on board for nearly 2 hours awaiting ambulance an unable to be moved off train.

I have multiple other examples of trains stopped for hours awaiting ambulances.

It does seem that in those circumstances it should be possible to agree with the ambulance dispatcher to move the train forward to a bigger station where there is good access for the paramedics and where there are other platforms so the train isn't stopping the job totally. Having certain stations pre-designated for such operations would seem to make sense.

 

[800001]

It does seem that in those circumstances it should be possible to agree with the ambulance dispatcher to move the train forward to a bigger station where there is good access for the paramedics and where there are other platforms so the train isn't stopping the job totally. Having certain stations pre-designated for such operations would seem to make sense.

And that would be down to the ambulance service to dictate.

There will be certain situations where ‘control’ will say get the train to Xx station rather than where the guard has asked for , purely because there is more chance of a quicker response, but where the ambulance will attend will be down to the ambulance service.