Discussion on panic attacks and general first aid training at work

[6Gman]

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!

Love the story!

Could have been worse - imagine if it had been a Pathologists' Conference.

"Sorry, can't help until he's dead ..."





Yes, I know pathologists don't only deal with the deceased ...

 

[Llanigraham]

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
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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

Agreed in most situations, Neil, but don't forget there are some people here who have to suffer DOO trains!

AED's, I know, I've been trained to use them!
People are scared of them and think they are going to cause harm, but the modern ones cannot do that. I looked at a new one recently that is only just bigger than a mobile phone!

From experience some of the worst "first aiders" are nurses and doctors, unless they work in A & E, mainly because they never have to deal with these type of things, but they can still be useful.

 

[ralphchadkirk]

Valid point, but very bad analogy. A heart attack would see the person on the floor in seconds and dead in minutes. I doubt even the most heartless jobsworth would fail to notice, or ignore, that.

In the majority of cases, no it wouldn't.

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

Absolutely.

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.

It is still taught (I was) but there's a lot of misinformation spread which leads to under-confidence.

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.

Yes, there is normally a stimulus with panic attacks that it is best to remove.

Even broken ribs under CPR are considered "normal".

Happens all the time!

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.

I would agree that this role is considerably more important. Getting stuck in leads to tunnel vision which leads to poor task distribution and management. There needs to be a leader.

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?

You don't need to be trained to use one.

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.

Isn't that 'orthopaedic surgeon'?

There are many levels of first aid training. I've only done a one day course and we didn't cover things like panic attacks, or how to deal with them.

Panic attacks aren't within a first aider's scope.

There are at least 15 different causes of hyperventilation all of which need to be ruled out before a panic attack diagnosis is made (and most of which are life threatening). Even then all first-presentation panic attacks should be examined in hospital.

 

[455driver]

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.

That was in Plymouth after a doctor helped a man who had a heart attack in the City Centre, he suffered broken ribs during the CPR and sued on the grounds of the injuries he sustained. The judge asked him how much he wanted (as compensation) and then asked him how much his life was worth and that was the amount he had to pay the doctor.

After dismissing the claim, the judge 'had a word' with his legal team.

 

[tony6499]

Part of a TM/Conductors training is to be able to ascertain the big picture with medical emergencies and to arrange all the help needed in a timely and proper manner.

I was never given any kind of first aid training so I would never attempt to do something I wasn't trained to do but I was trained to ask for assistance and to assess the situation and where the best place possible was to get an ambulance etc

 

[Flamingo]

Anyway, there are thousands of StJohns/Red Cross members out there just aching to put their training into use outside a training room (I know, I used to be one of them). It makes their day to do it (at least it used to make mine!)

 

[anme]

If my aunty had testicles she'd be my uncle.

The OP wasn't having a heart attack, she was having a flounce panic attack because the nasty mean jobsworth had nastily and meanly caught her breaking the law. And now the OP is trying to retaliate because she still thinks she's special and that the rules don't apply to her.

As for the "severe psychological trauma" of being caught without a ticket, I can highly recommend the simple yet effective solution buying a ticket next time. I normally charge £100 an hour for such expert advice, but the OP can have it for free.

That is extrapolating a lot from the OP's single post. I'd only ever heard the first sentence in the comedy programme "The Office" before, and people should bear in mind that this kind of post does bring to mind such characters as David Brent, Alan Partridge, Jeremy Clarkson and Basil Fawlty.

 

[Flamingo]

That is extrapolating a lot from the OP's single post.

That's the point really. The OP has not been back since to clarify anything, seek further advice, or do anything to alter the view of forum members such as myself who on the information contained in that post (as that is all we have to go on) think that they are probably some sort of narcissistic T W A T who thinks the world owes them a living, and is now trying to find some way to get what they perceive to be revenge on the ticket inspector who dared to catch them fare-evading.

That's the joy of the internet, everybody has a platform - but with that, they can also put up with people who might say things about them they may not like.

( Mods: T W A T = Travelling Without A Ticket, not an insulting term, it's railway jargon)

 

[Greenback]

The internet is home to many posts where people ask for advice, don't like the replies they get and never come back. It's understandable really, especially if their situation is based on some sort of misconception.

Then again, there are also those who continue to argue that black is white until they are blue in the face.

I personally think that everything that can be said has been said, and there is little point in continuing to discuss what might or might not have happened without any further information from the OP, which it seems we are unlikely to get now.

 

[cuccir]

It's been interesting to read about the comments on first aiding - my response to the OP was initially a genuine question as to whether or not staff working with the public were first aid trained. I think some good reasons have been provided for why they are generally not.

 

[Flamingo]

It's been interesting to read about the comments on first aiding - my response to the OP was initially a genuine question as to whether or not staff working with the public were first aid trained. I think some good reasons have been provided for why they are generally not.

Of course, staff may not be "First Aid Trained" by the railway, but may have skills from a previous lifetime - some of my colleagues are trained nurses, paramedics, ex-Army medics, St Johns Ambulance, etc.

 

[BestWestern]

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.

Really? You would attempt to instigate disciplinary proceedings against a non-medically trained staff member, for failing to identify a relatively minor psychological condition which a passenger begins to display midway through a 'caught red handed' fares dispute? The unions (and your managers, I expect!) would love you! Eeek

Any first contact regarding a passenger complaint, unless accompanied by enough evidence so as to make it almost indisputable, should be an informal conversation with the staff member concerned, to establish the appropriate onwards path. It is possible, I've received exactly that myself, and very good management it is too. The 'steaming straight in' method is a surefire way to foster poor staff-management relations.