Monday, June 6, 2011

First Aid?


Metro says all operators are trained in first aid.

From Jacquelyn:
I was on the train the other day, and another rider passed out for 5-10 seconds and hit his head hard.

I was the first responder, and when he came to, I asked him to remain on the floor until help arrived.

This happened between the Pentagon and Arlington Cemetery.

When we reached Arlington Cemetery, the operator came, saw that the passenger was awake, and didn't seem to understand why he was on the floor, even after I told him that he had passed out and hit his head.

The conductor had him get up and walk off the train and called for help.

Soon after, the passenger passed out again.

When the paramedic came, the conductor only told him that he had passed out twice. I then went up to the paramedic and told him the full story.

My complaint is that the conductor was not trained in the very basics of first aid.

First of all, I realize that it is rush hour, but if a passenger hits his or her head from a fall, you DO NOT move them. Even if they are awake and can move their legs.

They can have a concussion, or develop bleeding. Are those small possibilities? Yes, but all head injuries should be treated as serious.

Second, when the passenger passed out again, the conductor did panic a little. Again, because he wasn't trained.

I hope this complaint is taken seriously.

I do not fully blame the conductor for his actions, as I understand that when he first saw the passenger, the rider was conscious.

What I am angry about is that he did not listen to me and then didn't understand the potential significance of a head injury, most likely because he was not trained in the basics of first aid.

I hope the passenger is OK and that he was sent to a hospital, because I got the impression he wasn't, even after all that happened.
Other items:
More railyard woes (Examiner)
Bus driver ignores detour goes wrong way down street (ARLnow)
Re-designing the Metro map (WaPo)

Comments (44)

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Interesting post. I would have never known you don't move someone who hit their head. Then again, i don't have the lives of thousands in my hands.

Suuuuuure they're trained.
Corresponding Toads's avatar

Corresponding Toads · 720 weeks ago

"He's a train operator, not a medic!" -future comment by anonymous/random name
2 replies · active less than 1 minute ago
Actually, it should be "Dammit, Jacquelyn, he's a train operator, not a doctor!"

Seriously, though, I'm happy that Jacquelyn stepped in. We hear of too many instances of people just standing by and watching. It's good to see people who have some idea of what they're doing helping out.
Strictly speaking, it should be "Dammit, Jim, I'm a doctor, not a train operator!" :-)
Wouldratherdrive's avatar

Wouldratherdrive · 720 weeks ago

Jeez -I would have thought that to be common knowledge that the person was not to be moved, whether they can feel or move their legs or not since they still could have a spinal injury that could potentially paralyze them if moved the wrong way unless ther head and neck are stabilized first.
UnSuck Fan's avatar

UnSuck Fan · 720 weeks ago

I get on & off at Metro Center. I see an Automated External Defibrillator at one of the entrances/exits and have had two questions regarding it. (1) How often is the battery checked (I haven't looked at it closely to find out if there's a light to indicate the battery level) and (2) Are the WMATA employees trained how to use it and are they certified to use it?
1 reply · active less than 1 minute ago
Boycotting and Happy's avatar

Boycotting and Happy · 720 weeks ago

You're on your own out there. Barely any cops and Metro staff untrained in first aid and crown control should there ever be a major emergency requiring evac.

Even if Metro cars and rails were safe, the stations are not. They're death traps for the most part.
4 replies · active less than 1 minute ago
"Even if Metro cars and rails were safe, the stations are not. They're death traps for the most part."

Death traps? Seriously? Please, that's a bit over the top -- for all the crime and commonplace accidents that do occur in Metro cars and rails, I'm sure walking on DC streets is much more dangerous... I think most people are prone to their own unintentional self-destriction if left to their own devices.
It's possible for more than one thing to be a death trap.

The stations are death traps in that they are inadequately designed for large crowds. How often have we seen people lined six or seven deep, waiting for a delayed train? Then there are the elevated platforms with exactly one exit and hundreds of people pushing to get to it. In the snow or rain.
I still don't see how this equates to being a "death trap" -- show me the statistics that crowded platforms = eminent death...how many people have died because of crowding? Just shear sensationalism -- OH NOEZ LOTS OF PEOPLE...

Having been hit TWICE by taxis on bike and motorcycle, I'll be willing to figure that DC's roads and walkways are considerably more dangerous. Scratch that... considering having a fellow classmate stabbed and another one hit and killed by a drunk driver last year -- I'm sorry, in relative terms, I don't think the Metro can't be considered a "death trap".
That being said, yes, I find it annoying and disturbing that the capital of the free world's metro system is pathetic compared to those of others that I've frequented...it's often extremely inconvenient and uncomfortable, but to say it's a "death trap" is just not warranted -- especially compared to the alternatives.

Truth in labelling people...let's be sensible and perhaps some progress can be made in making Metro a better, safer system within reason...calling Metro a death trap is the equivalent of Glen Beck comparing Obama to Hitler.
From the Examiner article:

"Most of the employees involved in recent violations received unpaid suspensions of at least five days, Stessel said, but one was suspended for 20 days without pay. Another was fired, he said."

Dan, please keep us informed on this, especially if these personnel actions get reduced or overturned. Many of us have grown quite cynical with regards to the staying power of these actions.
alkebulan's avatar

alkebulan · 720 weeks ago

"What I am angry about is that he did not listen to me". LOL I think that is the real reason for this letter. Next time just as the conductor to call the Wahhhmbulance for you.
1 reply · active less than 1 minute ago
VeggieTart's avatar

VeggieTart · 720 weeks ago

I think the OP was right to be pissed off that the operator was not letting her explain what had happened and why she thinks the victim shouldn't have been moved. You don't need much medical training to know that 1) head injuries are serious, 2) his confusion was a clear sign os something wrong, 3) you don't move someone with such an injury. Clearly the operator of the train was more worried about finishing his route than the victim's safety. But it wouldn't be the first time a train held for a sick or injured passenger--far from it.
Frustr8dCommuter's avatar

Frustr8dCommuter · 720 weeks ago

True that. And if they do have to take a first aid test, I am sure they will sell them the answers.
Sometimes when people are put into these situations, they forget their training. I was at a restaurant in Court House after the Marine Corps Marathon last year when a runner who was patronizing the establishment passed out at the table. "First Aid Trained" individuals all looked on shocked and froze. I had to jump in to act, conduct ABCs, call 911, etc. I'm not excusing the operator for this one, but I can understand how they may have made the mistake moving this poor soul.
Correct about the not moving and hospital. As someone with epilepsy 99% of the time a hospital is a wasted trip. If there is any sort of a complication though (or if you do not know the person suffers from seizures) call an ambulance ASAP. Good job, since a stopgap to medical care when there might be a head injury is to have them lie down, make sure they are breathing and not bleeding, and watch them for further complications.
I'm fairly sure I saw Jacquelyn talking to metro employee a bit back at Arlington Commentary – was looking from the door of a car just behind where she was. At the time it felt odd because it was clear she was trying to communicate with the Metro Employee and it was obvious that the male employee was not responding to what she was trying to tell him.
Obviously, if you expect train operators to be certified in basic CPR, you believe in slavery.
to be perfectly honest with you , i am a metro employee who will never touch an injured person on a train. i will try to establish communication with them and call for an ambulance when asked for or deemed necessary. we have been told in the past that we are not covered under the "good samaritan" policy. like police and fire personnel. we can be sued and Metro will not back us. i am not about to be sued for trying to do the right thing. sorry ain't happenin'! also the train operators are instructed by OCC to see if the passenger can be moved under their own power to the platform. OCC only wants their trains moving, bottom line. and as for first aid training.... i was instructed in CPR 20+ years ago. nothing since and haven't heard about any future training.
6 replies · active less than 1 minute ago
elizabeth's avatar

elizabeth · 720 weeks ago

Thank you for giving riders a bit of insight to what Metro employees are instructed to do...but I'm confused- how are you not covered by the good Samaritan law? Is it because Metro claims all its employees are trained and if something DOES happen and they look into employee records they will find out of date certifications and therefore be exposed? The good Samaritan law is to protect ANYONE who acts in good faith in an emergency situation (you can still be sued, but the law is on your side- this is what I was told 6 months ago when MY Infant/Child/Adult CPR/AED/First Aid training was renewed- which is required for my profession as a teacher). I believe about management wanted the trains to move and don't care about the passengers (not the conductor's fault, although they are the one's who get blamed for everything). Maybe a clever employee- or an auditor- should remind Metro that CPR certifications are only good for 1 year and must be re-taught each year (a lot has been revised in the past 5 years, much less 20!) and First Aid is every 3 years. This way they can remedy the situation and help keep those aboard Metro, passengers, employees, and those in the community safe.
Yes. As Elizabeth said, the good samaritan law protects everyone. I have never heard of someone, no matter their profession, being successfully sued for trying to help. I HAVE heard about plenty of suits where someone sued a company for negligence because someone 'in charge of the area' (employee, etc) was informed but was instructed to do nothing by their higher ups (and did so).

Even if someone has 0 first-aid training they can do what seems reasonable and that is a lot ... like make sure the person is okay until help arrives. Under no circumstances should you try to move someone who might be injured, as you say, you are not trained ... let EMTs or other people who are make that call. Not that you should sit on them if they move themselves, but a REASONABLE PERSON might advise against it if they think that is not a good idea.

Yes, everyone grumbles when a train gets delayed. Metro uses "sick passenger" and "emergency situation all the time though. So I am mystified as to why they feel they could not say it when it actually happens too.
There's a difference between not being sued successfully and not being sued. It adds up to a lot of money for the non-rich.
Well, if you are going to make that argument anyone can sue anyone else about anything. Of course, if it is frivalous it will be laughed out of court, but it is not like you can avoid someone *trying* to sue you.
Yes you can, you can not do anything.

Getting laughed out of court is damn expensive.
Actually, the rules about recertification were changed recently. Both CPR and First Aid are now good for two years.
hrh king friday 13's avatar

hrh king friday 13 · 720 weeks ago

How did he hit his head? Was it that guy who runs around the train screaming when nobody is on?
First of all, I am happy that Jacqueline was where she was when the passenger passed out. Thank goodness for her quick thinking. And second: Really? Metro claims all their train operators are trained in First Aid? I truly don't believe that they are trained, so Metro is once again lying to us. And another thing, I don't actually want those losers (male metro employees) touching me. They are mean and vulgar and have said nasty comments to me before. Plus, weren't the station managers at Dupont Circle running a prostitution ring a while back?
3 replies · active less than 1 minute ago
The sex trade was being run out of the Friendship Heights Metro station by two female employees.
"I hope this complaint is taken seriously."

You'll have better luck hoping for a peaceful resolution to the Middle Eastern conflicts.
Metro Ryder's avatar

Metro Ryder · 720 weeks ago

In a previous job I was required to be certified in CPR. The local fire department (I didn't live in DC) gave us the training. It was pathetic. They barely gave us any information and mostly chatted. We didn't even have to practice anything they told us. One guy told us how he refused to give mouth to mouth to a guy because he didn't have his mouth guard and recommended we do the same. (Am I correct that mouth to mouth is not longer protocol?)

Knowing how bad my first aid and CPR training was, I'm not at all surprised the metro employee didn't seem to have any. I really can't fault him for it, if his training was up to date, it may not have been any good.
2 replies · active less than 1 minute ago
I'm sorry you had such a horrible training experience. Most CPR and first aid trainers are better than what you experienced. You are correct that mouth-to-mouth is no longer standard procedure, but most medical professionals I know still recommend it when a patient is not breathing. Recent studies have shown that chest compressions are just as effective as compression/breath CPR, but it never hurts to do the mouth-to-mouth if the injured person is dead (um, that's what no breath/no pulse means). Rest assured that, despite that firefighter's ridiculousness, there's little risk to performing mouth-to-mouth, and if you're really concerned about it carry a guard. I would think that this wouldn't be a concern so many years after AIDS panic, but people are morons.
UnSuck Fan's avatar

UnSuck Fan · 720 weeks ago

I was re-certified through work and my certification is good for two years. Yes, how to administer CPR has changed. They discovered that more lives are saved by giving chest compressions alone (though when a person has no pulse, giving mouth-to-mouth is needed). Long story short, go to www.handsonlycpr.org for more information. You can also go to www.suddencardiacarrest.org for information on using an Automatic External Defibrillator. Click on the link that says "Resources" and arrow down to the section that says "Multimedia". Click on that link and scroll almost all the way to the bottom. It has video demonstrations of how to use an AED.
n2deep pretty well nailed it. I'm not sure about whether or not Metro employees are covered by the Good Samaritan Law though.

I retired from Metro last year. I can't recall the last time my coworkers and I in Automatic Train Control (ATC) had CPR training. Over the 27 years I was with Metro I had CPR at least twice, maybe 3 times. I don't recall ever having first aid training.

As with so much else at Metro, the primary problem is a lack of oversight. Metro answers to no one except themselves (the WMATA board of directors).

If the situation is the same in Operations (I'd guess it is) we can't blame the Train Operator for not being knowledgeable. It is often the case that when employees appear to be incompetent it is actually the fault of management for not providing proper training and testing.
In Metro-Land the business at hand is "move the trains." This has been the mentality from day 1. While I understand the need to keep the flow going, I can also understand the frustration for riders that can't comprehend this culture. I have little doubt that this operator was doing _exactly_ what he was being instructed to do by Metro's rail operations center. If possible, remove the victim from the train.The trains need to MOVE! MOVE! MOVE! You want to feel even better? They will _rarely_ hold the trains for the POLICE! I know Metro police guys who have said they get calls all the time for various disruptions (fights, disorderly people, etc.) and Metro continues to move the trains making it difficult to catch it to take care of the problem. It's even happened on "man with a gun/knife" calls.
Former EMT's avatar

Former EMT · 720 weeks ago

I used to be a volunteer EMT and I once had a train offloaded because of a sick patient.

The train was delayed on the Green line (I think at West Hyattsville or PG Plaza.) A woman stuck her head inside the car I was sitting and asked if anyone was a doctor or medical pro. I told her I was an EMT and she asked if I could help.

She brought me to the car where a young woman was semi-conscious. I did what little I could to get a basic patient assessment - talked to her, asked her about her medical history, asked if she had any pain, if she could remember anything, if she had Diabetes or Epilepsy, etc. With no equipment (bp cuff, etc.) I couldn't get her vital signs - since I don't wear a watch I couldn't even get an accurate pulse...
Former EMT's avatar

Former EMT · 720 weeks ago

...I told the driver to call 911 and have a crew with the proper equipment check her out. The train was offloaded and people complained, but it was the right thing to do. I think both basic life support and paramedic ambos arrived and took over treatment.

Was the patient's life in danger? Probably not. She actually refused to go to the hospital and signed a release form. But I felt she needed to at least have her vitals taken and she needed the option fo transport to the ER. It happens some times - your commute gets disrupted by someone who might need to go to the hospital asap.
Absolutely, the guy should not have been moved. It's one thing if he had gotten up on his own, but he was made to get up. Unfortunately, there are first aid situations where you have to get authoritative to keep other 'helpers' from causing further injury. Me personally, I would have taken a C-spine hold on the passenger and not let go until a uniformed EMT showed up. Anyone who wanted to argue with me about that would have gotten an earful, for sure.
The Red Cross offers this training for organizations
http://www.redcross.org/portal/site/en/menuitem.d...
Even though the incident happened at the beginning of the month, it took until today for me to get a response. So here is the official Metro statement verbatim.

"Your email was received by Metro's Rail Transportation Customer Service. Please excuse this delinquent response due to my workflow back-log. Regarding the action taken by the rail operator, when a rider has taken ill, the rail operator is trained to call for medical assistance. If the customer is able to walk off of the train, than the train will keep moving, otherwise, the rail operator will be instructed to remain until EMS arrive. Usually a Metro supervisor will enter the train if the rider is unable to move. Thank you for the assistance rendered. We welcome and appreciate conscientious riders with suggestions to help make the system better. "

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