ATOC Guidance Note Responding to Ill Customers on Trains

Transcription

1 ATOC Guidance Note Responding to Ill Customers on Trains Synopsis Submitted by This document provides guidance on developing policies for responding to ill customers on trains Daniel Mann Operations Manager, ATOC Authorised by Gary Cooper Head of Operations, ATOC

2 Part A Part B Contents Section Description Page Appendix Issue Record 3 Responsibilities 3 Explanatory Note 3 Guidance Note Status 3 Supply 3 1 Purpose 4 2 Scope 4 3 Definitions 4 4 Introduction 4 5 Guidance on Process 5 6 Situational Guidance 5 7 Briefing and review 9 A Process flow chart for dealing with ill customers 10 Page 2 of 9

3 Part A Issue Record This Guidance Note will be updated when necessary by distribution of a complete replacement. Amended or additional parts of revised pages will be marked by a vertical black line in the adjacent margin. Issue Date Comments One Original Document Responsibilities Copies of this Guidance Note should be distributed by ATOC members to persons responsible for ensuring compliance with the appropriate Railway Group Standards. Explanatory Note ATOC produces ATOC Guidance Notes for the information of its members. ATOC is not a regulatory body and compliance with ATOC Guidance Notes is not mandatory. ATOC Guidance Notes are intended to reflect good practice. ATOC members are recommended to evaluate the guidance against their own arrangements in a structured and systematic way. Some parts of the guidance may not be appropriate to their operations. It is recommended that this process of evaluation and any subsequent decision to adopt (or not to adopt) elements of the guidance should be documented. Guidance Note Status This document is not intended to create legally binding obligations between Railway Undertakings and should be binding in honour only. Supply Copies of this Guidance Note may be obtained from the ATOC members web site. Page 3 of 9

4 Part B 1. Purpose 2. Scope This document provides guidance to Railway Undertakings on developing procedures for responding to ill customers on trains. This Guidance Note applies to all ATOC Members. 3. Definitions Next suitable booked station The next suitable, staffed station on the route at which the train is booked to stop. An ill passenger, who does not have a life threatening condition or illness as specified in section 6.1, should be de-trained at this location into the care of station staff to await an ambulance. Next suitable station The next suitable station along a line of route (whether or not the train is booked to stop or not) at which a passenger who has a life-threatening illness or other illness as specified in section 6.2, can be passed directly in to the care of ambulance staff. Emergency Stop Points maps can be used to highlight next suitable stations on a network. 4. Introduction Having a procedure designed to provide guidance in dealing with customers who become ill is an important element of a Railway Undertaking s performance management process. It is important to minimise the risk of customers being trapped in queuing services which consequently creates the risk of more customers becoming ill or agitated on following services. A robust policy, understood by station and on-train staff as well as local Ambulance Services and the British Transport Police (BTP), will help to mitigate this risk and furthermore reduce the risk of customers self-egressing from trains that are trapped. 5. Guidance on Process Railway Undertakings should identify measures suitable for the geographies specific to their businesses for dealing with non-life-threatening and life-threatening situations. Liaison with the appropriate emergency services (Ambulance service/btp) when formulating guidance is crucial to developing a robust process, understood by all parties. Having done so, Railway Undertakings should determine appropriate methods for minimising risk to the ill passenger whilst also mitigating the risk of safety-of-the-line incidents brought about by self-evacuation from trapped and queuing trains. Page 4 of 9

5 The use of an Emergency Stop Points map can assist in timely decision-making when it comes to determining suitable locations for dealing with ill customers. 6. Situational Guidance 6.1 Non life-threatening situation If the injury or illness does not appear to be life-threatening, arrangements should be made with the Control to have the passenger transferred into the care of station staff at the next suitable station. The next suitable station will be agreed between the Driver and/or Guard and the Control. The Driver and/or Guard and medical person (a volunteer member of the public) on the train must decide if an ambulance is required. Exceptions to this rule are: The station is unstaffed Serious injury or internal blood loss is suspected Childbirth is imminent The passenger is in an active phase of seizure, fit or convulsion removal can take place as soon as this has stopped On the instruction of professional medical advice. 6.2 Life-threatening situation If the injury or illness is immediately life-threatening the Driver and/or Guard must request that the train is stopped at the next suitable station, even if the train is not booked to stop there. The Driver and/or Guard must consider the train speed and remoteness of station which can be called at en-route. Clearly larger town and city stations are likely to be better served by the Ambulance Service and have better access. In all cases customers must not be forcibly moved if unconscious or semi-conscious. 6.3 Requesting an ambulance It is important to have a robust process, understood by all parties, for requesting ambulance/paramedic assistance. Agreeing appropriate protocols with local Ambulance Services, relative to the types of geography and service patters in operation, can significantly assist the management of ill customers on trains. Some Railway Undertakings elect to place all requests for an ambulance through the Control Office. In some cases, Railway Undertakings establish a three-way conference call between the member on on-train staff, the Control Office and the Ambulance Service. A conference call can help to establish the most suitable place to de-train the ill passenger or hold the train for an ambulance to attend. Page 5 of 9

6 An Ambulance Service Controller will require the following details of the ill or injured passenger: Person s age (approximately) Male/Female Any breathing difficulties Whether conscious or unconscious If there is any heavy bleeding visible The precise location of the passenger If obvious, the nature of the illness/injury Location and postcode of station stop (Control Office may be able to provide this information). Further questions may be asked depending on the details given. 6.4 Ambulance Response Time Category A in 8 minutes Category B in 19 minutes Immediately life-threatening calls where an emergency response dispatched by and responsible to the ambulance service arrived on scene within eight minutes of the call being received in the control room. Emergency but not immediately life-threatening calls where an emergency ambulance able to transport the patient arrived on scene within nineteen minutes of the call being received in the control room. The likelihood is that the Ambulance Service will send a paramedic and then an ambulance to an incident. Many Ambulance Service staff have been briefed that ill/injured customers need to be moved off the train quickly, when this is not likely to cause further injury, within a target time of two minutes (as per the standard instructions for ill/injured customers on planes at airports). Railway Undertakings may wish to assure themselves that Ambulance Services within their defined geographies advise their staff of this requirement. 6.5 Control Office staff responsibilities Control Offices should be responsible for the overall management of ill passenger incidents. Incidents should be logged with as much detail as possible for review; this should include the passenger s details. Control Offices should agree with the Driver and/or Guard where the most suitable location/station is for an ambulance to meet the train. Control Offices should provide the Ambulance Controller with the contact details of the Driver and/or Guard and Station Staff. Page 6 of 9

7 6.6 Alternative considerations There are other actions that may be put in place by Railway Undertakings as part of the overall process for dealing with ill customers on trains. These alternatives are listed below: 1) First aid and first aiders at every station - First aid at work courses should include how to deal with person ill on train incidents 2) Customer advisory messages - e.g. PA announcements on stations. Also consider using Twitter to provide advice and guidance to customers on prevention and what action to take on becoming ill (e.g. get off train and seek help at station) 3) Seasonal poster campaigns e.g. carry water, get off train if feeling unwell, open window. On-train notices e.g. near passenger alarms seek assistance at the next station 4) Train and station radio at all locations used to get assistance when required 5) Exploring with BTP response officers being trained to paramedic standard 6) Single point of calling emergency services 7) Use of dedicated location codes that are agreed in advance with emergency services that identify stations and station areas 8) Reassurance to staff assisting customers 9) Business awareness of BTP police officers of knock on risks. BTP understand ripple effect of incidents that lead to stranded trains, congestion and crowding. BTP will generally seek to remove a person to minimise wider risks. 7. Briefing and review 7.1 Briefing It is essential that all parties involved in deploying and acting upon the arrangements set out in company-specific policies are briefed on their individual actions and role in the process. Joint briefing sessions with the relevant emergency services should be considered to assist with developing relationships and understanding other parties roles in the effective management of the policy. Conducting table-top style simulations may also help to embed policies. A process flow chart, detailing the responsibilities of all parties involved in the execution of the policy, may assist briefing sessions. An example is included in appendix A. Page 7 of 9

8 7.2 Review Arrangements should be in place for reviewing the on-going effectiveness of policies, in particular, ensuring that where Railway Undertakings operations overlap, at key major interchanges for example, individual company policies complement those of neighbouring Railway Undertakings. Post-incident reviews should consider the effectiveness of the policy. Railway Undertakings should notify other Railway Undertakings of risks or areas of weakness identified in policies during post-incident review. This will ensure good practice is shared and lessons learned result in a continuous improvement cycle. Page 8 of 9

9 APPENDIX PROCESS FLOW CHART FOR DEALING WITH ILL CUSTOMERS Page 9 of 9