# Emergencies on Amtrak



## Sammette (Oct 20, 2019)

If someone needs emergency medical assistance on Amtrak, will they stop the train or how do they handle it?


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## pennyk (Oct 21, 2019)

I was on the Crescent in July 2018 when a passenger (and friend) was having a heart attack. The LSA (who was a trained paramedic) performed CPR while the train traveled to the closest crossing where an ambulance could meet the train. The crew acted quickly and professionally.

I have been on other trains where we have made unscheduled stops so that passengers could be transported.


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## Palmetto (Oct 21, 2019)

This is a good reason why crews need to know their territory very well, and know exactly where they are at a given moment. The lack of situational awareness can have disastrous consequences, as some train wrecks have amply demonstrated.


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## Acela150 (Oct 21, 2019)

pennyk said:


> I was on the Crescent in July 2018 when a passenger (and friend) was having a heart attack. The LSA (who was a trained paramedic) performed CPR while the train traveled to the closest crossing where an ambulance could meet the train. The crew acted quickly and professionally.
> 
> I have been on other trains where we have made unscheduled stops so that passengers could be transported.



And it's not the same without him.  



Palmetto said:


> This is a good reason why crews need to know their territory very well, and know exactly where they are at a given moment. The lack of situational awareness can have disastrous consequences, as some train wrecks have amply demonstrated.



Well said! This is one reason that can be forgotten as to being qualified on Physical Characteristics!


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## me_little_me (Oct 21, 2019)

It's so much better than flying. Unruly and/or dangerous passengers can be removed quickly as well as the aforementioned medical emergencies. And yes, unruly passengers have been removed and placed in the custody of the nearest local police department.


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## Dakota 400 (Oct 21, 2019)

me_little_me said:


> And yes, unruly passengers have been removed and placed in the custody of the nearest local police department.



I observed this on the Southwest Chief leaving LAX. I was sitting in the SSL having a before dinner drink when a "gentleman" entered the car from the Diner. There had been "issues" in the Diner with him and he was removed. Shortly, the Conductor and the Trainman arrived as we approached a station stop to remove him from our train. He became combative with them. I rose from my seat along with a much younger man (who told me to "stay out of this") to help the train's crew and he assisted the others in getting out of the SSL and into the custody of the police.


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## Rasputin (Oct 21, 2019)

Sammette said:


> If someone needs emergency medical assistance on Amtrak, will they stop the train or how do they handle it?


Here is one recent answer on this thread:
https://discuss.amtraktrains.com/threads/8-13-window-evacuation-at-minot.76162/


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## Qapla (Oct 21, 2019)

On my last trip from Tampa on the Star we had to stop in an intersection for medical emergency - they had to remove a passenger having chest pains and transport her to the hospital.

It is nice to see how quickly these things are taken care of by the Amtrak staff and the local emergency personnel


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## Palmetto (Oct 22, 2019)

Qapla said:


> On my last trip from Tampa on the Star we had to stop in an intersection for medical emergency - they had to remove a passenger having chest pains and transport her to the hospital.
> 
> It is nice to see how quickly these things are taken care of by the Amtrak staff and the local emergency personnel



Let's not forget the train dispatcher, either. It's s/he who orchestrates the whole operation from Omaha, Jacksonville, Ft. Worth, or wherever the railroad's dispatching office is.


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## Devil's Advocate (Oct 22, 2019)

pennyk said:


> I was on the Crescent in July 2018 when a passenger (and friend) was having a heart attack.


I'd like to take this opportunity to reference some first aid steps for people believed to be experiencing a heart attack.

Mayo Clinic Link: https://www.mayoclinic.org/first-aid/first-aid-heart-attack/basics/art-20056679?p=1

I'd like to draw special attention to this part: "*Chew and swallow an aspirin,* unless you are allergic to aspirin or have been told by your doctor never to take aspirin."

I would advise passengers to bring aspirin with them rather than relying on someone else to have it, and to store it somewhere easy and obvious to access it.

_The life you save may be your own._


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## pennyk (Oct 22, 2019)

Devil's Advocate said:


> I'd like to take this opportunity to reference some first aid steps for people believed to be experiencing a heart attack.
> 
> Mayo Clinic Link: https://www.mayoclinic.org/first-aid/first-aid-heart-attack/basics/art-20056679?p=1
> 
> ...


Interesting that you should mention that. Before the crew visited Alan in his roomette to administer first aid, in response to a text, I went to his room to check on him, and he asked me if I had Bayer aspiriin. I did not, but I "ran" to the dining car and asked everyone in the dining car if they had any aspirin. No one did.  I carry Bayer aspirin with me whenever I travel now.


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## Qapla (Oct 22, 2019)

I have a pill holder on my keychain. It contains my prescription meds and aspirin


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## RSG (Oct 22, 2019)

Qapla said:


> I have a pill holder on my keychain. It contains my prescription meds and aspirin


If you keep your keychain in your pocket (or anywhere warm, really), periodically check--or better, replace--the aspirin in the container. Aspirin degrades over time and once it breaks down, is generally useless.

This also goes for bottles of aspirin, as well. A quick way to tell if the disintegration process is occurring is if you open the container and notice a vinegary smell. Enteric coated aspirin (Ecotrin, etc) will stay shelf stable longer, but isn't much use for emergency purposes such as a cardiac intervention or a stroke event.


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## Qapla (Oct 22, 2019)

I use generic aspirin - they seem to dissolve much quicker and cost less than the hard-pressed name brands pills

I am supposed to take one each day anyway ... most of the time my pill holder hangs on the outside of my pocket

Since I have pains in several places my aspirin usually does not last long enough to deteriorate 

I do rotate the pills I carry with me just they won't expire


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## Dakota 400 (Oct 22, 2019)

But, what strength of aspirin? 81 mg or full strength? I daily take an 81 mg aspirin on my cardiologist's orders. Always have a bottle of that medicine with me during a trip.


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## RSG (Oct 22, 2019)

Dakota 400 said:


> But, what strength of aspirin? 81 mg or full strength? I daily take an 81 mg aspirin on my cardiologist's orders. Always have a bottle of that medicine with me during a trip.


If you're taking it for emergency purposes, it should be a regular strength (325 mg) single aspirin, preferably of the chewable variety (once upon a time called "baby aspirin"), which would be equivalent to four (4) traditional children's aspirin. 

The problem with carrying children's/chewable aspirin is that it's equally prone to the disintegration issue mentioned above. Many doctors recommend the enteric-coated low dose aspirin because it doesn't dissolve in the stomach and therefore doesn't cause irritation and stomach bleeding (and is more shelf stable). But again, that's not useful for an emergency situation where time is of the essence and it needs to get into the bloodstream ASAP.


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## Dakota 400 (Oct 23, 2019)

RSG said:


> If you're taking it for emergency purposes, it should be a regular strength (325 mg) single aspirin, preferably of the chewable variety (once upon a time called "baby aspirin"), which would be equivalent to four (4) traditional children's aspirin.
> 
> The problem with carrying children's/chewable aspirin is that it's equally prone to the disintegration issue mentioned above. Many doctors recommend the enteric-coated low dose aspirin because it doesn't dissolve in the stomach and therefore doesn't cause irritation and stomach bleeding (and is more shelf stable). But again, that's not useful for an emergency situation where time is of the essence and it needs to get into the bloodstream ASAP.



Thanks for your reply. I use enteric-coated 81 mg aspirin usually. I'll get a supply of aspirin that is chewable.


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## Sauve850 (Oct 23, 2019)

Chewable is the best to carry. I have it at home, carry it on a trip and also have a bottle in my suv.


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## Qapla (Oct 24, 2019)

I don't carry any meds in my SUV ... but then,


Spoiler



I don't have an SUV


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## railiner (Oct 24, 2019)

If you are a cardiac patient, you should carry prescription nitroglycerin tablets with you for such emergencies...

I wonder if Amtrak has them in their first-aid kit, as all airliner's do? 
While airliner's are sometimes several hours away from the nearest emergency help, a train crossing the Rockies or desert can be as well....


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## Devil's Advocate (Oct 24, 2019)

railiner said:


> I wonder if Amtrak has them in their first-aid kit, as all airliner's do? While airliner's are sometimes several hours away from the nearest emergency help, a train crossing the Rockies or desert can be as well.


Yeah, I was wondering about this as well. Seems like there should have been a first aid kit per car, each with their own set of cheap and effective aspirin. In a heart attack every minute counts so time is an issue even if you're in the middle of a major city.


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## Barb Stout (Oct 24, 2019)

railiner said:


> If you are a cardiac patient, you should carry prescription nitroglycerin tablets with you for such emergencies...
> 
> I wonder if Amtrak has them in their first-aid kit, as all airliner's do?
> While airliner's are sometimes several hours away from the nearest emergency help, a train crossing the Rockies or desert can be as well....


I was checking into which one was better, aspirin or nitroglycerin, and came upon this on a first aid website: "Nitroglycerin “Nitro” is a symptom relief medication and does not target the underlying cause of the heart attack. First Aiders should focus on helping the person take aspirin over nitroglycerin, as long as there is no contraindication. Remember to ask “Are you allergic to aspirin?”"


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## Sauve850 (Oct 24, 2019)

Think everyone should discuss their individual situation with their Dr.


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## RSG (Oct 24, 2019)

railiner said:


> If you are a cardiac patient, you should carry prescription nitroglycerin tablets with you for such emergencies...
> 
> I wonder if Amtrak has them in their first-aid kit, as all airliner's do?
> While airliner's are sometimes several hours away from the nearest emergency help, a train crossing the Rockies or desert can be as well....





Barb Stout said:


> I was checking into which one was better, aspirin or nitroglycerin, and came upon this on a first aid website: "Nitroglycerin “Nitro” is a symptom relief medication and does not target the underlying cause of the heart attack. First Aiders should focus on helping the person take aspirin over nitroglycerin, as long as there is no contraindication. Remember to ask “Are you allergic to aspirin?”"


One needs to be exceedingly careful when using nitroglycerin. It's really only for use in certain types of cardiac care.

Both my parents were cardiac patients. My father had angina, so nitroglycerin was the appropriate emergency care for him. One time, both of them were at a small family gathering one summer and my mother started to feel "woozy" (as she described it). My father gave her one of his nitroglycerin tablets and she subsequently fainted. Emergency services were called and she was transported to a regional medical center. After evaluation, it was determined that the reason she didn't feel right was because she was dehydrated and because her cardiac condition was electrical (arrhythmia or similar), nitroglycerin was of no use and actually exacerbated her condition.

So from that point on, as their caregiver, I always made sure they (particularly my mother) carried water, especially during warmer months. Even when my dad didn't "feel right", I would ask him if he drank any water recently and insisted he did so before he took any nitroglycerin.

Aspirin, on the other hand, is generally safe for all cardiac patients, unless one is allergic or has been instructed by their doctor not to use it. Yes, one should always consult with their physician or cardiologist before taking it, but in an emergency situation, it's better to give it than not give it. [Assuming the patient is able to answer basic questions about their health and condition.]


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## Acela150 (Oct 24, 2019)

Sauve850 said:


> Think everyone should discuss their individual situation with their Dr.



Hey!!!! That makes to much sense! :O 

But yes. This is the best idea.


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