Amtrak nurse (proposal for the future)

[PVD]

An AED is carried in each food service car. Not sure what happens on a Keystone.

 

[daybeers]

There already is one in every food service car.

Like PVD said above, what happens on trains with no food service car? Empire Service, Keystone, Hartford Line, any others? Is it thought those trains have closer station spacing and/or more reliable and fast-response EMTs available in the territory they run through? Seems to me at least some stations are far enough apart to make installing an AED worthwhile.

 

[MARC Rider]

Unless you could broker some kind of interstate compact, it would be difficult. An RN at minimum is the equivalent of a 2 year college program, there is already a shortage nationally, as much as I would love to see it, from a comfort standpoint, adding an expensive additional staff person is unlikely. They don't even want to have adequate staffing of OBS.

I wonder how the railroads did it in the 50s and 60s.

 

[PVD]

I would imagine the rules were very different.

 

[PVD]

Like PVD said above, what happens on trains with no food service car? Empire Service, Keystone, Hartford Line, any others? Is it thought those trains have closer station spacing and/or more reliable and fast-response EMTs available in the territory they run through? Seems to me at least some stations are far enough apart to make installing an AED worthwhile.

Empire Service trains have a food service car, it is not staffed on the trains that don't go past Albany, but the cars are still in the set.

 

[MARC Rider]

I would imagine the rules were very different.

Indeed, they may have been, but the essential part, that medical personnel are licensed by each state, was true back then, too.

 

[basketmaker]

We (at least some-not me though?) are overall healthier than we were in the 1950's - 2000's for heart issues. AEDs should still be common on all modes of commercial transportation.

 

[pennyk]

There already is one in every food service car.

During the medical emergency on the Crescent in July 2018, the LSA used the AED, on which he had been properly trained.

 

[mp492_5]

Road crossings and EMS. Why a nurse on a train?

 

[Seaboard92]

A defibrillator is worth its weight in gold. Wall mounted and very potable and friendly to use. The cost of one starts at about $2000. Maybe have three per train.

The safety card in the seat pocket could explain them and where they’re located.

I would say that is excessive but I can remember one day in my railroad career where we used two of them in one day within five hours of each other. So I could see an argument for at least two.

The cabin crew are trained and qualified to handle the equipment on board.

These incidents on long ETOPS 180 or 220 flights can require considerable medical expertise on board should something go sideways. Even if there is an airport available, it could be in the sticks in the middle of Siberia with no medical facility in sight.

We get significant training on this. And if we can't pass actual physical tests not just word tests we will not earn our wings. As far as lack of medical experience on board we are able to call to Med Link which is like a phone bank of doctors who only work for aviation problems. And they are the ones who make most of the decisions based upon what is relayed to them. I believe they are in Arizona if I remember correctly.

As far as the middle of Siberia may I recommend Novosibirsk the third largest city in the country, Krasnoyarsk another large city, and Irkutsk home of Lake Baikal. Honestly I would just follow the rail line to find hospitals. Most trans Russian flights tend to follow the rail line anyway. I know my Aeroflot flight from VVO to SVO did. We didn't even overfly China which would have cut some time off.

 

[Willbridge]

As far as the middle of Siberia may I recommend Novosibirsk the third largest city in the country, Krasnoyarsk another large city, and Irkutsk home of Lake Baikal. Honestly I would just follow the rail line to find hospitals. Most trans Russian flights tend to follow the rail line anyway. I know my Aeroflot flight from VVO to SVO did. We didn't even overfly China which would have cut some time off.

Before my 2010 Russia trip, my doctor, who had experience in the former Soviet Union, recommended hepatitis shots first in case I ended up in a Russian emergency room. He said that his firm used medevacs to Hungary for care.

On the other hand, Aeroflot used to advertise itself as "First in the skies of Siberia" so some airlines' crews might have more knowledge of alternatives than would others.

 

[Willbridge]

I wonder how the railroads did it in the 50s and 60s.

One clue is the old schedules that I dug up. Each of the lines that had a stewardess-nurse either dropped the idea or switched to non-nurse stewardesses. It may have just been a headache. (No medical pun intended.)

 

[ehbowen]

Some ideas stimulated by this thread:

• While having a trained medical responder aboard is a great idea, swapping them out every 8 hours like T&E crew is gilding the lily. T&E have constant work to do throughout their stint. There's no reason why you can't wake someone up with a knock on the door in the middle of the night if a passenger has an emergency. If he/she dies in the two minutes it takes to throw on some clothing & sandals, the responder probably wouldn't have been able to save him/her anyway.
• Rather than a registered nurse, how about offering a $7 (or so) an hour premium to any crew member who takes EMT training and maintains his/her certification?
• How about a discreet announcement or seat pocket card which says, in essence, "If you are a licensed medical professional or EMT and are willing to assist in the event of an onboard emergency, please make your presence known to the conductor now. You will receive a complimentary selection from the cafe car."

 

[jis]

I would say that is excessive but I can remember one day in my railroad career where we used two of them in one day within five hours of each other. So I could see an argument for at least two.


We get significant training on this. And if we can't pass actual physical tests not just word tests we will not earn our wings. As far as lack of medical experience on board we are able to call to Med Link which is like a phone bank of doctors who only work for aviation problems. And they are the ones who make most of the decisions based upon what is relayed to them. I believe they are in Arizona if I remember correctly.

As far as the middle of Siberia may I recommend Novosibirsk the third largest city in the country, Krasnoyarsk another large city, and Irkutsk home of Lake Baikal. Honestly I would just follow the rail line to find hospitals. Most trans Russian flights tend to follow the rail line anyway. I know my Aeroflot flight from VVO to SVO did. We didn't even overfly China which would have cut some time off.

But non stops from India to US quite often fly perpendicular to the rail trunk routes in Siberia, i.e. South to North and then over Arctic Ocean. They fly way far north of the great circle route westbound to avoid the jet stream on the nose.

 

[Cal]

How about a discreet announcement or seat pocket card which says, in essence, "If you are a licensed medical professional or EMT and are willing to assist in the event of an onboard emergency, please make your presence known to the conductor now. You will receive a complimentary selection from the cafe car."

I don't think the last part should be added. Someone who isn't actually licensed will say they are.

 

[danasgoodstuff]

I don't think the last part should be added. Someone who isn't actually licensed will say they are.

And it might invalidate good Samaritan protection.

 

[ehbowen]

I don't think the last part should be added. Someone who isn't actually licensed will say they are.

1. You can ask that they show documentation.
2. The selection I'm thinking about is a non-alcoholic beverage. If you've got someone willing to perjure themselves for a soda or a cup of coffee, well...welcome to 2021!

 

[Cal]

1. The selection I'm thinking about is a non-alcoholic beverage. If you've got someone willing to perjure themselves for a soda or a cup of coffee, well...welcome to 2021!

As @danasgoodstuff, it might invalidate good Samaritan protection. And I'd sincerely hope any medically trained people would make themselves known without needing incentive.

 

[cirdan]

Why not? What would be the disadvantages? I only see advantages.

There is a huge shortage of nurses in hospitals and clinics as it is, meaning many patients are not getting the care they deserve.

Diverting nurses to work in other, less essential, places would only make it worse.

 

[cirdan]

There is always a good chance that there is an MD, RN, NP or EMS professional as a passenger on board that could assist. The automatic defibrillator (AED) should be on every train. They run from $599 and up. And probably less in large bulk orders.

The more people on the train, the higher the odds that somebody among them will have medical qualifications.

This would be a soft argument for longer consists.

 

[cirdan]

Then they held a conclave to decide whether to land in Turkmenistan or Afghanistan or carry on to Delhi or at least Peshawar. They decided in consultation with his family that the gentleman had been revived to a point where he would survive the less than two or so remaining hours of flight to Delhi, so we charged on at expedited speed. Upon landing at Delhi we were expedited to our designated gate in T3 and a fully equipped mobile medical crew was waiting to take him to the airport medical facility and possibly then onto a hospital. After he was disembarked, the rest were allowed to disembark. On the whole I was very impressed with the handling of the situation.

Odds also are that a hospital in Delhi would be better equipped to deal with such an emergency than a hospital in Afghanistan or Turkmenistan.

If that was me I know where I would prefer to be treated.

 

[cirdan]

We (at least some-not me though?) are overall healthier than we were in the 1950's - 2000's for heart issues. AEDs should still be common on all modes of commercial transportation.
View attachment 25116

Wow, that's quite an amazing statistic.

Any idea what the reason is?

It can't be food as that has got less healthy if anything.

 

[jis]

Odds also are that a hospital in Delhi would be better equipped to deal with such an emergency than a hospital in Afghanistan or Turkmenistan.

If that was me I know where I would prefer to be treated.

That is exactly what one of the most major consideration was. Delhi has world class hospitals. Not so much in Ashgabat or Kabul. Peshawar, Islamabad in Pakistan and Amritsar in India were possible alternates if an emergency arose. All have good hospitals, but not quite as good as Delhi.

 

[Ryan]

I'm late to the party, so you folks have done a great job of enumerating why this is not a great idea.

This thread bolster's AU's unofficial motto: "Bad solutions in search of non-existent problems".

 

[Danib62]

A defibrillator is worth its weight in gold. Wall mounted and very potable and friendly to use. The cost of one starts at about $2000. Maybe have three per train.

Three per train? Are you expecting three simultaneous cardiac arrests?