This morning's medical emergency reminded me of the time I was involved in a medical emergency. On Monday August 22, 2011, I was riding the P506 inbound to Boston. I was scheduled to travel to New York City later that day, so I had my luggage with me. I usually sit in the head end car for my commute, but on this particular day I was at the very back of the train so I could put my luggage on the larger overhead rack of a single level coach.
As we pulled into the West Newton station, someone boarding the train called out that someone had collapsed on the platform and needed assistance. As a CPR and First Aid instructor, as well as a First Responder (and former EMT), I grabbed my work bag and went out to offer assistance. Upon my arrival, I found two fellow passengers had started doing chest compressions on a passenger who had collapsed just before boarding the arriving train. I always carry a CPR breathing mask in my bag, and I used that to give rescue breaths while another passenger (an EMT) performed chest compressions.
Within minutes, we saw the Newton Fire Department ambulance squad running down the platform towards us. I remember thinking that they arrived REALLY quick - I later learned that they had been at a nearby bagel shop when the call came in - so their response was quicker than it usually would have been. Once they arrived on scene they attached a defibrillator and I could see the obvious ventricular fibrillation heart rhythm on the monitor. After one shock, the patient converted to a somewhat normal sinus rhythm.
The patient was rushed directly to Beth Israel and went straight to the cardiac catheterization lab, where he had three blockages removed. He made a full recovery. Every year on the anniversary he calls me up to check in and when he first introduces himself on the phone I always have a senior moment, thinking...I know I'm supposed to remember you for something important...
I recall that as the patient was loaded onto the stretcher and I was talking to the police, I mentioned to a train conductor that my luggage was still on the train and I didn't want to lose it. The conductor said something like "don't worry, we'll wait for you..." and I just looked around and the magnitude of what had happened started to settle in. We ended up being delayed in the station only about 20 minutes! Who knows if the patient would have survived with our intervention or not - there is no way to know. But our CPR probably increased his chances. Lots of happenstance - lucky to have the ambulance crew so close, lucky to have trained and willing passengers to help out, lucky (for me) that I sat in the coach closer to the incident, lucky that I had my CPR mask with me...
My wife kept the kids out of school and drove them into Boston to attend the ceremony where MBCR gave us all a certificate. After sending an e-mail to my daughter Charlotte's second grade teacher to tell her that Charlotte would be late to school, the teacher immediately replied with an incredulous e-mail saying "oh my gosh, the man that was saved is my roommate's father!" Small world...
After reflecting upon the incident, I wish we had remembered to call out for the AED that is on every train. A conductor eventually remembered to go get it, but by the time he had retrieved it, the ambulance crew was already on scene with their professional defibrillator.
HINT: Every commuter rail train has an AED. How do they arrange the trains so that each train has one AED? Every "control coach" (the coach that has controls for the engineer to operate the train) has an AED - and every train must have one control coach for the train to be able to make the inbound trip with the engineer at the front of the train. Therefore each train has one AED! Obviously the control coach is the coach closest to Boston - the first car on an inbound trip and the last car on an outbound trip. This is true for all commuter rail lines into and out of North Station and South Station, not just the Framingham-Worcester line. Also, all control coaches have four digit car numbers - the first digit being a 1. And only control coaches have four digit car numbers. On single level control coaches, the AED is about at the middle of the coach, in a cabinet bolted to the luggage rack. On bi-level control coaches, the AED is in a cabinet at the end of coach closest to where the engineer operates the train.
Why does every train have an AED? Not only because it is just a common sense good idea, but also due to an unfortunate incident on the Framingham - Worcester line where a passenger (Dr. James Allen) died of a heart attack aboard a train in 2002. In addition to no AED being available on that train, the entire situation was handled very poorly (which led to a $3.9 million settlement by the MBTA). Dr. Allen boarded the train at Wellesley Farms and collapsed soon after boarding, but the train crew decided to have Boston EMS meet the train at Back Bay station. For some reason the train then made all three stops in Newton. I recall speculation when this happened that perhaps the train crew thought the patient would receive better care in Boston (as opposed to Newton), hence their decision to pre-arrange a meeting with EMS at Back Bay.
Stories about that:
Train Didn't Stop for Heart Attack Victim
Widow glad MBTA to get defibrillators
This also explains the current policy that when a medical emergency happens, the train must stop at the closest station and remain there until the ambulance crew arrives and the train is cleared by first responders to proceed. So think of Dr. James Allen next time you think about complaining about a delay due to a "medical emergency."
But more importantly, go out and get your CPR and AED training! And know where the AED is on your train, in your workplace, and in any other place you frequent (church, community center, etc.). And don't hesitate to respond, even if it is just to grab the AED and bring it to the incident. That simple action might save someone's life.