The clinic is coming to you! Or how I visited the Health Train. What to do if the road gets bad
High-speed train"Swallow" came out on the afternoon of October 2 from Nizhny Novgorod to Moscow. Here is what Alexander Sokolov told the Pravmir correspondent: the editor of the Anthropogenesis.ru portal who was riding this train: “The elderly man became ill, people shouted: “Doctor!”.
The conductor came running, the police came. They began to shout: “Who has a blood pressure monitor?”. The passengers found the device. But there was nothing on the train. If there was a first aid kit, they would have brought it. According to him, the conductor and one of the passengers took turns giving the victim a heart massage, but the impression was that they did not know how to provide first aid.
The Lastochka staff contacted the ambulance substation, but the train went 40 minutes to the nearest half-station. All this time, the victim was given first aid, but when the train stopped and the ambulance doctor entered, he pronounced him dead. The ambulance doctor refused to take the body, demanding to call the police, the policemen who were in the car argued with him. As a result, the body was carried to the platform on a soft stretcher, and the train left.
“I felt sorry for the conductor. It was clear that he was worried and tried to save this person as best he could, - the witness said, - it is not known if they could help the person if there was a first-aid kit. But she wasn't! Lastochka has neither first aid nor people who can provide it. But they sell wonderful souvenirs,” Alexander Sokolov told us.
Was there a first aid kit in that Lastochka?
When asked why Lastochka did not have a first-aid kit, the press service of the Federal Passenger Campaign (a structure of Russian Railways) answered:
– All Lastochka trains operated by JSC FPC are equipped with first aid kits in accordance with the current Sanitary Rules for organizing passenger traffic, approved by the Decree of the chief sanitary doctor Onishchenko G.G. dated March 4, 2012 No. 12.
– The train is coming non-stop, it turns out that a heart attack in the "Swallow" with a high probability can lead to death?
- The train can stop at any nearest station, even if it is not scheduled in the schedule, in order to provide assistance to the passenger as soon as possible. To do this, you need to contact the head of the train, who will call the doctors to the nearest station. Without waiting for the arrival of the doctors, the head of the train must also find out whether there are doctors among the rest of the passengers using the speakerphone or through the conductors. Train conductors long distance V without fail are trained to provide first aid to passengers.
The press service of JSC FPC reported that there was a first-aid kit in Lastochka, and following the results of an internal investigation of violations in the actions of employees railway transport was not identified.
Will the conductor's first aid kit help the passenger?
The press service of JSC FPC told us that all the cars passenger trains long-distance trains, including the Lastochka electric trains, are equipped with medical supplies for first aid in accordance with the order of the Ministry of Social Development of the Russian Federation No. 498n dated May 5, 2012.
The first-aid kit includes means for temporarily stopping bleeding and fixing fractures (tourniquet, bandages, splints, adhesive tape, etc.), a device for pulmonary resuscitation (breathing bag with masks for newborns and adults), there is even a kit for there are other medical devices to help you deliver, such as a frameless stretcher.
But can a first aid kit really save someone? Will it help a person with a heart attack survive? There are no anti-shock drugs in the railway first-aid kit, these are potent drugs that require special storage conditions. There are no defibrillators on trains. A defibrillator is an expensive and specific thing and is found only in intensive care units. Doctors or nurses are also not allowed on the train. As a rule, a medic can be found among the passengers. But for a physician, providing assistance in the field also often turns into a problem.
Cardiologist, candidate of medical sciencesAnton Rodionov previously told Pravmirabout how it is set up health care on board the aircraft, and why a doctor should help the victim on the street, but has no right to do so.
In addition, even if a doctor is found, he does not carry any medicines or equipment with him.
Perhaps, first-aid kits on trains and planes should be more specialized, discussions about this have long been ongoing in the relevant departments. There is another problem - an ambulance arriving at the nearest station cannot always deliver the victim to the hospital, the nearest specialized hospital may be too far away. The idea of creating a special unit of transport medicine is being discussed, but the Ministry of Transport and the Ministry of Health have not yet reached an agreement on this issue.
Where to go, what to ask?
Where can the relatives of a deceased passenger go? What can they expect? Under the insurance, which is sold together with the train ticket, you can only receive compensation if the passenger's injury is related to the movement of the train, for example, in an accident.
But, according to the lawyerStalin Gurevich,the absence of a first-aid kit on the train may be a reason to go to court: “The absence of a first-aid kit on the train is a violation of the consumer protection law and the provision of services that do not meet safety requirements is a reason to bring criminal and civil liability. But there is an important question - was the lack of a first aid kit and first aid skills of the conductor the cause of death? Could this person have been saved?
If the relatives of the deceased passenger want to find out, they need to apply to the Investigative Committee, with a statement about initiating a criminal case and conducting a forensic medical examination. If the examination establishes causal relationships, then the perpetrators can be held accountable.”
What to do if a person becomes ill on the train
If a person next to you becomes ill, the first thing to do is to inform the guide about it. The conductor is obliged to contact the head of the train, if he does not do this - insist, go to the next car, contact another conductor.
The guide must have a first aid kit, all guides are trained in first aid. The guide must provide first aid using the first aid kit.
The head of the train should use the speakerphone to try to find a doctor among the passengers and call an ambulance to the nearest station, if necessary.
Remember that actions must be coordinated, ask the conductor how you can help (support the person, bring water, mark the time), do not panic and do not frighten other passengers. Remember what is happening in order to tell the doctor the necessary information at the station, to answer questions.
Do not get annoyed and do not resent what is happening - the train workers are doing everything they can. If you do not feel the strength to help, look at a person in serious condition, it is better to go out into the corridor of the train, into the vestibule, into the dining car and rest - do not interfere with those who are fighting for the life of the victim.
Organizing task medical care during train journeys, as a rule, it is solved by the sick people themselves. And what measures have been taken by Russian Railways and other people who are obliged to make decisions and actions in order to at least reduce the risks of losing people or worsening their health along the way?
Medical industry
In accordance with the order of the Ministry of Health and Social Development of the Russian Federation dated May 5, 2012 No. 498 N “On Approval of the Requirements for Completing Medical Devices for First Aid for Railway Transport Injured Persons in the Provision of Passenger Transportation Services”, special medical packages have been issued - sets of medical preparations placed in special container for storage and transportation.
Thus, to say that in terms of equipment inaction reigns is not true. In particular, the issue of providing medical supplies and medicines has been resolved.
At Moscow railway stations
There are medical stations at all nine stations in Moscow. At Rizhsky and Savelovsky, medical assistance is provided by one paramedic. On the rest, except for the paramedic, there is also a doctor. The Health Department of Russian Railways, together with the polyclinic, are responsible for passengers. The station management is obliged to provide the Department with equipped premises and make special navigation (badges) for passengers, by which one can easily find a medical center. The duties of the staff include reporting to the medical center that someone has become ill, as well as transporting this person to the first-aid post.
During parking
The paramedic or doctor receives information about a call to the train by telephone or radio communication from the station attendant. The problem is that if you need help, the train will have to leave. The parking of the train due to the fact that there is a sick person in it cannot be extended. In any case, the train will leave on schedule, and since at some stops the stopping time is extremely limited, in practice it can be quite problematic to get medical assistance on time.
Russian Railways, according to their information, has the ability to control a sick person on the road during stops throughout the entire route of the train using the relay method.
Going on the road
You will have to rely only on yourself. When considering your trip or the trip of your relative, you do not need to rely on the help of strangers. They are, of course, most likely to help in a critical situation. But you need to make a decision in favor of the trip only when you are sure that you will move the road on your own, without resorting to outside help.
1. Take your medication. Firstly, for some reason, the first-aid kit may not be in your car, and secondly, even if it is, the necessary drug may not be found. Since there are many different diseases, the medicines in it are intended for the most common cases, and sometimes your personal one simply cannot be foreseen. Thirdly, by taking medicine, you can help other people, and not look indifferently at how a person dies before your eyes.
2. Remember that if you feel bad, the conductor is obliged to provide first aid and inform you of the need to call an ambulance, so do not be silent about your problem if it has arisen and you cannot cope on your own.
3. Do not attempt to stop the train. Often, after a stop, people died only because the train was moving to the station for a long time and the sick person could not receive medical care on time.
4. Remember: in a critical situation, it is better to leave the car upon arrival at the station, use the services of a doctor and continue moving later than, taking risks, go further and “fall short”.
Moscow - St. Petersburg is the most popular railway line in Russia. Every year, 8.5 million passengers travel between the two capitals. Evgeniy Trofimchuk, director of recreation at the OneTwoTrip online travel service, decided to find out everything about the trains running along the route, and for two weeks he rode non-stop from Moscow to St. Petersburg and back ..
First aid kit will not be provided
Trains have special medical packs (first aid kits), but you will not find pills in them. The fact is that, according to the rules, conductors do not have the right to give passengers pills or medicines, since they do not have a medical education. Nevertheless, guides still undergo the minimum required training: everyone can provide first aid, stop bleeding, make bandages and even take birth.
If someone on the train becomes ill, it is necessary to call the conductor or the head of the train. He will announce over the speakerphone that they are looking for a doctor among the passengers to provide first aid. If there is no doctor, an ambulance is called to the nearest station, and the train will stop there, even if the stop is not scheduled according to the schedule.
Actors serve you
The conductors of some branded trains take compulsory acting courses. There they are taught to speak beautifully, move and even just stand on the platform, and they are also told how to always look good - including in difficult road conditions.
Anyone can become a conductor
Getting a job as a conductor is much easier than being a steward. To do this, you need to contact the nearest railway depot, from where you will be sent to a three-month course. Pass the exam after graduation - and you can get a job! The main thing is to be able to not sleep for 24 hours.
If you want to be promoted to the head of the train in the future, courses are not enough: you need to get a higher education and work in various sections of the railway.
There is a shower!
It's not a myth, it exists! Now there are showers in many branded trains between St. Petersburg and Moscow, and you can use it for a small fee. For example, in double-decker trains it will cost only 150 rubles, you can pay the conductor (in cash or by card if there is a terminal in the car). Most importantly, do not forget a towel and rubber slippers: they will not be given to you on the train. Splashing for a long time will not work either, only 16 liters of hot water are allocated per person.
studio games
Few people know, but the cost of your ticket includes the use of board games: dominoes, checkers and chess. They can be asked from the conductor, but, however, not all trains have games.
Take a seat closer to the conductor
Choose seats at the beginning of the car, closer to the conductor's compartment. There are several bonuses at once: firstly, tea will be brought faster. Secondly, if the neighbors make noise, more chances that the conductor will hear and come to reassure. Plus, there will be a couple of steps to sockets and titanium with boiling water. And you will be among the first to leave, as in the business class of an airplane.
See What You're Buying
Before buying a ticket, search the Internet for information about the cars of the train you are interested in. Prices for tickets in cars of different classes may differ by 100-200 rubles, but one will have air conditioning and a vacuum toilet, while the other will not.
Search in neighboring classes
There are times when higher-class tickets are cheaper than a reserved seat/coupe or only slightly more expensive. Therefore, when searching, do not limit yourself to only the cheapest reserved seat, see all the options.
How to buy the bottom two seats
... Or the top two. If you have ever bought tickets through the Russian Railways website, then you know that it is impossible to buy the top two shelves there: for some reason, the site offers to take two seats on one side of the table (top and bottom). The solution is simple: buy tickets on other sites.
Extend your trip for free
You can get off at any station and within 10 days continue your journey free of charge on the same ticket, you do not need to buy a new one. To do this, you need to find the head of the station at which you got off, and issue a "stopover" with him.
Do not slow down when issuing a ticket
The role plays every hour! The amount that will be returned if you decide to return the tickets is tied to the time, and the time depends on where you bought the ticket: in Russia, the CIS countries or abroad.
In Russia
Almost all the money spent can be returned only if more than 8 hours are left before the train departure: you will be charged a refund fee (192 rubles 70 kopecks as of September 2017), and the rest of the amount will be returned.
If before departure from 8 to 2 hours, the arithmetic becomes more complicated: you will be refunded 100% of the cost of the ticket and only 50% of the cost of the reserved seat. Here you need to clarify: the ticket consists of two parts - the cost of the ticket itself (fare) and the cost of the reserved seat (fee for a seat in the car, and it doesn’t matter if you are traveling in a SV, compartment or reserved seat).
If less than 2 hours are left before departure, you can return 100% of the ticket price, but the entire part of the reserved seat and the refund fee will be withheld. You can return the ticket even after the train has left, the main thing is that no more than 12 hours have passed from that moment.
What part of the ticket price falls on the reserved seat, you can see in the order information file. It will be sent to your email after purchasing the ticket.
If you are still late for the train, do not relax and still run to the ticket office (the return is usually processed there anyway). Ideally, be in time for an interval of no more than 3 hours after the departure of the train, then there will be no difficulties. If up to 12 hours have passed since the departure of the train, you will need to write a claim statement to return the money. And if the train left within a period of 12 hours to 5 days, the only way to return at least part of the money is to attach proof to the application that the delay was not your fault (a certificate from a doctor, for example, will do). If you just overslept, and then decided to postpone the trip to the station, you will not be able to get the money back.
To the CIS and the Baltic States
The full amount, minus the refund fee, can be received if the tickets are returned no later than 24 hours in advance. Less than a day is left before departure, but more than 6 hours - then you will be refunded 100% of the ticket price and 50% of the reserved seat (and withhold the fee). 1 hour before departure, you can get 100% of the ticket price, and the reserved seat cannot be returned. And if the train leaves in an hour, then tickets can no longer be returned, and you will lose money.
To foreign countries
The full amount will be refunded if you manage to return the ticket no later than 6 hours before the train departure, you will only have to pay a refund fee (for international destinations it is 10 euros). If the train leaves in less than 6 hours, the ticket cannot be returned.
When traveling by train, be sure to think about the problems that may arise along the way. This is especially true for people who have chronic diseases or other health problems.
- A huge crowd of people in a confined space several times increases the risk of catching all kinds of infections. Therefore, it is advisable to avoid close contact with other passengers whenever possible, use only disposable hygiene products and disinfect hands several times a day with special liquids. Indeed, on the handles of vestibules and all parts of the train there is a huge amount of microbes.
- Boiled water containers, which are constantly carried by passengers in the cars, can also pose a danger. In this case, sudden braking in this case increases the risk of getting burned. Sudden stops can also lead to injury.
- On a trip, you should take only those products, the quality of which will remain worthy even after a few days. This rule is especially true for long trips. Otherwise, the risk of getting food poisoning increases significantly.
- insufficient ventilation, a large number of dust, especially in summer, increase the risk of complications in people with asthma and allergies.
As you can see, there are more than enough situations where medical intervention may be needed on the train. Therefore, be sure to bring a first aid kit with all the necessary medicines.
You should be aware that all guides are usually medically trained and will be able to provide you with first aid. If, nevertheless, a serious situation arises when the intervention of doctors cannot be avoided, then the train foreman will be obliged to call an ambulance to the nearest station along the route. Arriving at the station medical staff help the patient. If the health problem is life threatening, then the victim is hospitalized in the nearest hospital.
Going on any trip, be sure to find half an hour and think about what you might need on the trip. Then, if necessary, you can help yourself, your loved ones or neighbors in the car.
Passengers of train No. 209, following the route Labytnangi - Moscow, worried for five hours about a 60-year-old man who had a heart attack. The incident took place on June 21 this year. A man who had previously suffered a stroke was traveling with his family to reserved seat car when he got sick. The attack began in the morning at about 10 o'clock, after which the conductors began to look for doctors among the passengers in neighboring cars. We managed to find two doctors, they were next to the patient for several hours. At the same time, the train crew did not have any medicines.
The man's condition worsened, his breathing stopped, but this section of the track does not pass between major stations, and the first ambulance brigade waited for the train only at the Kostylevo station at 13.30.
Kostylev's doctors examined the man in the carriage, gave an injection, delaying the train for 15 minutes, and said that they could not help him: “He is in a serious condition, he needs to be hospitalized, but we have nowhere, we have to take him to Velsk.”
As a result, the patient was taken more than an hour to Velsk, where the second ambulance team hospitalized the victim. As a result, at least five hours passed from the moment of the attack to hospitalization. Eyewitnesses were indignant not only about the delay in the provision of medical care, but also about the strong closeness in the car - the patient only got worse because of this. To alleviate the condition of the man, I had to keep open doors in the vestibule
“We have either ventilation in our cars, or boiling water in titanium. The police travel on the train, but there are never any doctors,” one of the conductors explained the stuffiness on the train, in which more than five hundred people were traveling.
Passengers are cold and poisoned
Complaints about inadequate temperature regime in carriages - one of the most common among passengers. “Last year, on May 4, we returned from Kazan, there was some additional train, because they ran out of scheduled tickets, ”Margarita Verkhovskaya, a resident of Moscow, told Gazeta.Ru. - Frosts began, and the train had a broken heating system.
It was terribly cold, five degrees, no more. There were no extra blankets, nothing to keep warm.
The head of the train refused to do anything about it. I arrived in Moscow and immediately fell ill with a temperature, I had to take sick leave. I wrote a complaint to the RZD website. A few months later the answer came: they say, everyone was punished. But the names of the conductor and the head of the train did not match, so it seems to me that it is unlikely that an investigation into this matter was carried out.
When asked about what the company is doing in connection with passenger complaints about stuffiness in trains or too much air conditioning, the FPC replied that “the conductor passenger car must promptly respond to the requests of passengers, to the extent possible, fulfill the wishes of passengers. Special attention at the same time, it is given to passengers with limited mobility, the elderly, passengers with children. For understanding: in cars with forced ventilation and air conditioning installation, ventilation must operate continuously in automatic mode, depending on the air temperature in the car.”
However, health problems may arise in passengers not only because of stuffiness or frost in the cars. President of the League of Patient Defenders Alexander Saversky told Gazeta.Ru that two years ago, when he was traveling with his family by train to Kislovodsk, he and eight other people in the car got severe food poisoning after trying "on-board meals" that can be ordered at train.
“My wife and child and I were almost taken off the train and deprived of rest in the sanatorium where we were going, they thought that we had some kind of infection. At the same time, we did not receive any medical assistance for 12 hours, there was no doctor on the train and he was not called to the station, ”Saversky explained.
What help to expect from Russian Railways
Such cases are not isolated - every year in Russian trains, at stations, platforms and other railway transport facilities, medical care is provided to approximately 1 million people. And 70,000 sick passengers seek help at medical stations at stations located along the route of the train, according to statistics from the Federal passenger company(FPK).
If the passenger becomes ill, then the first thing to do is to call the head of the train, the rules say.
It is he who must contact the medical workers who will be waiting for the train at the nearest station, and also find out by “loudspeaker” or through the conductors whether there are doctors among the other passengers. At the same time, the conductors themselves can only provide the passenger with first aid, because they are not medical workers.
For first aid, special medical packages (first aid kits) are stored on the train. There, in particular, there are means to temporarily stop bleeding, products for pulmonary resuscitation - for newborns and adults - a hypothermic package, an isothermal rescue blanket, splints in case of fractures, frameless stretchers, etc.
Saversky and eight passengers who were poisoned were to be treated right on the spot.
Train staff regularly undergo training, where they are explained how to help a person with “injuries, various poisonings, foreign bodies, wounds, squeezing of limbs, bleeding, fractures, bruises, sprains, dislocations, burns and frostbite.” The press service of the FPK Gazeta.Ru explained that the training program also includes first aid for people affected by the action of electric current, methods of performing artificial respiration and external heart massage, first aid for heat and sunstroke, as well as for epileptic fit.
If there is no threat to life, then the called doctors organize a relay medical escort to the destination or send the passenger to the nearest hospital where they can help him. If the life or health of a passenger was harmed while being transported by train, then the case is recognized as insured - the FPC has a contract of compulsory insurance of the carrier's civil liability. In addition, passengers can additionally take out voluntary accident insurance policies when they buy tickets at FPC ticket offices or on the Russian Railways website.
True, it is not easy for passengers to get money for “automatic” insurance, lawyers admit. It is quite difficult to prove that the harm to health was caused precisely during transportation, unless some kind of accident occurred. And in cases of poisoning or a cold, it is recommended to send a complaint to Russian Railways and collect testimony from witnesses. And even if all the documents are in hand, “litigating such cases means wasting a couple of years of your life without a guaranteed result,” sums up the president of the League of Patient Defenders.
