Bystander CPR on the Island Princess

[sunshine426]

First let me state that I love Princess and had a wonderful Island Princess Cruise thru the Panama Canal. I hope to write a review as soon as my house quits rocking and the laundry is done....

 

But, I do have some serious safety concerns after an incident on the last day of our cruise. While waiting to sign for my cocktails at the Lido Bar I heard a loud thump. Looking around I asked the bartender what fell. I then noticed a woman on the ground by the Pizza Counter. As the bartender reached for the phone I asked him to call 911.

 

I then went to the woman's side. She was able to speak, but, seemed a bit confused. A family member was at her side. I asked if she had diabetes or heard heart conditions and she said no. Within moments she began to seize. With assistance we rolled her to her side and I watched her airway. My husband was near and he asked what we needed. I told him to make sure they had called for help and to get an AED. Within a few short moments this woman quit breathing and went pulseless. We turned her on her back and began CPR after establishing unresponsiveness and no breath or pulse. After only 5 cycles she gasped and I could feel a weak thread pulse. She then quit breathing again and I resumed CPR. After a few more cycles she again gasped and this time regained some responsiveness. She was able to tell me her name, and that she needed to "throw up'. Again rolled her to her side and kept her airway as clear as possible while nature took it's course. After 18 minutes a Medical Responder arrived. I told her that she had seized and needed cpr. After checking her bp and oxygen level she assisted her to a wheel chair and then off to medical.

 

So these are my concerns. Anyone who has taken bystander CPR knows that an AED makes a huge difference in outcomes. This is an automatic diffibrilater devise that is designed so a layman can use it. Almost every restaurant has one, most country club's keep then in the bar and most bartenders are trained in their use. They are all over the airport. I was very disturbed to find out that Princess staff are not trained in CPR and that this devise was not available. What we were told was that the staff is taught not to intervene and wait for "medical" to arrive.

 

We plan to write to Princess with our concerns, but, wanted to share on cruise critic as well.

 

On a amusing note...after the woman was taken away the bartender found me so I could sign for my coctails....seriously.

[Colo Cruiser]

. I was very disturbed to find out that Princess staff are not trained in CPR and that this devise was not available. What we were told was that the staff is taught not to intervene and wait for "medical" to arrive.

 

We plan to write to Princess with our concerns, but, wanted to share on cruise critic as well.

 

 

This is inaccurate, every crewmember is required to have a first aid certificate which includes CPR. This is kept up to date and they are required to have these cert when they arrive onboard.

[sunshine426]

This is what we were told when we asked about it at the Passenger Service Deck. And all I can say is not a single cruise member came to assist during this incident.

[seamanfs]

18 minutes seems like a very long time to respond to that situation. I would have thought the AED's should have been in place and staff trained on use, too. On one of our trips to Hawaii, can't recall which ship there were 2 nurses with back packs who responded to emergencies on the ship quickly. We watched them running through the ship several times on that 15 day cruise.

[sunshine426]

I didn't time it but several other passengers did time it. The responder brought a wheelchair with her so that might have slowed her down.

[whatcruiseisnext]

to medical.

 

So these are my concerns. Anyone who has taken bystander CPR knows that an AED makes a huge difference in outcomes. This is an automatic diffibrilater devise that is designed so a layman can use it. Almost every restaurant has one, most country club's keep then in the bar and most bartenders are trained in their use. They are all over the airport. I was very disturbed to find out that Princess staff are not trained in CPR and that this devise was not available. What we were told was that the staff is taught not to intervene and wait for "medical" to arrive.

.

 

There are several AED's placed throughout the ships. Take a walk and around....you will see them.

[ar1950]

This is inaccurate, every crewmember is required to have a first aid certificate which includes CPR. This is kept up to date and they are required to have these cert when they arrive onboard.

 

And what good is this, if, as the OP states:

What we were told was that the staff is taught not to intervene and wait for "medical" to arrive.

[sunshine426]

We did look and didn't see any after the incident. And again, none of the staff watching knew what we were talking about.

[Crystabel]

What a scary story! Thank goodness that you were there to help, and deserve credit for possibly saving this woman's life. I will be checking out the location of any AEDs on the ship from now on.

 

Regarding the bartender searching for you to sigh for your drink??? He gets a thumbs down from me. Princess can do a better job in both cases.

[Colo Cruiser]

And what good is this, if, as the OP states:

 

Exactly, they are to wait for medical personel to arrive.

The OP stated they were not trained in CPR, but they are.

Edited May 3, 2014 by Colo Cruiser

[sunshine426]

I have no doubt that medical staff are trained in CPR and I imagine Advanced Life Support as well. My concern was that no staff came to our assistance and waited for medical to arrive. At 18 minutes response time I do not think this lady would have survived.

[pcl2001]

This is inaccurate, every crewmember is required to have a first aid certificate which includes CPR. This is kept up to date and they are required to have these cert when they arrive onboard.

 

That's not true at all. Only the medical staff are required to have CPR. I think you're confusing the "first aid certificate" with a medical certificate, which has nothing to do with CPR or first aid. It's simply to certify that they are fit to work at sea. These are required by every crewmember when they come onboard.

 

Crewmembers are instructed to call 911 and not intervene during a medical emergency because they're not medically trained, so it's a liability issue. They're not trained in CPR because it's not cost-effective when medical staff are never more than 5 mins away. I would be concerned if it really took 18 mins for the first responder to arrive. Most people tend to overestimate the time it takes during an emergency. Not saying it couldn't have taken 18 mins, but something obviously went wrong if it did, such as the wrong location was given.

[boone2]

The expected response time on the line I work for is 3 minutes. I we are not given clear directions it can take longer

Terry

[Coral]

This passenger is very lucky you were nearby! Thank you for coming to their assistance.

 

I work at a college campus and we have AEDs in every building. Every custodal/maintenance person is required to take CPR which includes AED training and everyone who works on our campus can take the class for free. You are right - the new AEDs are so easy to use.

 

I am guessing it is a liability issue also (why nearby employees didn't respond), which is sad. The real question is why it took forever for Medical personnel to make it to the site. I am just thankful there was someone like you nearby!

Edited May 3, 2014 by Coral

[sunshine426]

I understand that during an emergency time can seem to freeze. However in this case the times were accurate. And that is what we were told. Crew members do not provide any first responder cpr...

[OCruisers]

18 minutes is a terribly long time for the first person from medical to arrive. :o

LuLu

[Colo Cruiser]

That's not true at all. Only the medical staff are required to have CPR. I think you're confusing the "first aid certificate" with a medical certificate, which has nothing to do with CPR or first aid. It's simply to certify that they are fit to work at sea. These are required by every crewmember when they come onboard.

 

 

 

I am aware of what a medical certificate required by a crew member is.

 

All crew are required to take a first aid course and have cert when they board.

First aid training includes CPR.

[nanabananna]

Why would any Princess employees not help someone they saw and could help struggling for life? Is it because they would/could loose employment?

I just do not see how some people can ingore another that needs help.

 

Under the 2000 Federal Cardiac Arrest Survival Act, Congress gave immunity from civil damages to people administering CPR or an automatic external defibrillator, with exceptions in cases of gross negligence or willful misconduct. All states have Good Samaritan laws that grant some immunity protection for those performing CPR and an AED (again with restrictions) but they vary. I would like to know somebody helped my loved one--atleast they made an attempt.

 

This event has made me more aware and I will go back for a refresher CPR course. I want to be able to help if necessaary.

[pcl2001]

I am aware of what a medical certificate required by a crew member is.

 

All crew are required to take a first aid course and have cert when they board.

First aid training includes CPR.

 

I don't know where you're getting your information but it's not true, not on Princess. I work there, so I think I would know. There is no first aid certificate or CPR training required for non-medical crew.

[pcl2001]

Why would any Princess employees not help someone they saw and could help struggling for life? Is it because they would/could loose employment?

I just do not see how some people can ingore another that needs help.

 

Under the 2000 Federal Cardiac Arrest Survival Act, Congress gave immunity from civil damages to people administering CPR or an automatic external defibrillator, with exceptions in cases of gross negligence or willful misconduct. All states have Good Samaritan laws that grant some immunity protection for those performing CPR and an AED (again with restrictions) but they vary. I would like to know somebody helped my loved one--atleast they made an attempt.

 

This event has made me more aware and I will go back for a refresher CPR course. I want to be able to help if necessaary.

 

They probably did not realize the seriousness of the situation and if they did, may have been scared. Most of them have no medical training so they wouldn't know what to do. All of them are more than willing to help out, but usually require some type of direction, which is why they're instructed to call 911 and wait for medical to arrive. Ideally the first responder will be there in less than 5 mins, but something obviously went wrong for it to take 18 minutes. I'm sure this incident will be reviewed by the shoreside medical department and a corrective action report made.

[PescadoAmarillo]

18 minutes is a terribly long time for the first person from medical to arrive. :o

LuLu

 

Unfortunately, we heard about this exact same thing happening three different times on the Emerald Princess last winter, and twice more I actually witnessed it (and, in fact, was the one who alerted 911 one time). The reality is that it took between 7 and 15 minutes each time for someone from medical to show up. What is truly frightening is that all calls to 911 are received at the PSD, who ask what the issue is and then call the Medical Department. I saw it happen, where that person then had to wait for someone from Medical to pick up and relay the information to them. I'd like to believe that Princess analyzed this and determined this was the best way to handle 911 calls, but it does seem like precious minutes are wasted.

[ceejay_San Angelo]

We were on Caribbean Princess in January 2014 when a passenger slipped on the deck by the Lido bar, went down hard, hitting his face on the deck and causing his glasses to gash his face pretty badly, and teeth to cut up his mouth -- lots of blood. He was unresponsive for several minutes, but still breathing and had a pulse. NO ONE from the crew initially responded to this young man's situation. Passenger bystanders went to him, checked him out, turned him on side, stayed with him, tried to find his companions, etc. The bar staff, the entertainment staff, any other staff passing by --- none of them did anything.

My expectation was that ship staff should assume leadership in a medical situation. Even if they don't know CPR, they should get involved and act like they care. Someone must have called the infirmary, because about 15 minutes later, what appeared to be a nurse and orderly appeared with a wheelchair. They did a quick check of him, then loaded him up and took him presumably to the infirmary.

[Coral]

 

Under the 2000 Federal Cardiac Arrest Survival Act, Congress gave immunity from civil damages to people administering CPR or an automatic external defibrillator, with exceptions in cases of gross negligence or willful misconduct. All states have Good Samaritan laws that grant some immunity protection for those performing CPR and an AED (again with restrictions) but they vary. I would like to know somebody helped my loved one--atleast they made an attempt.

 

I doubt they are covered by this US Act/Protection.

 

For example - a lawsuit had to be brought to the Supreme Court to make ships that go to US ports to follow ADA regulations.

 

It is not a given that all US laws cover cruise ships, especially at sea.

Edited May 3, 2014 by Coral

[pcl2001]

Unfortunately, we heard about this exact same thing happening three different times on the Emerald Princess last winter, and twice more I actually witnessed it (and, in fact, was the one who alerted 911 one time). The reality is that it took between 7 and 15 minutes each time for someone from medical to show up. What is truly frightening is that all calls to 911 are received at the PSD, who ask what the issue is and then call the Medical Department. I saw it happen, where that person then had to wait for someone from Medical to pick up and relay the information to them. I'd like to believe that Princess analyzed this and determined this was the best way to handle 911 calls, but it does seem like precious minutes are wasted.

 

This is an inherent problem with any emergency services. When you call 911/999/112 at home, the call will first be routed to an answering center which gets the nature/location of the problem, and then may transfer you again before the actual responders are notified. On board it's no different. Maybe one day there will be a better system.

[custompcsys]

This passenger was very lucky indeed that you were there when she arrested. What you likely witnessed was a v-fib seizure, and the fact that you were able to establish unresponsiveness and cardiac/respiratory arrest almost immediately is what enabled you to recover a pulse with CPR only. Great job! That woman is still here because of you.

 

After more than 20 years in EMS and a CPR instructor, its disturbing to me that crewmembers are instructed not to intervene. I realized this is most likely a liability issue, but in cases like this time can make all the difference. Given the limited number of available medical responders on board and the fact that they are likely coming from deck 4, it may take the medical team a while to get there. Crew members trained to the level of first responders could make all the difference. You could have a hundred AEDs spread all over the ship, but they won't do a bit of good if people aren't trained to use them or instructed not to interfere. The American Heart Association CPR program is designed to train the general public and have as many trained responders as possible out walking the streets. There is no reason, in my opinion, that crew can't be trained to at least the bystander level with AED.

 

And what the heck were they going to do with a wheelchair for an arrest???