Bystander CPR on the Island Princess

[thyme2go]

Thank you OP for helping this woman in her serious emergency.......and THANK YOU also for posting this! I am shocked that someone on Medical staff would walk up with a wheelchair (or any mobility device) in a situation like this. Wouldn't the first thing be to get there quickly and assess the patient---in any medical emergency? That takes the description factor out of the equation.......which someone who is not medically trained should not be doing anyway! Also seems like putting her into a wheelchair (despite all the good work of the OP) was NOT an appropriate medical response. If she'd had another incident they'd have to let her collapse onto the floor again and do CPR down there........and at this point, I'm not sure they'd even do it!! This is very disconcerting and does not bode well for those that need help while at sea. Thank you again for sharing this.......and those that supported the OP's story. Princess needs to do more than 'review' what happened............there is a lot of room for improvement on their medical behaviors......STAT! :mad:

[Coral]

As Americans' date=' we have expectations of medical standards that may not be met on foreign flagged ships. I cannot say that I have seen any AEDs on any ship, and I have been on some behind the scenes tours and seen crew corridors on these tours.

[/size']

 

On the other hand, my mom had been sick on the Sapphire Princess. I can only say positive comments about the Dr. who we saw on the Sapphire. He had her check in daily to make sure she didn't get worse. I actually thought he was more thorough than her GP back home. I kept thinking if I could only find a similar, caring doctor back home like we had on the ship. While he charged us for initial consult, he only charged us for medication after that.

[JimAOk1945]

I'm sure everyone read their Passage Contract, but just in case you didn't, you may want to familiarize yourself with this section :

 

12. HEALTH, MEDICAL CARE AND OTHER PERSONAL SERVICES.

Due to the nature of travel by sea and the ports visited, the availability of medical care may be limited or delayed and emergency medical evacuation may not be possible from every location to which the ship sails. All health, medical or other personal services in connection with Your Cruise are provided solely for the convenience and benefit of Passengers who may be charged for such services. You accept and use medicine, medical treatment and other personal services available on the ship or elsewhere at Your sole risk and expense without liability or responsibility of Carrier whatsoever, and agree to indemnify the Carrier for all medical or evacuation costs or expenses incurred on Your behalf. Doctors, nurses or other medical or service personnel work directly for Passenger and shall not be considered to be acting under the control or supervision of Carrier, since Carrier is not a medical provider. Similarly, and without limitation, all spa personnel, photographers, instructors, guest lecturers and entertainers and other service personnel shall be considered independent contractors who work directly for the Passenger.

 

Thanks for posting this information. I was not aware of it. I'll be sure to read my passenger contracts from now on!

[Loonbeam]

Press release from 1999 (Doesn't say where they are but I am almost certain I saw them on a UST not necessarily in passenger spaces):

 

LOS ANGELES--(BUSINESS WIRE)--March 17, 1999--

 

Latest Technology in Lifesaving Equipment for Cardiac Emergencies

 

Adds to Princess' Commitment to Quality Medical Care at Sea

 

Further demonstrating its commitment to offering the highest- quality medical care at sea, Princess Cruises has equipped its entire fleet with more than 65 automatic external defibrillators (AEDs) to assist in the treatment of sudden cardiac arrest.

 

The portable defibrillators, which augment the larger defibrillators currently found in all Princess shipboard medical centers, will provide the quickest possible care in the event of a cardiac emergency while at sea. The Heartstream ForeRunner units are made by Hewlett-Packard Co.

 

"Lightweight portable defibrillators will enable us to perform resuscitation efforts on cardiac patients much more quickly," said Dr. Alastair Smith, Princess' vice president of fleet medical. "Since we know that fast response and treatment of cardiac patients enhances the likelihood of recovery, this should provide another level of assurance to passengers about our commitment to a high quality of medical care."

 

Heartstream ForeRunner AEDs use breakthrough low-energy SMART Biphasic technology, which allows a broad range of emergency first- responders (e.g., emergency medical technicians, fire department personnel, police officers, security guards, flight attendants) to deliver time-critical defibrillation to victims of sudden cardiac arrest.

 

"Princess Cruises has taken an important step in providing enhanced response capabilities to passengers in times of medical emergencies at sea," said Deborah DiSanzo, operations manager of Heartstream Inc. "We are pleased to see the company equip its ships with such a full complement of machines, as this will greatly facilitate timely treatment of cardiac arrest patients."

 

Smith stressed that this new equipment is a further enhancement of Princess Cruises being able to provide the highest level of medical care available at sea. "All our shipboard medical centers operate with a full complement of equipment and supplies, and each center is staffed by a full-time team of British-registered doctors and nurses," he said.

 

The company has been a forerunner in the field of maritime medicine and was the first company to introduce telemedicine capabilities between its ships and land-based medical specialists.

 

Princess Cruises is one of the three largest cruise lines in the industry and operates a fleet of 10 ships deployed on approximately 150 different itineraries calling at more than 220 ports worldwide.

 

Heartstream, based in Seattle, is a subsidiary of Hewlett-Packard Co.

[jnc411]

To the OP, thank goodness you were there, if the family of this injured person has not contacted you to thank you , they should. If you had not been there , this probably would have had a different ending.

Also , after reading this post . I am going to sign up for CPR training , always meant to do it , but never got around to it. Well now I am going to. And thank you OP for making all of us aware of the situation.

Cori

[sunshine426]

Lot's of "Monday morning quarterbacking" at my place of work yesterday. As I described the events to people who are all cpr certified the initial concerns I had were validated.

A second responder would have been wonderful to help insure that my compressions were adequate and just a second set of eyes to make sure that I was not missing something...so all of you who are traveling...take cpr and do not hesitate to come to assistance. Very very lucky that this woman had a pulse return via just compressions. Not always the case.

As for treatment in the medical department itself. I have no real doubt that she was not taken care of very well by the time she arrived. My understanding is that the department has a very well qualified staff and it set up to handle these type of emergencies. Attempt to stabilize her condition and plan for the next course.

[sunshine426]

And of course travel by sea has inherent risks. You just can't evacuate a critical patient in the middle of the south seas. And a ship's medical facilities are not an acute trauma facility or a sophisticated ICU.

 

If cruiseline policies are to wait for medical then medical needs to up there game. Triaging at the scene is critical and that I do find fault with.

 

If the article was correct about AED's on board than they need to be visible. And they are designed and meant to be used by bystanders until medical response teams can arrive.

[Ethel5]

Lot's of "Monday morning quarterbacking" at my place of work yesterday. As I described the events to people who are all cpr certified the initial concerns I had were validated.

A second responder would have been wonderful to help insure that my compressions were adequate and just a second set of eyes to make sure that I was not missing something...so all of you who are traveling...take cpr and do not hesitate to come to assistance. Very very lucky that this woman had a pulse return via just compressions. Not always the case.

As for treatment in the medical department itself. I have no real doubt that she was not taken care of very well by the time she arrived. My understanding is that the department has a very well qualified staff and it set up to handle these type of emergencies. Attempt to stabilize her condition and plan for the next course.

 

I'm confused by this statement. Are you suggesting that she was NOT taken care of appropriately in the medical center?

[Loonbeam]

Side note - I managed to confirm a few things:

 

911 calls from passenger cabins are routed to PSD - depending on the ship, they have a different ring pattern or other form of notification.

 

Alert stations (fire alarms, cabin pull cords, etc) are routed to the bridge.

 

Staff have the ability to contact either PSD or the Bridge as appropriate and there are guidelines for doing so.

 

Making it very clear they did NOT know the particulars of the incident in question, from what I can tell, if the bartender thought it was just a fall, they should have initially contacted PSD. If they realized it was life threatening, they could have called the bridge. Code Alphas come from the bridge over the PA system normally.

 

This brings up a question - did anyone hear a Code called? If not, that may explain a lot of the response issues, as its probable the urgency was not communicated. If that is that case, that in itself is a huge issue, since as soon as someone started performing CPR, the urgency is there and the call should have been escalated, if not by the bartender than by other staff.

 

To the OP - If you have not contacted Princess (or been contacted by them) regarding this matter, it is recommended you do so. Again, without specific knowledge of the incident, the person I spoke to is of the opinion proper protocol was not followed.

[Coral]

Side note - I managed to confirm a few things:

 

911 calls from passenger cabins are routed to PSD - depending on the ship, they have a different ring pattern or other form of notification.

 

Alert stations (fire alarms, cabin pull cords, etc) are routed to the bridge.

 

Staff have the ability to contact either PSD or the Bridge as appropriate and there are guidelines for doing so.

 

Making it very clear they did NOT know the particulars of the incident in question, from what I can tell, if the bartender thought it was just a fall, they should have initially contacted PSD. If they realized it was life threatening, they could have called the bridge. Code Alphas come from the bridge over the PA system normally.

 

This brings up a question - did anyone hear a Code called? If not, that may explain a lot of the response issues, as its probable the urgency was not communicated. If that is that case, that in itself is a huge issue, since as soon as someone started performing CPR, the urgency is there and the call should have been escalated, if not by the bartender than by other staff.

 

To the OP - If you have not contacted Princess (or been contacted by them) regarding this matter, it is recommended you do so. Again, without specific knowledge of the incident, the person I spoke to is of the opinion proper protocol was not followed.

 

Thanks - very helpful! Appreciate your contacts' information.

[lone_stranger]

Further demonstrating its commitment to offering the highest- quality medical care at sea, Princess Cruises has equipped its entire fleet with more than 65 automatic external defibrillators (AEDs) to assist in the treatment of sudden cardiac arrest.

 

Princess Cruises is one of the three largest cruise lines in the industry and operates a fleet of 10 ships deployed on approximately 150 different itineraries calling at more than 220 ports worldwide.

 

So does that mean six or seven AEDs per ship or about 65 per ship? If only six or seven per ship, I imagine they would be difficult for passengers to find.

[Beachdude]

Something I have observed over the years is the ship crews have a hard time reacting to abnormal situations. They are trained hard and their responsibilities are so repetitive that they just aren't good at reacting to unusual situations.

 

We had a friend who was injured at a port show up just as the ship was about to pull the gangway. She needed assistance to walk but nobody offered to walk off the ship. When I pushed my way to help her (only 20 ft. away) they stopped me because no passengers were allowed off the ship. When I asked one of the crew to assist her (an officer) he said his responsibility was pulling the ganway. The must of been a dozen of us there at the gangway enterence waiting for her to limp up the gangway.

 

 

I was casually repeating this story to a crew member and she said that everyone is trained so hard that they become robots. She siad there was no reason a crew member couldn't help our friend, they were likely just waiting for someone who is assigned that duty to go do it or tell them to go do it. She said its a mariner thing, crews of most any ship are trained to perform a specific duty, nothing more nothing less.

 

Burt

[sunshine426]

I am so sorry for a confusing post. Missing my room service coffee this morning. I meant to say that I had no doubt that she was well cared for. We checked what Princess offers as far as emergent care prior to this cruise and felt very comfortable traveling, even with some health concerns of our own

 

I am open to suggestions as to who I should write at Princess?

[Colo Cruiser]

I am so sorry for a confusing post. Missing my room service coffee this morning. I meant to say that I had no doubt that she was well cared for. We checked what Princess offers as far as emergent care prior to this cruise and felt very comfortable traveling, even with some health concerns of our own

 

I am open to suggestions as to who I should write at Princess?

 

 

Grant Tarling would be the Chief Medical person at Princess.

[lone_stranger]

I was casually repeating this story to a crew member and she said that everyone is trained so hard that they become robots. She siad there was no reason a crew member couldn't help our friend, they were likely just waiting for someone who is assigned that duty to go do it or tell them to go do it. She said its a mariner thing, crews of most any ship are trained to perform a specific duty, nothing more nothing less.

 

Burt

 

God help us in an emergency, if the crew assigned to launch the lifeboats are incapacitated.

[notentirelynormal]

I've seen AEDs on the ships. Maybe because I worked for a safety training company and we sold them I am more aware. They are super easy to use and anyone can use them without experience. The machines tells you what to do. These don't look like the ones we sold but that was 15 years ago. I know they have them by the pools.

 

 

 

[sunshine426]

I walked all around the Lido Deck after the incident. Felt sure that their was a misunderstanding and one would be visible. Nope.

 

I feel like one of the most important places would be on the Lido Deck by the pools. Heck, just train the bartenders. And I am actually perfectly serious. These are smart men and women and I know are very caring.

[pcl2001]

Side note - I managed to confirm a few things:

 

911 calls from passenger cabins are routed to PSD - depending on the ship, they have a different ring pattern or other form of notification.

 

Alert stations (fire alarms, cabin pull cords, etc) are routed to the bridge.

 

Staff have the ability to contact either PSD or the Bridge as appropriate and there are guidelines for doing so.

 

Making it very clear they did NOT know the particulars of the incident in question, from what I can tell, if the bartender thought it was just a fall, they should have initially contacted PSD. If they realized it was life threatening, they could have called the bridge. Code Alphas come from the bridge over the PA system normally.

 

This brings up a question - did anyone hear a Code called? If not, that may explain a lot of the response issues, as its probable the urgency was not communicated. If that is that case, that in itself is a huge issue, since as soon as someone started performing CPR, the urgency is there and the call should have been escalated, if not by the bartender than by other staff.

 

To the OP - If you have not contacted Princess (or been contacted by them) regarding this matter, it is recommended you do so. Again, without specific knowledge of the incident, the person I spoke to is of the opinion proper protocol was not followed.

 

Everything here is correct, except the bartender cannot "escalate" the incident. Only the medical team technically has the authority to call a code alpha and it's not even called that anymore.

[sunshine426]

Communication is huge in an emergency. Clear concise communication. I have been asked why I didn't change the call. Why I did mouth to mouth at great risk. Why did I not call out for more help....

 

My sweet husband was present. He is not able to do cpr but did help with crowd control and called for an AED.

 

I will say that crowd control was well maintained and that as soon as I asked for some cold cloths I was rushed them by one of the crew staff. I placed them on her neck and fore head to keep her calm and comfortable. Later I spoke with this young woman. She was tearful and shaking. My husband hugged her and told her that she was very helpful.

[hockeygal54]

Communication is huge in an emergency. Clear concise communication. I have been asked why I didn't change the call. Why I did mouth to mouth at great risk. Why did I not call out for more help....

 

 

I will say that crowd control was well maintained and that as soon as I asked for some cold cloths I was rushed them by one of the crew staff. I placed them on her neck and fore head to keep her calm and comfortable. Later I spoke with this young woman. She was tearful and shaking. My husband hugged her and told her that she was very helpful.

 

 

You deserved gratis drinks for the duration of the voyage as did your DH! And I personally think PCL PR dept needs to contact you two and see which ship/destination you would like to have your all expenses paid SUITE located in! I'm an RN of many years and most of it in ICU but I hope I never have to get involved in something like that again. Did once many years ago on a catamaran off the coast of Cozumel. I think if that bartender had tracked me down for those drinks HE would've needed CPR!! 😳

 

 

 

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[sunshine426]

Free Drinks might be enough!! My friends asked me if I went down to my room to brush my teeth and shower. Nope, I knocked back one double rum and tonic and a few shots of straight rum. Self medication.:D

[thyme2go]

Everything here is correct, except the bartender cannot "escalate" the incident. Only the medical team technically has the authority to call a code alpha and it's not even called that anymore.

 

The bartender should not be able to 'evaluate' an incident and that brings us full circle to how this whole thing was handled. Did the bartender call the person's collapse a "fall" because the passenger was near or on a bar stool? There's a problem right there.... Medical staff should have been on scene QUICKLY to evaluate the person as to whether it was a fall or not--there was a person not responsive to questions and someone other than medical staff should be able to call a Code Alpha, whatever the current phrase, in a life and death situation. My god, no pulse, turning blue, not breathing.......this is clearly a life and death situation! The bartender (and by extension Princess) had the drinks/money system under better assessment and care than the cruise customer on the floor......

 

I take no more comfort in the situation now, then when I first read about it........except that maybe more passenger's will know CPR, but as in many situations for every person that responds with the appropriate knowledge and actions, there are 50 or more that stand and watch. This really disturbs my sense of safety on a Princess cruise. It isn't just the physical structure of a ship that provides for safety.....it's the sense that there will be appropriate responses by staff to the needs of passenger's during any emergency on board............I'll be seeing their new ad campaign in a whole 'new' light..........rather than "come back new"......how about "come back alive?"

 

AND......Maybe the Sunshine who aided and saved the cruiser will be on my watch list for what cruises to take and what cabin to get as clearly.......you were the "saving grace" on this cruise!!!

Edited May 6, 2014 by thyme2go
more info

[Loonbeam]

I am pretty sure they are in crew areas near public areas, not out for public access. But that's still 1 per 2 decks on average, so I am hoping that's per ship.

 

 

So does that mean six or seven AEDs per ship or about 65 per ship? If only six or seven per ship, I imagine they would be difficult for passengers to find.

[hockeygal54]

I'm guessing 65 fleet wide, not per ship. Sorry for the pun but 65/ship would be a little "over kill"!

 

 

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[SeagoingMom]

Now I know why my husband, a "former" EMT, gets a fare discount on some cruise lines! (Including Princess, I believe!)