EMERGENCY CALL TO THE METRO

We are bound to witness at least once in our lives passengers fainting or having some kind of attack on the metro. There could be any number of reasons for this - the sheer numbers of passengers and the various chronic illnesses that some people have. And if an ordinary, healthy person, finding themselves in an enclosed space or in a rush-hour crush, can suffer, what about those who have heart problems? 

Of course, we all know that people with various illnesses should not use underground transport. But what if there is no alternative? Not everyone has private transport and one is forced to use public, the most popular of which is the metro because of its convenience and low cost.

The popularity of the Baku metro among passengers has increased even more recently following frequent problems with bus routes. In 2014 alone, for example, 215.5 million people used the Baku Metro, and about 590,400 people took part in Baku Metro Day that year. It is on the cards that these figures will be increased this year.

"Underground boiling point"

One reader who took part in our survey, Kamal Mahmudov, has pointed out more than once that for some people travelling on the metro has become unpleasant. This is usually because at busy, crowded stations there is a high flow of passengers, not just in the rush hours, but all day long. This is what he said: "This happened in the summer, during the First European Games in Baku. A man collapsed right in front of me on the platform at 28 May station. This wasn't the first time I've seen this, but this time I was more prepared, because shortly before this I had been to a first-aid class. I went to his aid straightaway, called for someone to get a doctor and to make sure he had plenty of air. The police started dispersing people, but didn't manage it very well and they continued to stand and watch. I started artificial respiration, and then a young lady passenger took over from me. Five minutes later an ambulance arrived and he was taken away. The next day I arrived at the same station, went to the first-aid point there and asked them how the man was. They said he had died, although they said this was the first time this had happened in ten years." They said their job was just to serve the staff and the drivers, but they assist passengers if there is an urgent need.

First-aid posts for all

Talking to R+ about the problem, Nasimi Pasayev, head of the Baku Metro's press service, said that first-aid posts at some stations on the Baku Metro are indeed for the use only of staff and drivers. "It is planned in the future to set up first-aid posts to serve passengers, too," he said. He also pointed out that if necessary platform staff give assistance and administer first-aid to people in need.

As regards stuffy air, Nasimi Pasayev said that there are 266 old cars operating on the metro at this moment in time, and installing an air-conditioning system in each one is impossible from the technical and safety point of view, So, in tunnels these cars are ventilated naturally. At stations the ventilation system works successfully and there are no problems here, the head of the press service says. But according to regulations, if the outside air temperature exceeds 35 degrees Celsius, air should not be pumped into the metro. Bearing in mind that in summer the air temperature in Baku often gets above 35 degrees, the problem of fresh air in the metro becomes critical, as is the metro acquiring new cars with air conditioners. 

Of course, having at least a few first-aid posts on the metro is some consolation, but there have been instances where a person's life depends on prompt, qualified assistance, and an ambulance may not arrive in time or may simply get caught up in a traffic jam.

Assistance comes in many guises

So, what should emergency aid be, and can ordinary doctors and passengers always provide it? Qaib Aliyev, an expert who does first-aid training, says: "Emergency aid in the form of heart massage and artificial respiration is not always effective, and then only in cases of drowning or breathing difficulties. If there are problems with the heart, the chances of survival are much less. In this case everything depends on qualified medical aid being applied in time. Statistics say that there is an 80 per cent chance of cardiac resuscitation if a defibrillator is used in the first four minutes after an attack or loss of conscience; but if time is lost, it becomes very difficult to do anything."

The deputy head surgeon of the First Aid Station in Baku, Oqtay Sahmaliyev, said that there are approximately 4-5 calls from the Baku Metro every day, and about 100-120 calls in a month. "However, it is not always passengers who are in trouble: metro workers also suffer."

What should a first-aid post be like?

The demand for first-aid posts in generally small, because their main function, after all, is not the treatment of victims but to help them to hold out until a doctor arrives. The demands on personnel are also small - one needs only to be a competent nurse or paramedic. According to the regulations, before a doctor arrives a first-aid post should have anti-spasmodic drugs, hypotensors (for reducing blood pressure), cardiac, antiseptic, anti-histamine (to counter allergic reactions), analgesic and anti-inflammatory medicines, antiemetic agents and bandages. Although, Qaib Aliyev says, according to international regulations, there should not be any medication in a first-aid post, because even for a simple injection one needs to know the whole medical background of a person who may be in an unconscious state and incapable of speaking about chronic illnesses and medical alerts. According to Euro-pean regulations, there must be defibrillators, water, bandaging and a telephone or other means of communication for a doctor to be called immediately and a registration book for recording the incident. 

"In many European countries and the US there are automatic defibrillators in access areas to public places which anyone can use; they are as compulsory as fire-extinguishers," Aliyev said. "Here, there are defibrillators in all sorts of places - in oil companies, some hotels and sports stadiums, but the law doesn't say who can use them. A first-aid post can also have a number of medications for use in a heart attack, provided, of course, someone has a needle."

"Life-saving…"

Apparently, according to current legislation, there is no provision for first-aid posts in public places. The Health Ministry's press service spoke to R+ about this. "They only have to be at business enterprises and in organizations. Of course, one needs to look at this in context," a press service spokesman said: "For example, a sports stadium is a public place, but it's not a business enterprise." 

At the State Committee for Architecture and Construction, our magazine was told that according to the regulations for the construction of domestic and administrative buildings, if more than 200 people work in them they must have a first-aid post. Accordingly, these first-aid posts must have a rest room, a medical cabinet with the necessary medication and materials, a treatment room and a store for domestic appliances. At the same time, all first-aid posts should be situated on the ground floor, and the width of the door to the reception room should not be less than one metre.

All this, of course, eases but doesn't solve the problem we are talking about - helping passengers on the metro. Yes, the metro isn't a business enterprise and, according to existing regulations, a local first-aid post may serve, basically, only the people who work there. But if you look at this problem from another angle, then on the Baku Metro, which carries over half a million passengers every day, an acute need has arisen to set up a broad network of public first-aid posts.

It may not be our place to do so, but we would like to give workers on the metro a piece of advice: taking the example of our neighbouring countries, in anticipation of first-aid posts being set up, introduce a useful initiative - in an emergency situation, when someone is in distress, use the public address system and ask if there are any doctors among the passengers. After all, life is priceless, and if someone can save one person today, that person could save another tomorrow.