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A GOVERNMENT minister has decried a worrying rise in the number of people “train surfing” on the Sydney rail network.

The past year has seen a 43 per cent rise in the number of people riding the exterior of trains.

Sydney Trains has released images and CCTV of the daredevil behaviour in the hope it will discourage the trend which saw 110 people caught train surfing in the last 12 months.

It is currently Rail Safety Week in NSW.

The images show people jumping onto the outside of the rear cabs of trains and then hanging on as the train departs. The images come primarily from the T3 Bankstown and T4 Illawarra lines.

CCTV footage of a man train surfing at Bankstown station in Sydney’s south west. Picture: Sydney Trains
CCTV footage of a man train surfing at Bankstown station in Sydney’s south west. Picture: Sydney TrainsSource:Supplied

Two people riding the rear of a train at Mortdale in Sydney’s south. Picture: Sydney Trains
Two people riding the rear of a train at Mortdale in Sydney’s south. Picture: Sydney TrainsSource:Supplied

The state’s Minister for Transport Andrew Constance said there was epidemic of people riding the outside of trains, playing chicken with trains and crossing the tracks, putting their lives in danger in the process.

“This is scary stuff,” he said. “People need to realise they are dealing with a 400 tonne vehicle, the chances of surviving if something goes wrong are very, very low,” Mr Constance said.

“Trespassing in the rail corridor or surfing the outside of the train is not only illegal, it’s also extremely dangerous and stupid behaviour.

“It only takes a train accelerating quickly or braking suddenly to shake someone onto the tracks. If the fall itself doesn’t kill you, the next train coming along probably will,” Mr Constance said.

Sydney Trains conducted an exercise to illustrate how long it takes a train to stop and the impact of a train hitting someone.

The organisation collided a train travelling at 100km/h, with the emergency brakes applied, into balloons and polystyrene boards at various distances.

The furthest objects were placed 225 metres from the train from the point where it slammed on the brakes.

“In the test we modelled, it took 325 metres for the train to come to a full stop. That’s more than three football fields in distance, that’s compared to a car which would likely take 128 metres to stop,” Mr Constance said.

Transport for NSW are working closely with Police Transport Command to target and deter reckless behaviour, and provide CCTV footage to help identify risk takers.

The minimum fine for people caught trespassing is $400 but this can be has high as $5,500.

“The message is it is not worth risking your life for a cheap thrill,” Mr Constance said.

Lets hope that this stops. Otherwise hopefully the people around to help have completed a first aid course recently. If you would like to book a first aid course in Canberra please see www.canberrafirstaid.com

The substantial client list of a winner at last year’s Irish Healthcare Awards is growing, and Mental Health First Aid Ireland is now teaching mental health first aid skills to blue-chip companies’ employees, Peter Doyle reports.

It has been a busy 10 months at Mental Health First Aid Ireland (MHFAI) since it was honoured at last year’s Irish Healthcare Awards, the so-called health Oscars.

After winning the Patient Lifestyle Education Project of the Year prize at last November’s award ceremony, the training body refused to rest on its laurels, and rolled out course after course at workplaces around the country.

Their substantial client list now includes blue-chip employers such as AirBnB and Vhi Ireland, while members of the Defence Forces are also learning mental health first aid (MHFA) skills alongside their basic training.

And MHFAI’s Manager Donal Scanlan has revealed to the Irish Medical Times that next month they will being teaching the art of MHFA to the ranks of An Garda Síochána.

MHFA skills
But to understand how MHFA skills will benefit gardaí in their day-to-day duties, it is perhaps best to get an insight into what MHFA actually is — and, more importantly, what it is not.

Developed in Australia around the turn of the century, MHFA is defined as the help provided to a person who is developing a mental health problem, experiencing a worsening of an existing mental health problem or in a mental health crisis.

To provide this help, people are trained in the skills and knowledge to recognise when a colleague is going through a difficult time.

This does not mean that a MHFA practitioner steams in at the first sign of a problem with, as Scanlan said, their “super-hero cape on and saying ‘I have all the answers’”.

“It is about giving people the tools to recognise when somebody might be having a difficulty, (and) the confidence to be able to offer them some support,” he added.

“We don’t want people coming away from a mental health first aid course thinking they are a therapist or a counsellor. They are not. They are coming away with a little bit more expertise, and a bit more knowledge, to be able to help each other on a person-to-person level.

“We do an awful lot of work in workplace settings. You do not want people going round, diagnosing. This is not about diagnosis, in any way. We are not sending people out to say, ‘I see you have depression, I see you have anxiety’. It’s not that.

“It’s about helping people to be able to respond to what someone’s experience might be like.”

There are obvious parallels with physical first aid and Scanlan hopes that the mental health first aider will become as ubiquitous in the workplace as the designated first aider armed with a box full of bandages and sticking plasters.

Stigma
But he is aware that the stigma that still surrounds mental illness may make people wary of admitting to feeling stressed or anxious at work, fearing that they will be perceived as weak or unbalanced.

It is something that many of the employers MHFAI works with are aware of too, as Scanlan revealed: “Some organisations have gone so far as to properly highlight that there is a mental health first aider, and because they have other roles (in human resources, for example) we are not clearly delineating people as being mental health first aiders.”

As for the so-called stigma, Scanlan hopes MHFA’s rising popularity — a recent survey by Laya Healthcare revealed that 91 per cent of parents of primary school children believe teachers should receive MHFA training — will bring about a cultural change, whereby people will no longer feel they can not admit to feeling stressed or anxious at work.

He further claims that employers are also keen on changing ingrained workplace attitudes and “are using mental health first aid to underpin that change”.

“A much more successful way of looking at mental health first aid training was, yes, have mental health first aiders, but maybe not confine it to a small group of people,” he said. “Let’s have a cultural shift instead, and use mental health first aid in a way that broadens the knowledge and the approach to mental health in organisations.

“In our mind, talking about mental health doesn’t cause mental health problems,” he added. “There is no evidence to suggest that. We shouldn’t be shying away from those conversations. If anything, we should be encouraging them.”

Strong evidence
There is, however, strong evidence in support of MHFA as something that can have a positive impact for staff.

For example, a recent meta­-analysis of MHFA training found that mental health first aiders were able to support their colleagues “up to six months after training”.

“Given low rates of treatment-­seeking, and evidence that people are more likely to seek help if someone close to them suggests it, the support that people receive from those in their social networks is an important factor in improving mental health outcomes,” Morgan et al concluded in their paper, ‘Systematic review and meta-analysis of Mental Health First Aid training: Effects on knowledge, stigma, and helping behaviour’, published in Public Library of Science Journal, May this year.

Another paper reported that mental health first aid course were responsible in significant improvement of knowledge in participants, “which has the potential to increase understanding and support for those suffering mental illness”.

“Mental health first aid courses potentially enable individuals who are not otherwise involved in mental health to assist people in need,” Morrissey et al added in their paper, ‘Do Mental Health First Aid courses enhance knowledge?’, which was published in The Journal of Mental Health Training, Education and Practice last year.

While, in 2016, a study focusing on the effectiveness of MHFA training for financial counsellors recognised that there was a “significant link between financial difficulties and mental health problems”.

And Bond et al noted in ‘Mental health first aid course for Australian financial counsellors: an evaluation study’ published in Advances in Mental Health Journal 2016, that financial counsellors in Australia were well-placed to help vulnerable clients get appropriate care and that MHFA was “an appropriate form of training for them” to enable them to do so.

The body of evidence in support of MHFA could well explain why over the past four years the number of mental health first aiders in Ireland has soared from several dozen to more than 3,000, as more and more organisations embrace the concept.

With research from the Economic and Social Research Institute revealing that 18 per cent of workplace absences were due to stress, anxiety and depression, there is little wonder that employers are now embracing the MHFA credo as a method of early intervention.

Arming communities
As Scanlan notes, this can only be good news for the primary care sector, especially general practitioners (GPs).

“Professionals are not always immediately available. Some people do not even recognise that what is going on with them is even mental health related,” he commented.

“This [MHFA] is an opportunity to arm our communities to respond to each other’s mental health first, and to see us as being part of the solution, rather than it always having to be about the medics, the doctors, and the nurses solving the problems.”

He added: “GPs need all the support they can get, and doctors and mental health professionals need support. It is not about increasing referrals to these services, it’s about being able to respond in the moment, so hopefully being able to prevent people ever being referred to professionals. Or if they do need it, then it is done appropriately.”

As MHFAI continues to develop courses for workplaces across Ireland, it has not neglected the growing need for the delivery of MHFA training for teenagers.

With this in mind, they are hoping to appoint a trainer in the very near future to help design and deliver courses for that particular age group.

Scanlan said: “One of the things I am really excited about is MHFA Teen, which is peer-to-peer support teaching young people themselves in secondary schools.”

“The idea of MHFA Teen is having adults, first of all, undergo MHFA youth training so you have one good adult supporting young people,” he explained.

“We have the material ready to go; we just have to redesign it for an Irish context. That’s what the new person is going to be doing, heading up this project.”

Guardians of peace
Meanwhile, the first of five MHFA courses for gardaí will be rolled out next month.

The pilot courses are part of a project they launched in conjunction with the Health Service Executive in April 2017 to make MHFA more widely available in Ireland.

And this was the project that was honoured at last year’s Irish Healthcare Awards. Scanlan said police forces around the world are turning to MHFA as a tool not only to help officers in the workplace but to help them also carry out their duties.

“We will see 100 gardaí trained in mental health first aid. It is just the start and we don’t know where it is going to go just yet,” he added.

“From the perspective of an internal support service, there is a lot of really good work going on in the gardaí that doesn’t always get highlighted.

“However, I think they need a little bit more support in not only supporting each other but also in relation to the guidance they might get on how to support the mental health of the people they are dealing with.”

A large proportion of the cases the gardaí are dealing with in the public realm are related to mental health, and MHFA has been used to train police forces around the world in the topic of mental health.

The Federal Government in the United States, the Western Australia police force, the Royal Canadian Mountain Police, are all using MHFA as part of their training.

Scanlan added: “We would like to have that same kind of impact in Ireland. The gardaí themselves are interested in expanding that project afterwards, but we will see where that goes.”

For more information, visit www.mhfaireland.ie.

Or book in to a first aid course with Canberra First Aid at www.canberrafirstaid.com

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EDMONDS — Principals, coaches and about 120 staffers in the Edmonds School District went back to the classroom this week, to learn their ACTs.

A new crash course boils down a standard first aid lesson to a one-hour summary — quick, easy, memorable keys that could be the difference between life and death.

The curriculum was designed by staff at South County Fire, for the modern layperson.

“Not a lot of people want to come in for eight hours on a Saturday for a first aid class,” said Shaughn Maxwell, deputy chief of emergency medical services. “So how much of what we teach in eight hours is going to save someone’s life, in those first five minutes before the firefighters get there?”

This Cliff’s Notes version gives the bare essentials.

Just three things.

A is for antidote, a grim reflection of the reality that overdoses are now a leading killer of people under 50. Paramedics show how to spray naloxone into the nose of a mannequin head, to reverse an overdose on opioids.

C is for CPR, a centerpiece of any first aid course.

T is for tourniquet, a tool that can stop bleeding in accidents, stabbings and shootings.

About 250,000 people are served by South County Fire, in the general area of Edmonds, Lynnwood and Mill Creek. Paramedics found they were training maybe 20 people per week in their full-on first aid classes, Maxwell said. If you have a cardiac arrest, and you’re counting on a passerby to save your life, those numbers don’t sound too comforting.

Maxwell hopes the simplified program can train 6,000 people a year.

The first mass lesson was held Friday in the Great Hall at Edmonds-Woodway High School. Small groups split into stations, rotating every 15 minutes. Men in khakis and striped dress shirts knelt in the south end of the hall, pumping chests of pink plastic dummies, to the beat of the Bee Gees anthem “Staying Alive.” Time was counted by South County Fire Capt. Andre Yoakum, in one of several semi-circles of school administrators. They had to pump for two minutes before they could call in a reliever.

“This should be physically grueling,” Yoakum said. “It’s kind of like doing a workout. It’s kind of like having to climb that mountain, if you focus your mind on the physicality of doing this job — one minute! — it’s going to help distract your mind and keep you doing 120 beats per minute.”

Posters explain the steps. Call 911; send someone to get an AED; start compressions; hook up the AED, follow instructions and keep going until help shows up.

In a cardiac arrest, the odds of survival go down 7 to 10 percent with each minute that passes without CPR, according to the American Heart Association.

“This is a tunnel vision job,” Yoakum said. “You don’t need to be thinking about anything distracting, other than getting other people in here to help you.”

Once the hands-on training is over, there’s time for questions — for example, how do we know when we’re supposed to give CPR? (Answer: If the patient is not breathing and not responding.)

Many emergencies of today are not the emergencies of, say, 1918.

“The way we do first aid now is really the same way we’ve done it for 100 years,” Maxwell said. “But we know our world has changed significantly in the past 100 years.”

We have an opioid epidemic.

We have a mass shooting epidemic.

We die from cardiac arrest, diabetes and obesity-related health problems.

So the class aims to battle the public health crises of the day. And as far as Maxwell can tell, no one else is doing a class like this in the country. He dreams of every local high school freshman going through the training, and eventually seeing the program go nationwide.

For now, he’s seeking grants to better fund it.

Demand has been far too high for South County staff to handle. In a way, he said, that’s a good problem to have.

Caleb Hutton: 425-339-3454; [email protected]. Twitter: @snocaleb.

If you would like to book in to a first aid course in Canberra. here is the link www.canberrafirstaid.com

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When someone is choking, their airway is partly or completely blocked, meaning they may be unable to breathe properly. They might be able to clear it by coughing, but if they can’t you will need to help them straight away.

What to look for

1. They may have difficult breathing, speaking or coughing. 2. A red puffy face. 3. They may show signs of distress and may point to their throat, or grasp their neck.

What to do 1. If you think someone is choking, ask them ‘Are you choking?’ If they can breathe, speak or cough then they might be able to clear their own throat. If they cannot breathe, cough, or make any noise, then they need your help straight away. 2. Cough it out. Encourage them to cough and remove any obvious obstruction from their mouth. 3. Slap it out. If coughing fails to work, you need to give five sharp back blows. To do this, help them to lean forwards, supporting their upper body with one hand. With the heel of your other hand give them five sharp back blows between their shoulder blades. After each back blow, check to see if there’s anything in their mouth. 4. Squeeze it out. If back blows fail to clear the obstruction, give five abdominal thrusts. To do this, stand behind them and put your arms around their waist. Place one hand in a clenched fist between their belly button and the bottom of their chest. With your other hand, grasp your fist and pull sharply inwards and upwards up to five times. Check their mouth again, each time. 5. If the blockage has not cleared, call 999 or 112 for emergency help straight away. Repeat five back blows and five abdominal thrusts until help arrives, re-checking their mouth each time.

If they become unresponsive at any point prepare to start adult CPR. For those looking for quick, easily accessible first aid information, the Allens Training app is available free on smartphones and the website ( www.canberrafirstaid.com) offers demo videos, an interactive game, and lots of free advice. For more information about first aid course call 0449746357.

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A QUEENSLAND judge’s suggestion that Australia’s blood-alcohol limit of 0.05 might be “a bit low” has drawn criticism right around the country.

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A VICTORIAN man has been diagnosed with the deadly and uncommon fungal superbug Candida auris (or C. auris).

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A YOUNG Sydney woman, who thought she had fallen ill with the flu, says she was shocked when told she was just 30 minutes from death.

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Symptoms of food-induced anaphylaxis in infants are much less severe than in toddlers and older children, according to a study from Ann & Robert H. Lurie Children’s Hospital of Chicago published in the Annals of Allergy, Asthma and Immunology. Anaphylaxis is defined as a reaction that involves multiple systems in the body or a presentation with significant cardiac or respiratory symptoms. While in older children an allergic reaction to food can be life-threatening, anaphylaxis in infants mostly manifests as hives and vomiting, the study found. With over 350 cases analyzed, including 47 infants, this is the largest study to date to describe food-induced anaphylaxis in infants under 1 year of age compared to other age groups.

“We found that infants, unlike older children, have a low-severity food-induced anaphylaxis, which should come as reassuring news to parents who are about to introduce their baby to potentially allergenic foods like peanuts,” says lead author Waheeda Samady, MD, from Lurie Children’s, who also is an Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Since early introduction of peanuts is now encouraged by national guidelines, it is understandable that parents might be fearful of triggering a serious reaction.”

The latest guidelines from the National Institute of Allergy and Infectious Diseases, released January 2017, recommend that infants be introduced to peanut-containing foods between 4 and 6 months of age. These guidelines are a major shift from previous recommendations to avoid early introduction of peanut-containing products. The current guidelines are based on a study demonstrating that early peanut introduction to high-risk infants significantly decreased their risk of developing peanut allergy.

To describe food-induced anaphylaxis in infants, Dr. Samady and colleagues conducted a retrospective review of children who presented with this condition at the Lurie Children’s emergency department over a two-year period. Their analysis included 47 infants, 43 toddlers, 96 young children and 171 school-aged children.

They found that infants presented with gastrointestinal symptoms more frequently than any other age group (89 percent of infants vs. 63 percent of toddlers, 60 percent of young children and 58 percent of school-aged children). Vomiting, in particular, was present in 83 percent of infants. Infants and toddlers also presented with skin involvement more often than school-aged children (94 percent in infants and 91 percent in toddlers vs. 62 percent in school-aged children), with hives as the most common skin manifestation found in 70 percent of infants. Any respiratory symptoms including cough were more common in older age groups (17 percent in infants vs. 44 percent in young children and 54 percent in school-aged children). Only one infant in the study presented with wheezing. Low blood pressure also was present in only one infant. No infant in the study died from anaphylaxis.

“If a baby develops only a mild rash or gastrointestinal symptoms after trying a new food, we advise parents to discuss this reaction with the child’s physician,” says senior author Ruchi Gupta, MD, MPH, from Lurie Children’s, who also is an Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “If there are multiple symptoms, make sure to call 911 and get emergency help immediately.”