My late father was a diabetic, so I got a fair amount of practice in the management of a diabetic comma. He managed his illness very well, but there were occasions where he got the balance between insulin and food intake wrong. The one occasion he collapsed in public where he was assumed to be drunk by the police who were all for locking him up for being D & D, but fortunately the Ambulance Service set them right.
A lad on the seat behind me on the train back from Shrewsbury on Tuesday collapsed. No obvious smell of drink, could have been pills and potions or could have been concussion from some type of accident or diabetic comma or something else. The train manager could not wake him once he had collapsed between the seats and she made a lot of effort.
It does not really matter the cause from a 1st aid point of view. Make sure their airway is clear and put in recovery, seek help. Our poor unfortunate had his head against the side of the carriage, forcing his head forward. The possibility of doing a Hendrix is somewhat raised and if he had been sick, well, you know what could happen.
The conductor who was both most caring and intent on doing the right things, called for an ambulance to meet the train at Machynleth Station. All good. However, neither she or the driver-manager(not quite sure I understand what they are) felt that they could move our friend to release the pressure on his neck because of Arriva rules(thats my understanding at least of their conversation). So I did it and put him in the recovery position [ which he promptly moved out of, but at least his neck was not constrained ]. I figured that should he die, it would spoil my evening more than the shadow of a no-win no fee solicitor.
We can't expect all train staff to be 1st aid trained, but they could at least ask if any passengers are. If he had stopped breathing, he may not have made it to the paramedics without CPR and that would have fallen to a passenger, in this case probably me, to keep his breathing and circulation going.
So if you are going to take drugs, drink yourself into oblivion, bang your head or not manage an illness properly and wish to travel on an Arriva train while unconcious, take someone with you who knows how to handle the situation. The Arriva staff will do their very best for you, but believe they are constrained by the rules their company gives them to follow.
No idea what happened to him or the cause, but he was still breathing at Machynleth as the Paramedics took over and I got off.