Last week, a man suddenly collapsed on a crowded Tube train, landing hard on the floor. Of the 60 or so people present, only one person moved – a young woman, who took one quick look then nipped off to the other end of the carriage.

The [edited] video makes for pretty uncomfortable viewing. Some passengers pretend they haven’t noticed the prone figure on the floor beside them, while others just stare at him. The idea that someone in need of help could be so completely alone in the middle of a crowd is genuinely upsetting.

According to The Daily Telegraph, the man was unconscious for a full five minutes before the train pulled into the next station. At that point, every passenger simply got off the train, many actually stepping over him to continue with their journey.

A further ten minutes passed – and scores more people walked past or briefly stopped to have a look – before some kind souls arrived and actually helped the stricken passenger. Up to that point, literally no-one had lifted a hand to offer him assistance. So why not?

Bystander effect

What’s going on here is the bystander effect, a well-documented phenomenon which states that, the more people there are at an incident, the less likely anyone is to help. Basically, everyone starts to think someone else will step in and so nobody actually does.

(Incidentally, I witnessed this kind of behaviour first-hand last year when I reached out to catch a woman who’d fainted on a really packed tube train. As she passed out, those passengers closest to her moved out the way to give her a good, clear run at the floor.)

‘Significant risk’

Luckily, the man seems to have been alright in this instance, but it’s helpful to look at the possible first aid implications of such a scenario. If he had suffered a cardiac arrest (Ie. he’d been unconscious and not breathing on the train floor), things would have been over for him pretty quickly without outside help. As people sat by, he would most likely have died before the train even reached the station.

It turns out this casualty was actually unconscious and breathing – which is much better – but he was still at significant risk, simply because of the position he was lying in. You see, when someone is unconscious and lying on their back, their tongue can easily fall back and block the airway. The result: they quietly die in a matter of minutes without any real outside signs of a struggle.

It’s a stupid, unnecessary way to die, and the way to prevent it is simple – just roll the person on their side into the recovery position and their airway will automatically be cleared.

Needless fears

So again: why did no-one help? Part of the reason people are reluctant to step forward is due to a misconception that first aid is overly complicated. Many are scared of ‘getting it wrong’, or even of being sued (though no-one has ever been successfully sued in this country because they tried to help someone).

These are needless fears and, besides, much of the time even the smallest interventions can make a big difference.

It pays to learn life-saving skills – not least because, statistically, you’re most likely to end up treating your loved ones. Our Everyday First Aid course can, in just two hours, give beginners a thorough introduction to all the key stuff. You can even learn from the comfort of your own digital device by using our online resource.

News stories about members of the public ignoring stricken casualties seem to have become depressingly familiar of late. Perhaps if more people knew first aid, that poor man would have been less likely to be left on the train like an outsized piece of litter.