Medical situation/response on the Grand....

[thyme2go]

I know that every so often there are comments about people's experience's with medical interventions on a ship. We just returned from the Grand and were witness to this firsthand........and it did not leave us feeling good about what was provided.

This incident occurred in the aft hot tubs....on a sea day. A woman who had epilepsy and was pregnant (early) had a seizure according to her family. They immediately asked for someone to call 911. The crew ran around and we thought they were calling it in. Meanwhile passengers rendered aid..stabilized her head (she had collapsed onto the tub stairs) and monitored heart rate and breathing. At least five minutes passed and a suited food staff person showed up and assessed the situation......then picked up a phone. Was this the first actual call to Medical? Did the crew that were running around try to find a superior rather than call in the emergency? Either way it was not a good response. There was another time lapse and then a single male medical person ran up and rudely intervened.......there was no crowd, there was no problem with how she had been helped and it appeared to be protocol to be rude and not assess what had happened before he got there. He pulled out a glucometer and did a blood test. The reading was very low.......(yes, I looked at it). We now left the scene because we were not needed.

The next day my partner saw a member of the family and asked how she was doing and if they stabilized her blood sugar. The family member said "what?" He had not been told anything about her blood sugar. She had continued to have seizures and was sleeping a lot......the medical staff on board had done nothing to address this nor did they know what was causing her problem. She had seen the medical staff before the hot tub incident due to her first seizure on board and been told it was probably the "sun or heat" so that brought her seizure count to 5 in a little over 24 hours. She was not in the infirmary but in her cabin and the family was dealing with it as best they could. They wanted to disembark in Astoria, but the Captain did not dock there so they were on board for another 24 hours. We believe they got off in Nanaimo.

So, here are my points:

1.) The lack of a medical response in a timely manner is a continual issue on Princess in particular. We saw it first hand this time.

2.) The use of a glucometer and the lack of follow through on the result of the test is an abomination. This is a very simple test and the result left no doubt as to what the next step should be........For those that do not know.....hypoglycemia or low blood sugar, is a cause of seizures and is treated by administering either glucagon or an IV of dextrose--(sugar water) and monitoring blood sugar levels for normalization...a simple finger prick with a glucometer reading the test strip is used for assessing blood sugar levels.

3.) The fact that the family was not told about the test tells me that it was a routine procedure that was not given the attention it deserves by the person that administered it. It was simply done and that's it--no recognition was given to the result of the test.

4.) Administering treatment for a hypoglycemic incident (no matter what other conditions exist) is one of the simplest medical interventions there is. The fact it did not happen underscores the lack of even basic "medical" treatment on board this ship.

Lest anyone think this was a difficult situation to navigate........no, it was not. I am not looking for people to defend Princess and I know some people have felt fine about their experiences. This experience has left us with a very low opinion of service rendered in a medical emergency. It was the low point of the cruise and haunts us when we think about it now........We hope this young woman and her pregnancy are doing better and that she is getting appropriate medical treatment on land.

[PescadoAmarillo]

It's a concern. It's not that I think the crew is not well-intentioned...I think they are so used to escalating everything to a supervisor that they don't feel they can do anything outside of their specified duties. And once 911 is called, the call must go first to the PSD who then calls the Medical Center. I saw for myself how long it can take, and it was even longer than when a neighbor fell (non-life threatening), we called 911 and a fire truck and rescue squad appeared from a station 2 miles away.

[umbertsmum]

I am not doubting the OP however I have had personal experience of Princess managing an epileptic crisis and ongoing care over a period of a week and I am a health professional .

I have nothing but praise for the medical team I encountered

 

 

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[bdjam]

I'm not a medical professional, nor would I be injecting myself into a medical situation to discuss tests or their results with the doctor or the patient or the patient's family. That's sort of not my business and even if it was, not being present to witness everything that happened during the event and subsequent care/recovery leaves a lot of gaps that could explain what might seem as discrepancies or lack of proper care.

 

All that being said, what I could contribute to the situation is a call to 911. I often wonder about the hierarchy on board and what crew members are allowed to do. Are the folks working on deck allowed to call medical resources or do they have to go to a supervisor to get that done? In any case that call is something I could have done and perhaps the response would have been different.

[BratDet]

"low" can be a wide range.....

 

If you have epilepsy, that alone can be the cause of seizures.

 

.I have seen many times different people thru the years with a wide range of lows......the lowest was 17...and none of the people seized...myself being one of them....my lowest recorded was 38....

 

 

 

Bernadette

[thyme2go]

"low" can be a wide range.....

 

If you have epilepsy, that alone can be the cause of seizures.

 

.I have seen many times different people thru the years with a wide range of lows......the lowest was 17...and none of the people seized...myself being one of them....my lowest recorded was 38....

 

 

 

Bernadette

 

 

Bernadette......are you saying that the person who had a blood sugar of 17 or yourself at 38 were not treated for low blood sugar in some form? It really doesn't matter if you have a seizure (and you can be glad you didn't) but treatment to raise the blood sugar level is still the protocol when sugars are that low.

 

Yes, epilepsy can be the cause of seizures that are the same as low blood sugar. They both are the result of changes in the brain..........no or low sugar=nothing for the brain to utilize=seizure. There is no specific blood sugar number at which people will have a seizure--just like your situation, it is variable from person to person and from event to event. Thus, the specific number is not important. However, any reading below the normal range is indicative of hypoglycemia....low blood sugar. A seizure is the most dangerous symptom of low blood sugar and warrants immediate attention and medical action that apparently did not happen. So, even if the seizure was 'epileptic' the corresponding severe low blood sugar warranted treatment as well......

Edited May 20, 2014 by thyme2go

[shredie]

Well, I hope she and the baby are now okay. It must have been so frightening for her and the bystanders.

[capriccio]

OP - Did you share your concerns with the staff response with ship management and/or Princess headquarters? I certainly hope you did so even before you posted here since that (as opposed to a message board) has the real potential to do some good.

[Grannycb]

I'm thinking the the ship's medical response was probably quicker than it would be on land. How long would it take for an ambulance to arrive? Do the EMT's have Glucagon? Are they given permission to use it? How long is the drive to the hospital? How long is the emergency room wait? From what I've seen of ship medical centers, they are well staffed and professional.

[thyme2go]

OP - Did you share your concerns with the staff response with ship management and/or Princess headquarters? I certainly hope you did so even before you posted here since that (as opposed to a message board) has the real potential to do some good.

 

I will be considering that although I believe Princess reads this forum for a number of reasons. I posted here because I had always assumed a basic level of care (as advertised) while cruising and have now seen that could have been erroneous. It apparently did not happen in this situation and yes, I wanted to share this in case it is relevant to other cruisers.

[nschamp]

I believed it to be mg/dl since they are nearest US medical treatment and yes, this difference is usually encountered in Europe. Nonetheless I double checked it and yes it was mg/dl. Good catch, though.........

 

I have never been on any Princess ship that used that scale. Many cruises many glucose tests, all using mmol/L and I had to convert it. :confused:

 

It really doesn't matter where the nearest treatment center is, to my humble knowledge their Doctors are all British.

[Grannycb]

I'm thinking the the ship's medical response was probably quicker than it would be on land. How long would it take for an ambulance to arrive? Do the EMT's have Glucagon? Are they given permission to use it? How long is the drive to the hospital? How long is the emergency room wait? From what I've seen of ship medical centers, they are well staffed and professional.

 

I should have added that there is a lot of conclusion jumping going on. Did the patient tell her family everything about her health? Did she give the medical staff permission to speak with her family? Did the family understand her condition? Was she following doctor's orders? There's no way to know any of those questions.

 

I've never seen anything but mmol/l used on ships as mentioned by a different poster. An mmiol/l reading would appear very low while it would be normal if using mg/dl. Was the sun shining on the reading window? How close were you to the Glucometer? I don't think anyone could read mine unless within a couple feet.

 

I don't mean to be a cheerleader for the medical center or crew, but I don't necessarily read this situation as being poor care. There could be a lot that we don't know about.

[Carolyn R]

Who are you? What are your credentials? How irresponsible of you to post these accusations on a public board. Any medical professional qualified to assess would be addressing the issue on board the ship, if critical, or the Princess corporate office directly. Expecting Princess to get your expert evaluation of an emergency situation via your post on Cruise Critic is just plain wrong. Is it possible that first responder time could be improved? Sure, but that is another issue completely. BTW, I am a retired medical professional.

Edited May 20, 2014 by Carolyn R

[cherrybear]

Since the Medical Center staff is pretty small, perhaps they were involved in another emergency and responded as quickly as they could.

[Happy2cruise]

Maybe I missed something, but why didn't one of the passengers at the scene go to one of the nearby phones and call the emergency number themselves instead of waiting and watching the crew members search for their supervisor:confused:

[hockeygal54]

This just reinforces my belief that when I'm on vacay I'm on vaycay! I'm leaving any medical expertise @ the house! And I AM a "medical professional"!

 

 

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[IECalCruiser]

I will not get into a discussion about the speed or appropriateness of Princess medical care, but

I have had very different experiences than the OP observed. However, there was another recent thread about delayed medical response which appeared to be result of slow or no action by low level Princess staff. If I encounter a medical emergency on board in the future, I will make the emergency call and not rely on Princess staff.

 

 

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[jean s]

After reading these posts I agree that if I become aware of a medical emergency I will pick up the phone and call 911 immediately. I don't plan on waiting for a staff person to do so.

[capriccio]

I will be considering that although I believe Princess reads this forum for a number of reasons. I posted here because I had always assumed a basic level of care (as advertised) while cruising and have now seen that could have been erroneous. It apparently did not happen in this situation and yes, I wanted to share this in case it is relevant to other cruisers.

 

What you observed is relevant to the management. I have a problem if you are willing to share your observations and opinions with the masses here on Cruise Critic but are not confident enough in them to go directly to Princess.

[BratDet]

Not going to comment on whether it should have been treated...

 

Another thought occurred to me...as a passer by...

 

you may not have seen the full screen. It is very common, unless you are looking at the reading close and straight on, for you to miss a full reading...like 153 instead of 53....

 

Bernadette

[tml1230]

I usually stay away when threads become contentious but I think that in almost any medical situation, unless one is intimately involved, you are probably not privy to all of the details. It seems quite a leap to start speculating on whether the care was appropriate or not.

 

well stated…for the record i am not a health care professional, but i drove by a hospital and 2 ambulances today.

[Timbles]

I have never been on any Princess ship that used that scale. Many cruises many glucose tests, all using mmol/L and I had to convert it. :confused:

 

It really doesn't matter where the nearest treatment center is, to my humble knowledge their Doctors are all British.

 

 

I have had need to have my BS tested on two Princess ships, the Dawn (years ago!) and the Ruby two months ago. BOTH times the glucometer was using mmol/L. I was quite startled the first time, but expecting it the second time.

[Pam in CA]

It really doesn't matter where the nearest treatment center is, to my humble knowledge their Doctors are all British.

They may be British-trained and/or credentialed but the doctor who treated my brother-in-law a few years ago was from South Africa.

[sunshine426]

Thank you to the OP for posting this observation of a medical emergency on board a cruise ship. It certainly opened up quite a discussion.

 

My first thoughts would be to credit the first responders..in this case passengers. I do have concerns regarding the length of time medical took to arrive. My take away learning point. Pick up the phone and call myself.

 

As to the response team's time and actions at the site...really sounds poor from the description. Having recently been involved as a bystander in a medical emergency on the Island Princess, I have no real doubts as to the OP's observation.

 

Should this be posted on this board. Why not? We talk about all other subjects. Being aware of problems might make some of us act differently if we witness a medical emergency.

[derdejoh]

I will be considering that although I believe Princess reads this forum for a number of reasons. I posted here because I had always assumed a basic level of care (as advertised) while cruising and have now seen that could have been erroneous. It apparently did not happen in this situation and yes, I wanted to share this in case it is relevant to other cruisers.

 

I'm not going to comment on the actual situation you experienced, and I do hope the patients are doing well. But I'm curious about your comment about an advertised level of care. In fact, I'm not sure there is any legal obligation on behalf of Princess at all to provide any medical care (although the fact that they do so is a great service). As noted in the passage contract:

 

"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."

 

I'm not saying the availability of medical services on Princess is right or wrong, but do agree that everybody should be informed of the cruise lines legal obligations and perhaps we cruisers need to adjust our expectations?