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Intensive Care Paramedic here. Crush injury is a risk, but usually after more prologned entrapped, without blood supply to the affected area. Usually >45mins - but sometimes less. We carry drugs to counter the effect of the sudden release of toxins that damage the heart.

What is more risky here is not the release of the vicitim - but the potential for a failed release. What if 100 people tried to lift the bus, but it turns out they wernt strong enough, resulting in the bus just pivoting on the spot. That pivoting might have crushed the injury further - leading to significant more damage. When we extricate patients - we always aim to do it in a controlled environment. Even when they are sick, slow and steady is often best.

One of the worse worse worse things bystanders often do is pull objects out of patients. i.e. if you are stabbed, and the knife is still in you - do not pull it out.

I think bystanders think they need to do "something" - but sometimes doing nothing (i.e. dont pull the knife out) is best.

"One of the worse worse worse things bystanders often do is pull objects out of patients. i.e. if you are stabbed, and the knife is still in you - do not pull it out."

When I had my last first-aid-course, the instructor told us exactly this - do not pull out the knife. And then he added: but if you did and you realize your mistake, do not put it back in!

;-)

Trying to help is better than the "I can't help; not my job" attitude you seem to be proposing.

"Due to the risk of crush syndrome, current recommendation to lay first-aiders (in the UK) is to not release victims of crush injury who have been trapped for more than 15 minutes."

So crush syndrome is not relevant here. There's a reason why it isn't well known - because the naturally obvious thing to do is the right thing to do here (after first stopping the bus and calling an ambulance)

Is there any data about how many people suffer from "crush syndrome" versus the "bystander effect"? I'd guess the latter causes more suffering.

I saw a man die, so did a first aid course. The tutor was unequivocal that trying to help is pretty much always better than not trying to help.

Sounds like a short course.

But that's exactly my point. In some situations, trying to help when you don't know what you're doing can make a situation worse. There are many examples where the obvious thing to do is not the right thing to do, from magnesium fires to drinking lots of water during marathons.

I don't mean to advocate "I can't help" as an attitude, rather I think it's important to consider whether what you're doing is, in fact, helping. The classic examples of the bystander effect involve unambiguously helpful actions, like calling the police when you hear screaming. This is a little bit different. An ambulance had already been called, the situation was relatively stable, and I've always heard that unless you know what you're doing it's best to wait for the professionals.

Regardless, my point isn't that the people there did the wrong thing. I don't have the medical experience to know (nor, I suspect, do you). Even if I did, they were there, I wasn't, they had a short time to make the decision, and perhaps there are other facts not available to us. My issue is that the retelling of the story as "kind-hearted people triumph over the bystander effect" is incomplete without knowing the actual consequences. With the benefit of hindsight, perhaps it'll be "mob of impatient amateurs exacerbates trapped man's injuries in rescue attempt".

I know it feels good as written, and it is heartwarming that so many people wanted to help, but I think it's irresponsible to encourage behaviour in that kind of situation that might be medically harmful.

There are a small number of things you can do that might seem sensible but would make a situation worse. You learn those things in the right context.

Anyone who has a minimal amount of marathon training should know about hyponatremia; anyone who works with magnesium should know to put it out with sand; many people know that you shouldn't pull out the knife.

In a group of N people in London, there are first aiders and medical professionals present who contextually know this stuff.

On the balance of probability, I guarantee you there was more than 1 NHS worker pushing that bus.

I didn't read it that way. To me the article was not a feel good story about heroic passers-by. It was about the mechanisms of spontaneous coordination of a crowd of people in a shocking situation. Whether they did the right thing or not is not really the point of the article - it's more interested in why they did anything at all.

That's how I read it too. The article didn't say whether the person under the bus benefited from, or suffered extra as a result of, the actions of the crowd. But rather it was how an exception to the http://en.wikipedia.org/wiki/Bystander_effect can arise.

Ok. let me put it this way. If it was YOU under the bus, would you appreciate it if the bus was lifted off you?

Funny how when I put it like that - suddenly the answer becomes "obvious" to you.

It's cold blooded "logical" (to an extreme) people like you that are often a menace to society.

Sorry to point this out, but what you just said is 100% ridiculous.

>There are many kinds of injuries (not just puncture or spinal injuries) that get much worse if treated by someone with no medical experience.

So? Just leave the guy to die under the bus?

>The article said his leg was crushed but lifting the bus "looked like the most reasonable action to take".

The article is reporting second hand information from eyewitnesses. Basing your analysis on that is to put it bluntly - stupid.

>One of the possible consequences of a suddenly released crush injury is kidney failure caused by crush syndrome: https://en.wikipedia.org/wiki/Crush_syndrome

So what? You keep stating these as-if they are revelations. People already have a good understanding that injuries can have unanticipated complications.

>Like all of the people involved in this story, I'm not a medical expert,

How do you know that nobody there was a medical expert? They did not interview 100 people. Nor did they do a survey of all the people around the accident.

>However, I think it would be responsible journalism to ask a medical doctor whether the crowd did the right thing before hailing them as heroes and encouraging others to do the same.

The word hero was not in the article. In any case, they ARE heroes because they risked their own safety to help another human being.

> So? Just leave the guy to die under the bus?

I'm not sure of the specifics but the one thing that bugged me is that they dragged him out. If they could move the bus off of him (for all I know they just lifted it "up" enough to move him) then dragging is a terrible idea.

>Like all of the people involved in this story, I'm not a medical expert, so I don't know for sure whether these people helped or harmed the situation.

Faced with this situation, what would you have done?

They've made it pretty clear they would have stood by, watched, and yelled criticisms at those trying to help. Maybe even filmed it on their smartphone.

Filming is better than not filming. It provides useful documentation.

I would be more worried about them overdoing it and flipping the bus over...

I was thinking that myself but then realised most of the 12 tonnes mentioned is going to be towards the base (engine, etc). A double decker isn't going to be a top heavy object else it'd tip over any time it hit a corner a bit too fast

They'd have had to do some serious tipping to make it fall over https://i.imgy.org/NO2zZn26.jpg

I know they can stand some extreme tilt angle, but those tests are done with a slow and gradual rotation instead of a quick burst of force; being heavy also means that once it starts moving, it's harder to stop... so it's a good thing that those involved in lifting it were not too strong.

The CoG is actually pretty low. Here's an example of a tilt test:

http://therighttrack.millbrook.co.uk/wp-content/uploads/2010...

(See other replies) the low centre of gravity of double deckers is common knowledge here in the UK.

> However, I think it would be responsible journalism to ask a medical doctor whether the crowd did the right thing before hailing them as heroes and encouraging others to do the same.

Perhaps they did and the medical doctor said it's was OK in this situation.

that and not much blood becomes a whole lot if you remove pressure on the wrong place.

wait for the ambulance and help then, if they need it.