Amtrak. Service Standards Manual for Train Service and On-Board Service Employees (Version 6, 2011)

racks and storage compartments for any

unusual items. All findings must be reported to

the Conductor.

•

Once the equipment has been inspected and

cleared, Train and On-Board Service employees

will go car-to-car matching luggage and personal

belongings to the proper passenger while

checking for proper photo identification. All

findings must be reported to the Conductor.

•

In the event that crew members can not match

carry-on items (unclaimed) or a suspicious

package or device is found, all crew members

and passengers will be required to move two

(2) car lengths away from the package or

suspected device and ensure that all bulkhead

doors are closed and secured. No attempt

should be made to touch the package or

suspected device.

•

As soon as all passengers and crew members

are safely positioned away from the package or

suspected device, the Conductor will immediately

contact the Train Dispatcher with a description

and location of the package or suspected

device along with the car numbers of the

evacuated equipment.

•

In the event a passenger(s) cannot produce

photo identification when requested, the crew

should try to ascertain the name(s), date of

birth and any other relevant information about

the passenger(s). The information regarding

passenger(s) without photo identification will

be relayed to the Conductor who will inform

the Amtrak National Communications Center

(NCC) at (800) 331-0008 of the situation and

then wait for further instructions.

•

The Train Crew should prepare for a possible

evacuation of the entire train if instructed by

the Train Dispatcher.

Standing Train Inspection

Operating crews must take the following actions for

all trains that are stopped en route, stopped in a

station or will be stopping.

The Conductor will coordinate all instructions

covered in the En Route Train Inspection section in

addition to the following:

1-92

Terrorist Activity

The Locomotive Engineer will perform an interior

and exterior inspection of the locomotive(s)

looking for anything unusual. All findings must

be reported to the Conductor. At the completion

of the locomotive inspections, the Engineer

must return and remain on the head-end of the

locomotive.

b) The Conductor will perform or designate a Train

Service employee to perform an exterior

inspection of the entire train looking for anything

unusual or out-of-place. (If a designated Train

Service Employee is used, they will report the

findings back to the Conductor)

If an immediate emergency evacuation is needed,

make the following announcement: “Train

Evacuation Where Baggage Must Be Left on Train

Announcement” from “Service Standards for

Train Service and On-Board Service Employees ”

Chapter 10 - “On-Board Announcements &

Signage” which reads: Ladies and gentlemen

thank you for your patience and cooperation.

Due to the nature of the police activity, please

leave your baggage on board the train and exit

the train immediately as directed by a member

of the crew. Passengers on required medications

are asked to retrieve them at this time and exit

the train in an orderly fashion. We will provide

you with more information as soon as possible.

Thank you for your assistance.

d) If an evacuation is needed that is not an immediate

emergency, make the following announcement:

“Train Evacuation Where Baggage May be

Retained by Passengers Announcement” from

“Service Standards for Train Service and On-Board

Service Employees” Chapter 10 - “On-Board

Announcements & Signage” which reads:

Ladies and gentlemen, due to the nature of

the police activity, we ask that you gather all

of your possessions and exit the train in an

orderly fashion as directed by a member of

the crew. We will provide you with more

information as soon as possible. Thank you

for your assistance.

Service Standards Manual No. 6

1-93

Introduction

Amtrak personnel must cooperate completely with any

and all law enforcement agencies, and their agents, while

such agents are acting in an official capacity.

A. Transporting Prisoners

Amtrak will transport prisoners on-board trains only

with private room accommodations of adequate size

depending upon accommodations available and the

number of persons involved. The transporting agency

will provide two (2) escorts per prisoner. Amtrak

does not assume responsibility for the security of

prisoners. The transporting agency must notify the

Amtrak Police Department of the transport before

departure and provide all details so that an incident

number can be assigned to the detail. Amtrak

procedures will govern.

Firearms and Weapons On-Board Trains

Law Enforcement Officers

It is Amtrak’s policy that only qualified active law

enforcement officers employed by a local, state,

federal or railroad law enforcement agency on

official business be permitted to carry handguns

or small weapons (not exposed or needlessly

displayed) aboard Amtrak trains.

b) A “qualified active law enforcement officer” is

defined as an employee of a government agency

or railroad who:

• is authorized by law to engage in or supervise the

prevention, detection, investigation, prosecution

or the incarceration of any person for any

violation of law.

• has statutory powers of arrest.

• is authorized by the agency to carry a firearm

• is not the subject of any disciplinary action by

the agency.

• meets the standards, if any, established by the

agency which require the employee to regularly

qualify in the use of a firearm.

• is not under the influence of alcohol or other

intoxicating or hallucinatory drug or substance.

• is not prohibited by federal law from possessing

a firearm.

Service Standards Manual No. 6

1-97

c) Under no circumstances is a non-law enforcement

passenger or employee permitted to carry firearms

or ammunition on-board Amtrak trains either on

their persons or in carry-on baggage.

2. Carry-On and Checked Baggage

a) Firearms, ammunition and/or other weapons,

whether or not packaged, are prohibited in carry-on

baggage or on the person at all times, even if the

person has a permit to carry a firearm or weapon.

There are no exceptions, other than as stated in

number 1 of this section.

b) Firearms and ammunition are the only weapons

permitted in checked baggage. (Refer to Chapter 4

“Baggage Handling”)

1-98

Law Enforcement Issues

A. Injuries

In the event an employee or passenger is injured on-

board the train, your first responsibility is to ensure that

appropriate medical attention is provided. Appropriate

medical attention may range from providing basic first

aid to arranging an emergency medical assistance

response en route or at the nearest station. The level of

assistance required will depend on the crew’s assess-

ment of the situation and request from the injured

employee or passenger. Crew members are expected

to be supportive and lend assistance until the proper

level of care has been arranged.

General Instructions

When a passenger or employee requires immediate

medical attention, the Conductor must be notified

of the situation by the quickest available means.

The public address system should be used (if

operational) to alerted crew members of an

emergency by stating “immediate assistance” is

required along with the car’s location in the train.

b) The Conductor must notify the Train Dispatcher

when emergency medical assistance is needed.

The Train Dispatcher will determine the nearest

location where emergency medical services can

meet the train, directing the train to express to

that location. If the medical emergency occurs

while the train is making a scheduled station stop,

the train must remain at that location until either

medical assistance is rendered or the Train

Dispatcher directs the train to express to another

location where faster assistance can be provided.

At the direction of the Conductor, a PA

announcement may also be made requesting the

assistance of any medical personnel on-board.

(Refer to the “Medical Emergency Announcement”

in Chapter 10 “On-Board Announcements and

Signage”). Employees should clear the area or

car where the assistance will be provided when

practicable. If a person on-board identifies

him/herself as a medical professional, request

medical identification before allowing them to

give assistance.

Service Standards Manual No. 6

2-1

d) Many injuries can be treated on-board by following

the procedures outlined in the First Aid section

of this chapter and the materials found in the

First Aid kit. Injured employees or passengers can be

taken to a Customer Service Representative at the

next staffed station or to Police or EMS personnel

who can provide further assistance.

On-Train employees who have successfully

completed “Preparedness Training”, which

covers First Aid, Blood Borne Pathogens and

Automated External Defibrillator (AED) may

render emergency first aid treatment until the

services of a physician, emergency medical services,

or other medical professional can be obtained.

Employees should refrain from giving treatment

to passengers when they refuse it.

Amtrak will indemnify its employees, acting in the

course of their duties, against liability for injuries

they may cause while lifting disabled passengers,

giving first aid treatment or administering the

Automated External Defibrillator (AED) to an

individual in a manner that is reasonably consistent

with Amtrak’s policies, procedures, training courses,

or other instructions.

First Aid

Emergency medical situations can occur anytime and

anywhere. All Amtrak employees should, at the

least, be aware of the fundamentals of First Aid. The

following procedures include summaries from the

American National Red Cross Standards First Aid

Course. Although not a comprehensive listing, these

procedures will provide a guide for most serious

medical emergencies.

Procedures for responding to food-borne illnesses,

serious communicable diseases, and preventing

exposure to blood-borne pathogens can be found

in section B. “Illness” of this chapter.

First Aid is the immediate and temporary care given

to the victim of an illness or injury, until medical

assistance can be obtained.

2-2

Injury, Illness and Reporting

First Aid Kit

Each passenger car should contain a sealed First

Aid Kit located in the emergency equipment

compartment. On-Train employees who notice

missing First Aid Kits (or any other missing safety

related items) must promptly notify the appropriate

supervisor and record the missing item on the

“Record of Defect and Repair - MAP 21A”

(NRPC 2775).

First Aid Kit Contents

Unit

Pcs

Qty.

Description

Size

Strip Adhesive Bandage

1”x 3”

Alcohol Wipe

1” x 2”

Scissors, Metal

4.5”

Gauze Roll

2” x 6 yd.

Adhesive Tape

1.2” x 2.5 yd.

Trauma Pad

8” x 10”

Triangular Bandage with Pins

40”

Gauze Pads

4” x 4”

1PR

Gloves, Latex, Pair-Sealed Bag

M/L

CPR Barrier W/One Way Valve

Absorbent Powder

2 oz.

b) Automated External Defibrillator (AED)

Each Food Service Car on the train must be

equipped with a functioning AED unit, which

also contains an oxygen tank. The Federal

Railroad Administration (FRA) does not mandate

the physical presence of an AED aboard

Amtrak’s trains. Trains operating without AED

units or malfunctioning units may be dispatched.

AED units are stored in different locations based

on the design of the Food Service Car. The storage

compartment of the AED unit will have a red

sign with white letters affixed to the outside of the

storage compartment door. (Refer to Figure 2-1)

Figure 2-1 - AED Sign affixed to outside of Food Service Car

storage compartment door.

Service Standards Manual No. 6

2-3

The AED has a built in audible alarm to alert the

crew to a defect (such as a weak or dead battery).

The needle on the oxygen tank gauge should be

in the green or serviceable area of the gauge. If

the gauge needle is showing a red visual indica-

tion, the oxygen tank must be replaced.

Pre-departure inspections that identify the AED

unit and/or the oxygen tank is missing or operating

improperly must promptly notify the appropriate

supervisor and record the defective or missing

component on the “Record of Defect and Repair

- MAP 21A” (NRPC 2775).

For all AED or oxygen tank failures encountered

en route, contact the CNOC 24 hour Mechanical

Desk at at 800-424-0217 ext. 2082/2083, Bell

302-683-2082/2083 or ATS 734-2082/2083. This

does not relieve on-train employees of the

requirement to complete the “Record of Defect

and Repair - MAP 21A” (NRPC 2775). Provide

CNOC with the defective AED unit number.

CNOC will notify the final destination mechanical

facility of the need for the AED unit to be

serviced.

When an AED or oxygen tank is used, both the

“Operation Heartsaver, Employee Responder

Report” (NRPC 3245) (Refer to Section C.6 in this

chapter) and the “Record of Defect and Repair -

MAP 21A” (NRPC 2775) must be completed.

Personal Protection

When an employee renders First Aid, latex gloves

must be worn. Once used, the gloves must be

properly removed and placed in disposable bag.

d) Medications

Never offer prescription medication or over-the-

counter drugs to any employee or passenger. To

offer or present specific prescription medication

puts Amtrak and the employee in a legal liability

situation. If another passenger offers a prescription

medicine to an ill passenger and that passenger

accepts it, employees are not responsible.

2-4

Injury, Illness and Reporting

e) Bleeding

A person can bleed to death in one minute or

less if a large blood vessel is cut. Applying firm,

direct pressure to the wound can often stop serious

bleeding.

Serious Bleeding

Follow these instructions in cases of serious

bleeding.

If…

Then…

And…

The wound

elevate the

If bleeding persists, apply

is on an arm

extremity.

pressure on the

or leg

appropriate pressure point.

The wound is

apply direct

Continue applying pressure

not on an arm

pressure.

and bandage into place

or leg

the dressing used to stop

the bleeding.

The bleeding

The Conductor

continues

must call ahead for

uncontrolled.

medical assistance

or emergency

personnel.

Nosebleeds

Follow these instructions if a customer has a

nosebleed.

Step

Action

[1]

Have the person sit up or lie down with head and

shoulders elevated.

[2]

Apply direct pressure by holding the bridge of the

nose with the thumb and index finger. Press firmly.

[3]

If bleeding does not stop, pack the bleeding

nostril lightly with gauze (not cotton) and apply

pressure again. Cold towels applied to the nose

area may be helpful.

[4]

Get medical help if the bleeding does not stop.

Shock

Shock may occur in seriously injured persons and

can result in death, even though the injury itself

is not fatal.

Symptoms of shock are:

• Pale, cool, moist skin

• Weak and rapid pulse

Service Standards Manual No. 6

2-5

• General body weakness

• Restlessness or instability

• Rapid breathing

Preventing Shock

Follow these steps for preventing and giving first

aid for shock.

Step

Action

[1]

Help the victim lie down.

[2]

Cover only enough of the victim to keep him

or her from losing body heat.

[3]

Get medical help as soon as possible.

If further action is needed or the situation warrants,

follow these instructions.

If…

Then…

But…

The injury is

raise the victim’s

Never raise the victim’s feet

severe

feet eight to 12

if there is a head injury,

inches above the

an unsplinted fracture,

chest and head.

breathing difficulty, or if it

causes pain.

The victim has

raise their head

trouble

and shoulders.

breathing

The victim is

Never give fluids.

unconscious or

nauseated.

g) Rescue Breathing

The average person will experience brain damage

if deprived from oxygen for more than four (4)

minutes. It is often impossible to tell exactly

when a person stopped breathing, therefore,

follow proper CPR protocols when it comes to

initiating resuscitation.

2-6

Injury, Illness and Reporting

Follow these steps to administer artificial

respiration.

Step

Action

[1]

Open airway using the chin-lift method.

[2]

Kneel beside the victim’s shoulder.

[3]

Lift the chin up gently with one hand while pushing

down on the forehead with the other to tilt the

head back. The chin should be lifted so the teeth are

brought almost together. Avoid completely closing

the mouth.

[4]

Confirm the victim is not breathing.

[5]

If a pocket ventilation mask is available, place the

mask over the nose and mouth, maintain an open air-

way with the chin-lift technique, and begin artificial

respiration via mask.

[6]

Administer rescue breathing once every five seconds

to an adult, once every three seconds to a child. If

airway is blocked by the victim’s tongue, remember

to tilt the head back and, if absolutely necessary, jut

the victim’s jaw.

[7]

Continue to administer rescue breathing until the

person resumes normal breathing or until medical

assistance is available.

[8]

If breathing is difficult, clear airway and be sure

that victim’s tongue is forward.

h) Heart Attack

The signs and symptoms of heart conditions include:

• Shortness of breath

• Chest pain

• Bluish color of the lips and fingernails

• Nausea

• Sweating

Acute Heart Attack Symptoms

The principal symptoms of an acute heart attack

include:

• Pain in the chest, which may radiate down the left

arm to the upper abdomen, jaw, neck or back

• Shortness of breath

• Nausea, vomiting, sweating, light-headedness and

weakness

Service Standards Manual No. 6

2-7

Follow these steps if you suspect someone has a

heart condition or is having a heart attack.

Step

Action

[1]

Have the victim sit or lie down in a comfortable

position.

[2]

Loosen any tight clothing at neck and waist.

[3]

If shortness of breath is evident, raise the head and

chest to the most comfortable position with as many

pillows as needed. Do not block the airway. Guard

against drafts and cold.

[4]

Help the victim with prescribed medicine if under

medical care.

Moving the Victim

Moving the victim places added strain and should

not be attempted until medical advice is received.

If it is necessary to move the victim it is extremely

important that they remain comfortable while

being moved. An ambulance attendant may

transport the victim in an elevated position. The

Conductor should call ahead for medical assistance.

Stroke

A stroke is usually caused by a blood clot or

bleeding in the brain.

Listed are the symptoms and treatment for stroke

victims.

Stroke

Symptoms

Treatment

Severe

• Unconsciousness

• Keep the victim on his side

• Difficulty breathing

to allow fluids to drain

• Paralysis on one side

from the mouth

of the body

• Maintain an airway by

• Pupils of the eyes

keeping the head tilted

may be of unequal

• Provide moderate covering

size

• Get medical help as soon

as possible

• Do not give any fluids

or food

Less

• Dizziness

• Protect the victim against

severe,

• Headache

accident or physical

or a

• Sudden partial

exertion

small

memory failure

• Suggest medical attention

stroke

• Mood change

• Keep the victim under

• Muscular difficulty

observation at all times

involving some body

part

• Speech defect

• Ringing in the ears

2-8

Injury, Illness and Reporting

j) Simple Fainting

Simple fainting is a reaction of the nervous system

that reduces the blood supply to the brain for a

short time.

Follow these guidelines when treating a fainting

victim.

If a person…

Then…

Feels faint…

• Have them lie with their head low or,

• If they cannot lie flat, have them lower their

head between the knees and breathe deeply

Has already

• Keep them lying down for 10 minutes

fainted…

or more, with a pillow under their knees,

or until recovery is complete.

k) Burns

Follow these instructions for treating burn victims.

Burn Type

Treatment

First-Degree or

• Flush with cool water until pain subsides.

small second-

• Apply loose, moist, sterile dressing and

degree

bandage.

• Treat for shock

Third-degree

• Apply a loose, dry, sterile dressing and

bandage.

• Treat for shock if the burn covers a large area

• Get medical help immediately.

Large or

• Cover the victim according to the

severe

environment and treat for shock.

• Get medical help immediately.

Service Standards Manual No. 6

2-9

l) Effects Of Heat

Listed are the symptoms and treatment for heat

stroke and severe heat exhaustion.

Type

Symptoms

Treatment

Heat

• Hot, red skin

• Heat stroke is life

Stroke

• High body

threatening, so get the

temperature

person out of the heat

and into a cooler place.

• Cool the victim fast.

Apply cold packs.

• Treat for shock.

• Give nothing orally.

• Get medical help as soon

as possible.

Severe

• Cool, pale and

• Get the victim into a

Heat

moist skin

cooler place

Exhaustion

• Heavy sweating

• Lie victim on back with

• Dilated pupils

feet up.

• Headache and

• Loosen their clothing.

Nausea

• Apply cold packs.

• Dizziness and

• Treat for shock.

vomiting

• Give victim a half glass of

• Body temperature

water every 15 minutes if

about normal

conscious and can tolerate it.

2-10

Injury, Illness and Reporting

m) Head Injury

Follow these steps to treat a head injury victim.

If the

Never…

But you should…

victim

Conscious

Give Stimulants or

• Elevate the head

Liquids or Raise the

• Maintain an open airway.

Victim’s Feet

• Observe whether they have

stopped breathing or for a

blocked airway.

• Get medical help

immediately.

• Never bend head forward.

Unconscious

• Position the victim flat.

• Place a small pillow under

their shoulders to maintain

an open airway if there are

no signs of neck injury.

• Turn their head to the side

so fluids may drain from

the corner of the mouth-

remember to maintain an

open airway.

• Loosen clothing around

their neck.

• Observe whether they have

stopped breathing or for a

blocked airway.

• Get medical help

immediately.

h) Bruises, Sprains, Fractures

Follow these guidelines for treating a victim of a

bruise, sprain or fracture.

Always…

• Immobilize the sprain or fracture.

• Elevate the joint to reduce swelling.

• Remove any rings, watches, etc., from the

injured limb.

• Cover an open fracture wound with a clean

sterile dressing to reduce the possibility of

infection.

Never…

• Move a victim with a suspected back fracture.

(If the victim’s life is in danger, such as from

fire or chemical accident, obtain enough help so

the entire body is turned as a unit and no part

twists or turns faster than other parts. Whenever

possible, keep the victim in the position in

which they were found.)

Service Standards Manual No. 6

2-11

• Test for fracture by having the victim move the

injured body part or by having them try to

walk on a possibly broken leg.

• Allow an accident victim to move their head,

or move it yourself, when there is a possible

neck or spine injury.

• Bend the head or neck forward or back.

(Always maintain a neutral position.)

• Push back a protruding bone end of an open

fracture.

o) Epileptic Attack

Follow these steps to treat an epileptic attack victim.

Step

Action

[1]

Do not restrain the victim, but protect them from injury.

[2]

Push away nearby objects.

[3]

Do not force a blunt object between their teeth.

[4]

When the spasms are over, loosen the clothing from

around their neck.

[5]

Keep them lying down, and keep the airway open.

If…

Then…

Breathing stops

Give artificial respiration

Convulsions occur again

Get medical help

[6]

When they regain consciousness provide for undis-

turbed rest. Do not question him or her and try not to

embarrass the victim.

(Victims usually are drowsy and need a period of

undisturbed sleep. If they get up immediately and

walk around they might experience another attack.)

Prevent a victim from breathing vomit into their

lungs by turning their head to one side or by having

them lie on their stomach.

2-12

Injury, Illness and Reporting

p) Choking

Follow these steps to treat a choking victim.

If the

Then you should…

victim…

Can cough,

Not interfere, but observe

speak or

breathe

Cannot

Perform the abdominal thrust.

cough,

speak, or

breathe and

is conscious

• Check for responsiveness.

Unconscious

If no response, call for help.

• Position the victim.

• Open the airway.

• Check for breathlessness.

If…

Then…

No breath

Give two full breaths

Unable to breathe

Re-tilt the victim’s head and

air into the victim

give two full breaths again.

• Have someone call emergency medical service

for help.

• Perform five abdominal thrusts.

• Do finger sweep of mouth.

• Give two full breaths.

• Repeat the last three steps until the obstruction

is cleared or help arrives.

q) Foreign Object In The Eye

Never touch the eyeball or attempt to remove an

object with a match, toothpick or other instrument.

If the eyeball appears to be scratched or to have

been penetrated, even a fraction of an inch, the

injury may be extremely serious. Apply a sterile

dressing or clean cloth, bandage loosely, and get

medical help.

Never rub the eye. Rubbing can cause a loose

object to become imbedded or scratch the eye.

Rubbing the eye may cause an imbedded object

to cause further serious damage.

Service Standards Manual No. 6

2-13

Object Lodged In Upper Lid

Follow these steps to remove a loose, foreign

object in the eye, usually lodged on the inner

surface of the upper lid.

Step

Action

[1]

Ask victim to look down.

[2]

Grasp the edge of the upper lid firmly.

[3]

Apply slight pressure to the surface of the upper lid

with the side of a blunt pencil.

[4]

Turn the inner side of the lid outward.

[5]

If you see the object on the inner surface of the lid,

remove it by touching it with the corner of a clean

handkerchief. NEVER touch the eye itself.

Object Lodged In Cornea

Follow these instructions to remove an object

stuck to the cornea surface (the clear, front part

of the eye).

If…

Then…

And…

You see the

Ask the victim

If the object is not imbedded

object on the

to wink several

in the eye it will usually be

surface of the

times

washed away with the tears

cornea

produced by winking.

The object is

Do not try to

• Ask the victim to close his or

not washed

remove it from

her eyes.

away with the

the surface of

• Put a pad or piece of moist

tears.

the eye.

cotton over the closed lids.

Assume it is

• Bandage. Make sure bandage

embedded.

is not too tight, which will

cause the lid to press against

the eyeball and cause pain.

• Get medical attention as

soon as possible.

r) Moving The Injured

Moving an injured person before the full extent

of the injury is known or before the injured body

part(s) have been immobilized may cause addi-

tional injuries.

Follow these guidelines regarding moving the

injured:

• Do not move an injured person unless it is

necessary to protect him or her from further

injury or to provide urgent first aid care.

• Always check for injuries and immobilize

2-14

Injury, Illness and Reporting

injured areas, whenever possible, before moving

the victim even a short distance.

Medic Alert

Medic Alert is a medical identification, usually

worn as a bracelet or necklace, advising first aid

providers of a special medical condition such as:

• Diabetes

• Contact-lens wearers

• Allergies to common medications, such as

penicillin

Always look for a medic alert if the victim is

unconscious.

Motion Sickness

Motion sickness is caused by an imbalance in the

inner ear and can produce an upset stomach.

The symptoms of motion sickness (nausea) and

upset stomach are :

• Too much food

• Too little food

• Lack of air

Follow these steps to ease the discomfort of the

upset stomach caused by motion sickness.

Step

Action

[1]

Tilt the head back.

[2]

Apply ice to the forehead or back of the neck.

[3]

Loosen any tight clothing, scarves, belts, etc.

[4]

Offer ice chips to suck on or ginger ale to sip if the

mouth is dry, but do not offer anything to eat.

u) Over-breathing (Hyperventilation)

Over-breathing, or hyperventilation, occurs when

a person breathes too much air too quickly. The

result is too much oxygen causing the person to

become irrational. He or she feels they are

suffocating when, in reality, the problem is the

exact opposite.

Service Standards Manual No. 6

2-15

Follow these guidelines for a victim of over-breathing.

If…

Then…

A paper bag is

Place it over the mouth and nose until normal

available

breathing is restored and he or she returns to

the conscious level.

No paper bag

Instruct the victim to cup their hands over

is available

their mouth and nose and breathe normally.

Illness

Certain Amtrak employees may, during the course

of their duties, be required to assist passengers or

fellow employees who are suspected of contracting

a food-borne or blood-borne illness. This section will

help you understand and react to these situations.

Suspected Food-Borne Illness Procedures

In the event of a suspected food-borne illness the

Conductor or Division Supervisor will immediate

make a report to CNOC and the appropriate

manager. The report should include the following

information:

•

Train number

•

Car number

•

Name of LSA

•

Name, age and sex of person(s) involved

•

Address and telephone number

•

Where passenger boarded and their destination

•

What the passenger/employee ate on-board (as

complete as possible)

•

What time(s) the passenger/employee ate

on-board

•

What time did the passenger/employee

become ill and the duration of the illness

•

The symptoms of the illness (e.g., headache,

nausea, vomiting, cramps, diarrhea, fever, or

other)

•

Was medical treatment offered

•

Was medical treatment accepted

•

If possible, a 48 to 72 hour history of food

consumed and where, prior to the onset of the

illness

•

Was the person observed eating personal food

brought on-board the train

•

Whether the passenger/employee had other

medical problems, such as flu, intoxication, etc.

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Injury, Illness and Reporting

• How many of the same type meals were served

• Did other persons complain of illness

• Were there any mechanical (refrigeration or

freezers), stocking or preparation problems

• Were samples of any remaining suspected food

obtained (bagged, tagged, separated and

refrigerated).

• If samples were obtained, notify the commis-

sary to strip samples and store in refrigerator

for Amtrak Public Health bacteriological testing

• How long was food left out on display,

refrigeration, etc.

• Where was the food stocked

• What was the expiration date of the food

b) Stop serving suspected food(s) or beverage(s)

immediately.

c) Secure all suspected food(s) and beverage(s) in an

isolated refrigerated area. Hold suspected items

until an Amtrak Public Health representative or

other designated employee can retrieve them.

Serious Communicable Disease Procedures

The following information is excerpted from “Public

Health Bulletin 5-96”, revised February 3, 2006.

When a member of the crew is made aware that an

employee or passenger on-board the train may have a

serious communicable disease (SCD) (A list of serious

communicable diseases can be found in Section 3

“Communicable Diseases”), the subsequent steps

must be followed:

a) The Conductor must be immediately notified of

the situation.

• The Conductor should isolate the ill employee

or passenger from other persons on-board the

train, if possible

• If first aid or medical assistance is required,

follow the procedures in section A. “Injuries”

in this chapter

b) The Conductor must immediately notify CNOC

at (800) 424-0217 or ATS 734-2307 or 734-2105

and give the following information:

• Name of person notifying CNOC

• Train number

• The nature of the problem

Service Standards Manual No. 6

2-17

• Name and status of the ill individual(s)

• Name and phone number of personal physician

of the ill individual(s)

• Current location and next station stop

• If known, the name and phone number of the

local health department

• Course of action ordered or taken by the

health authorities

CNOC will disseminate the information obtained

from the Conductor and contact the appropriate

personnel and departments.

d) On-Train Employees should follow instruction from

CNOC and not contact the personal physician for

the ill individual unless instructed by CNOC.

The Corporate Communications Department will

issue employee and passenger advisories through

the Arrow system and by written notices posted at

appropriate locations, as deemed necessary. in

coordination with the local health department,

CDC and the following Amtrak departments:

• Law

• Medical

• Public Health

• Service Delivery

The Emergency Medical Facility and/or the

Amtrak Medical Director will make the medical

decisions as to the management of the ill individual.

If it is deemed necessary by the local health

authorities and/or the Amtrak Medical Director

that notification of passengers and crew is needed,

Amtrak will coordinate this effort with local and

state health departments and the CDC.

Medical details must not be revealed to anyone

other than properly identified Amtrak personnel

or local, state or federal health officials. The

confidential nature of Medical Information

must be upheld.

h) The importance of maintaining accurate passenger

and crew lists becomes apparent in these circum-

stances. The Conductor should obtain telephone

numbers and addresses of passengers who may

be involved, if possible, to help expedite any

further investigation or passenger notification.

The Conductor must complete a “Non-Employee

Injury/Illness Report” (NRPC 3116) or

“Employees Injury/Illness Report” (NRPC 260)

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Injury, Illness and Reporting

as the circumstances require. (Refer to Section C

“Injury and Illness Reporting” in this chapter.)

j) Effective and prompt communication is an essential

tool in handling this type of occurrence and can

lead to successfully preventing disease transmission

and defusing rumor and conjecture in these

circumstances.

k) For further information and assistance, contact:

Public Health Superintendent

60 Massachusetts Ave., NE

Washington, DC 20002

Phone: (202) 906-3943 ATS: 777-3943

Fax: ATS 777-2117

List of Serious Communicable Diseases (SCD)

It should be noted that this is only a partial list of

the most likely Serious Communicable Diseases to

be encountered in the United States that may be

transmitted from person to person through the air.

Serious Communicable Diseases that are transmitted

by other means, e.g., by blood, by vector (i.e., insects,

parasites, etc.) or by sexual activity, and are

considered not likely to be transmitted to passengers

and/or crew, have been omitted from the list.

• Tuberculosis

• Meningitis, Bacterial or Viral

• Encephalitis, Bacterial or Viral

• Chicken Pox

• Rubella (German Measles)

• Rubeola (Measles)

• Mumps

• Hepatitis “A”

• Alleged Food (or Water) Borne Illnesses

• Pandemic Influenza, such as Avian or Swine Flu

Blood-Borne Pathogens (BBP) Exposure Control Plan

Amtrak’s goal is to minimize the number of its

employees who are exposed to blood and body fluids;

thus containment of any such material to prevent

exposure is of paramount concern. It is conceivable

that any employee might experience an incidental

exposure. OSHA recognizes that accidents can occur

in any work environment and that exposure to blood

is theoretically possible in all work environments.

However, OSHA does not require that all employees

Service Standards Manual No. 6

2-19

be trained and protected under the provisions of its

regulations. In addition, OSHA recognizes a distinction

between requiring employees to assist injured persons

and so-called "Good Samaritan" acts. Only those

whose job duties may reasonably entail potential

exposure are covered.

Risk of Exposure

Designated Amtrak employees and their risk of

exposure are broken down into the following

three categories:

• All employees at risk of exposure such as nurses,

physicians and police/security personnel

• Some employees at risk of exposure such as

those designated to perform first aid and CPR

as part of their job duties

• Clean-up and janitorial crews can potentially

be exposed to BBP

Tasks/procedures with risk of BBP exposure

include: first aid, CPR, phlebotomy, intravenous

placement, restraining an uncooperative individual

and decontamination of potentially infectious

body fluids/tissue.

b) Universal Precautions

Amtrak guidelines are based on recommendations

by the Center for Disease Control (CDC) and

follow a "universal precautions" approach. Under

universal precautions, blood and other specified

body fluids are considered potentially infectious

for human immunodeficiency virus (HIV), hepatitis

B virus (HBV) and other blood-borne pathogens.

This approach is designed to protect employees

from parenteral (puncture/injection), mucous

membrane, or non-intact skin exposures to such

pathogens. Amtrak employees performing tasks

potentially exposing them to BBP will observe

universal precautions. In addition to blood, the

following body fluids will be treated as if they

were infectious with HIV, HBV and other blood

borne pathogens: amniotic, cerebrospinal,

pericardial, peritoneal, pleural, semen, synovial,

and vaginal fluids/secretions.

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Injury, Illness and Reporting

Not included, unless visibly contaminated with

blood, are saliva, urine, feces, tears, sweat, sputum

or vomit. Exposure in this context means eye,

mouth, and other mucous membrane, broken

skin or parenteral contact with any of the above

infectious fluids.

In case of mucous membrane or skin contact

with infectious fluids, the exposed areas should be

immediately flushed with water and subsequently

washed with soap. In the absence of washing

facilities, approved antiseptic skin cleanser may

be used.

Personal Protective Equipment (PPE)

On-train employees performing tasks that may

result in contact with body fluids are required to

use the provided personal protective equipment,

unless use leads to significant delays in saving life

or limb.

• Gloves shall be worn during all invasive

procedures, in wound care and cleaning and

decontaminating materials or spills.

• When splashing is possible, always wear safety

glasses with solid side shields.

• CPR resuscitation masks shall be used during

resuscitation efforts when available.

• With the exception of safety glasses, only

disposable PPE shall be used.

• Disposal of used PPE, unless grossly

contaminated, will be in non-infectious waste

receptacles.

• Grossly contaminated items will be placed into

infectious waste receptacles, which must be

clearly labeled as biohazard.

• Employees must never use their hands to pick

up or handle a blood-tainted item when a

mechanical device is available.

d) Personal Hygiene

Employees must wash their hands with soap and

hot water immediately after removal of personal

protective equipment (PPE) or performing any

task that involved contact with body fluids. In

case of mucous membrane or skin contact with

infectious fluids, the exposed areas should be

Service Standards Manual No. 6

2-21

immediately flushed with water and washed

with soap. In the absence of washing facilities,

approved antiseptic skin cleanser may be used.

Never touch or handle any infectious waste bags

after PPE has been removed.

Never wear clothes that have traces of a bodily

fluid on them. If blood or bodily fluid is found on

your clothes, they are to be removed, bagged and

treated as an infectious waste product. The CDC

recommends two methods of disinfecting items:

extremely high heat or washing in bleach and

water. If clothes cannot be disinfected they

should be identified as a biohazard and disposed

of with infectious waste.

Eating, drinking, smoking or applying cosmetics

and handling contact lenses is prohibited in any

area where emergency care is rendered.

Avoid placing your hands near your face.

En Route Housekeeping

Surfaces that may have become contaminated

with infectious material must be cleaned and

disinfected as soon as possible. Barricade the area

to be cleaned and do not remove barricade until

area has been cleaned and inspected. As an

option, if household bleach is available and

access to the area is needed for proper delivery

of the service (e.g., access to toilets, dining area or

walkways), wash all surfaces and items with a

solution of 1/4 cup of bleach with one gallon of

water. Anything that cannot be cleaned must be

removed, identified with a biohazard label and

placed with infectious waste.

Removal of Infectious/Contaminated Waste

Contaminated waste, protective equipment and

clean-up materials must be disposed of in biohazard-

labeled, leak proof, closeable bags. In the absence of

a biohazard bag, use a black plastic bag that is clearly

labeled and separated from other trash.

A licensed hazardous waste contractor must remove

infectious waste from Amtrak property. Employees

involved in hazardous/infectious waste clean-up can

expedite waste removal by having hazardous/

infectious waste containers placed in a location

away from passengers, designated by local

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Injury, Illness and Reporting

Amtrak management. The manager in-charge of

hazardous/infectious waste clean-up should have the

contact information, call procedures and any other

instructions regarding the hazardous waste container

and contractor.

Post-Potential BBP Exposure Evaluation

Should any employee be exposed to potentially

infectious body fluids or tissues, the employee or

their supervisor will make immediate arrangements

for a medical evaluation by a physician and will

report the incident to the Amtrak Medical

Department within 24 hours.

The employee may decline medical evaluation,

which must be documented in the employee’s

medical file. The Medical and/or Safety departments

will assist as necessary. If permissible by state law,

and the source individual consents, their blood

shall be tested for HIV and HBV and the results

disclosed to the exposed individual. A refusal to be

tested shall be documented. If medically indicated,

counseling and post-exposure prophylaxis is

offered to the exposed employee according to

the most recent CDC guidelines.

The Amtrak Medical Department will ensure

that any physician performing a post-exposure

assessment has a copy of the pertinent OSHA

standard and current CDC/BBP guidelines, as

well as access to the employee’s vaccination

status and any relevant information on a given

exposure case.

Injury and Illness Reporting

Amtrak is fully committed to the safety of its

employees, passengers and being in full compliance

with the letter and spirit of the Federal Railroad

Administration’s Accident Reporting Regulations

(49 CFR Part 225.33) for the complete and accurate

reporting of all accidents, incidents, injuries and

occupational illnesses arising from the operation of

the railroad.

Amtrak will not permit or tolerate any form of

harassment or intimidation towards any injured

person that discourages them from receiving proper

medical treatment or from reporting an accident,

incident, injury or illness. Any harassment or

Service Standards Manual No. 6

2-23

intimidation of this type will result in disciplinary

action (up to and including suspension and/or

termination) against all involved employees,

supervisors, managers or officers of Amtrak.

Any employee who has reasonable grounds to

believe they have been subjected to harassment or

intimidation regarding the reporting of an injury or

should contact the Amtrak Intimidation and

Harassment Hotline at (202) 906-3015 or ATS

777-3015, and may refer matters to the Inspector

General, if warranted.

Amtrak provides “whistle blower” protection to any

person subject to the harassment or intimidation

policy. Employees shall be free from restraint,

interference, coercion or reprisal for communicating

directly or indirectly information that they believe

violates the law or company policy.

Types of Reports

Non-Employee

•

“Non-Employee Injury/Illness Report”

(NRPC 3116)

This form is to be completed any time a

non-employee (passenger) is injured or ill.

(Refer to Section C.2 of this chapter.)

•

“Medical Information and Consent”

(NRPC 488)

This form should be completed, if at all possible,

for non-employee (passenger or trespasser)

injuries requiring professional medical attention.

(Refer to Section C.4 of this chapter.)

b) Employee

•

“Employee Injury/Illness Report” (NRPC 260)

This form is to be completed any time an

employee is injured or ill. (Refer to Section C.3

of this chapter.)

•

“Medical Information and Consent”

(NRPC 488)

This form is to be completed for all employee

injuries. (Refer to Section C.4 of this chapter.)

•

“Accident Investigation Report” (NRPC 405)

This form is to be completed for all employee

injuries. (Refer to Section C.5 of this chapter.)

Other

•

“Operation Heartsaver, Employee Responder

Report” (NRPC 3245)

This form is to be completed when an

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Injury, Illness and Reporting

Automated External Defibrillator (AED)

and/or oxygen is used. (Refer to Section C.6 of

this chapter.)

“Non-Employee Injury/ Illness Report”

(NRPC 3116)

All non-employee (passenger) injuries must be

reported, regardless of the circumstances, on the

“Non-Employee Injury/Illness Report” (NRPC

3116). (Refer to Figure 2-2) The front of this report

is to be completed by a member of the train crew

interviewing the injured person. Crew members

should refrain from telling passengers that a

representative from Amtrak’s Claims Department

will contact them within 5 days. Instead, refer all

passengers with questions to call the Passenger

Claims Unit’s toll free number at (800) 424-7960.

The backside of this form is to be completed by the

injured person and include, in their own words, how

the injury occurred and the extent of their injury. To

help in properly completing this report, the following

instructions have been provided:

Figure 2-2 - “Non Employee Injury/Illness Report” (NRPC 3116) Page 1

Service Standards Manual No. 6

2-25

Page 1 (must be completed by an Amtrak

employee)

• All numbered items must be completed.

• All information should be printed, except

where signatures are required.

• If a numbered item or question is not applicable,

enter “N/A”.

b) Incident Information Section

• Enter requested information.

• Item 9 should have only one box marked

identifying the “Class of Person”.

Description of Events Section

• Enter requested information.

• Be as detailed or descriptive as possible when

answering each question.

• You may need to repeat or elaborate the

question so that the passenger understands

what is being requested.

• Attach additional statements addressing the

condition of the passenger/non-employee,

facility and equipment that may be important.

• Item 17 must describe the body part injured

as a result of the event. (Be as descriptive as

possible.)

d) Treating or Medical Facility/Provider Section

• Enter requested information.

• Item 18 designates if the injured person

declined first aid and/or medical treatment.

Passenger Information Section

• Enter requested information.

Debriefing and Critique (49 CFR Part 239)

Section

• Enter requested information.

• Required for all passengers and non-employee

injuries on-board passenger trains if they are

removed from the train by emergency

response personnel.

Point of Contact Information Section

• Enter requested information.

• Amtrak employee entering report information

must completing this section.

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Injury, Illness and Reporting

Figure 2-3 - “Non-Employee Injury/Illness Report” (NRPC 3116) Page 2

h) Page 2 “Non-Employee Personal Statement”

(Refer to Figure 2-3)

• Must be completed and signed by the injured

person.

• If necessary, assist the injured in completing

this portion of the form and ask them to sign

it, unless they are unable to do so.

• Make note of any inability or refusal to

complete and sign this statement.

Additional Information (Page 1 or 2)

• Use the back of the page or additional paper

to make notes of conditions or situations relating

to the person’s injury.

• Submit additional pages along with the “Non-

Employee Injury/Illness Report” (NRPC 3116).

Submitting Paperwork

Submit the completed “Non-Employee

Injury/Illness Report” (NRPC 3116) to a station’s

supervisor where the injured person detrains, or

to a Passenger Service Supervisor upon completion

of the trip.

Service Standards Manual No. 6

2-27

“Employee Injury/ Illness Report” (NRPC 260)

All injuries must be reported, regardless of the

circumstances, on the “Employee Injury/Illness

Report” (NRPC 260). (Refer to Figure 2-4) All

employee injuries must be reported as soon as

possible to an appropriate supervisor and never after

the employee’s tour of duty has ended. In cases

where the injury may not require immediate medical

treatment, the injured employee must report it to the

Conductor or immediate supervisor and may receive

treatment at the next station where supervision and

appropriate medical treatment can be offered.

Employee injury reporting requires the employee to

complete “Employee Injury/Illness Report” (NRPC

260). The front of this report is to be completed by

a member of the train crew interviewing the injured

person. The backside of this form is to be completed

by the injured person and include, in their own

words, how the injury occurred and the extent of

their injury. To help in properly completing this

report, the following instructions have been provided:

Figure 2-4 - “Employee Injury/Illness Report” (NRPC 260) Page 1

2-28

Injury, Illness and Reporting

Page 1 (Must be completed by a member of the

train crew interviewing the injured employee.)

• All numbered items must be completed.

• All information should be printed, except

where signatures are required.

• If a numbered item or question is not applicable,

enter “N/A”.

b) Incident Information Section

• Enter requested information.

• Item 2 Res/Cen - If the Res/Cen cannot be

determine, the employee completing the report

must inform the submitting supervisor that

this field has not been completed. (Do not

enter N/A.)

Injured Person Information Section

• Enter requested information.

• Item 9 FRA Class of Person - Amtrak

employee on duty (e.g., compensated for time,

signed-in), Amtrak employee not on duty (e.g.,

on “downtime”, not signed-in, etc.).

• Item 26 Work Order Number is assigned to a

person who is on-duty but not working their

regular assigned position or extra board (e.g.

attending class).

• Item 27 Occupat ion should be in one of the

following: Conductor, Assistant Conductor,

LSA-Diner, LSA-Café/Lounge, Chef, Train

Attendant or Sleeping Car Attendant, etc.

d) Description of Injury/Illness Section

• Enter requested information.

• Be as detailed or descriptive as possible when

answering each question.

• You may need to repeat or elaborate the

question so that the employee understands

what is being requested.

• Attach additional statements addressing

the condition of the employee, facility and

equipment that may be important.

• Item 34 must describe the body part injured

as a result of the event. (Be as descriptive as

possible.)

Treating or Medical Facility/Provider Section

• Enter requested information.

• Item 38 designates if the injured person

declined first aid and/or medical treatment.

Service Standards Manual No. 6

2-29

f) Point of Contact Information Section

• Enter requested information.

• Amtrak employee entering report information

must completing this section.

Figure 2-5 - “Employee Injury/Illness Report” (NRPC 260) Page 2

g) Page 2 “Employee Personal Statement”

(Refer to Figure 2-5)

• Must be completed, signed and dated by the

injured employee.

• If necessary, assist the injured employee in

completing this portion of the report and ask

them to sign it, unless they are unable to do so.

• If they are unable to write or sign a statement,

someone else may transcribe what they are

told by the injured employee.

• The person writing the statement for the

injured employee must sign the report at the

bottom of the page indicating they accurately

recorded the statements made by the injured

employee. (In this case, it would be beneficial if

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Injury, Illness and Reporting

the employee could read and initial his or her

concurrence with the written statement.)

• Employees should include their assessment of

what caused them to be injured and what part

of their body is injured.

• Make note of any inability or refusal to

complete and sign this statement.

• If there were other employees or passengers

who were present at the time of the injury and

can attest to the circumstances, or personally

witnessed the events of the injury, their names

and method for contacting them are to be listed

(If possible, ask any witnesses to write a statement

of what they saw or heard. Attach any statements

from witnesses to the “Employee Injury/Illness

Report” (NRPC 260) when submitted.)

h) Additional Information (Page 1 or 2)

• Use the back of the page or additional paper

to make notes of conditions or situations relating

to the employee’s injuries.

• A brief description of the treatment the

employee received is also requested and should

include any forms of first aid, professional

medical assessment and treatment, or whether

the employee declined any professional medical

treatment that was offered.

• Submit additional pages along with the

“Employee Injury/Illness Report” (NRPC 260).

Submitting Paperwork

• Submit the completed “Employee

Injury/Illness Report” (NRPC 260) to a Station

Services Supervisor where the employee

detrains for treatment, or to a Passenger

Service Manager upon completion of the trip.

• It is mandatory that the reporting Supervisor

report all injuries to the Amtrak Injury Care

Hotline at (800) 505-5549, and follow the

directions given by the Right Care, Day One

Case Manager.

• Responding Supervisors should immediately

fax both sides of the “Employee Injury/Illness

Report” (NRPC 260) to Central Reporting

(800) 888-2185 or ATS 777-2595.

• Responding Supervisor must fax both sides of the

“Employee Injury/Illness Report” (NRPC 260)

to the Manager of Train Operations at CNOC

Service Standards Manual No. 6

2-31

ATS 734-2151, and to the Manager or Service

Manager of the employee’s home Crew Base.

“Medical Information and Consent” (NRPC 488)

This report is required to be completed for all

employee injuries and is recommended for

non-employees (passengers) and trespasser related

injuries requiring professional medical attention.

Employee injuries also require the injured to sign

the “Medical Information and Consent” (NRPC

488), which authorizes the treating physician and

facility to release information to Amtrak regarding

the evaluation and treatment provided. (Refer to

Figure 2-6)

All injured employees must complete the “Medical

Information and Consent” (NRPC 488), regardless of

whether medical treatment was received. If medical

treatment was declined, note this on the bottom of

this form.

Figure 2-6 “Medical Information and Consent” (NRPC 488)

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Injury, Illness and Reporting

Injured Person Information Section

• All information should be printed, except

where signatures are required.

• All information should be completed, if not

applicable enter “N/A”.

b) Release of Information/Case Consent Section

• The injured person should print their name,

sign and date.

Medical Treatment Information Section

• This should be completed by the Physician.

• The Physician should sign and date.

d) Submitting Paperwork

• The form is to be returned to the Supervisor

accompanying the injured person.

• Responding supervisors should immediately

fax the “Medical Information and Consent”

(NRPC 488) to Central Reporting

(800) 888-2185 or ATS 777-2595.

• The original “Medical Information and

Consent” (NRPC 488) is to be forwarded to

the appropriate Claims Department office.

“Accident Investigation Report” (NRPC 405)

The “Accident Investigation Report” (NRPC 405) is

used to record the facts and circumstances surrounding

an injury. It is intended to determine the cause of the

injury and identify ways to avoid similar injuries in the

future. (Refer to Figures 2-7 and 2-8)

Service Standards Manual No. 6

2-33

Figure 2-9 - “Accident Investigation Report” (NRPC 405) Page 3

A committee consisting of supervisors from other

crafts such as Maintenance of Equipment, Terminal

Services, Safety, etc. will be created to investigate how

the injury happened. To a large extent, the injured

person will be relied upon to provide a description of

their actions and the events leading up to the injury.

An inspection and report of the condition of the

equipment is often required to identify potential

defects that may have contributed to the injury.

Instructions on how to complete the “Accident

Investigation Report” (NRPC 405) can be found on

Amtrak’s Intranet in the Safety Section. Select the

“Accident/Incident Reporting Training Course” link.

“Operation Heartsaver, Employee Responder

Report” (NRPC 3245)

The “Operation Heartsaver, Employee Responder

Report” (NRPC 3245) is to be completed when an

Automated External Defibrillator (AED) and/or

oxygen is used. (Refer to Figure 2-10)

This form has four sections that must be completed

in its entirety at the time of incident.

Service Standards Manual No. 6

2-35

Figure 2-10 - “Operation Heartsaver, Employee Responder Report”

(NRPC 3245) Page 1

Section 1

• Clearly print the full name of the person being

treated.

• Check the appropriate box to identify if the

person is a passenger or an employee.

b) Section 2

• Check all options that describe the circumstances

to which you responded.

Section 3

• This section is to be completed by the employee

responding to the incident.

• Print clearly and complete all questions.

d) Section 4

After completing this form in its entirety, follow

these instructions:

• FAX a copy as soon as possible to: Mgr.

Emergency Preparedness at (202) 906-2138.

• MAIL original to: Amtrak, Mgr. Emergency

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Injury, Illness and Reporting

Amtrak. Service Standards Manual for Train Service and On-Board Service Employees (Version 6, 2011) - page 4