And this is one of the reasons the railway is in such a mess - it refuses to use available technologies simply because it is not the way it was done historically.
That argument leads to statements like 'a track circuit is an electrical device and is thus prone to failure'.
So if that is true why do we trust track circuit indications to be accurate?
Why do signallers in absolute block areas trust the telegraph to be accurate? It is an electrical device and thus is 'prone to failure'.
The lives of the people on the railway are trusted to complex arangements of electrical equipment all the time anyway, this simply takes that trend to its logical conclusion.
As someone who has some experience handling several hundred enebriated people (herding teenage new arrivals at my Hall of Residence who have discovered the delights of our on site bar out to the fresher's week nights out) with an average BAC which I hope would exceed the average for railway passengers I have come to the conclusion that once you drop below about 1:20 ratio it makes little difference if you remove staff.
One person copes about as well as Two people - ie. not at all.
Natural Wastage will have to deal with that - or voluntary redundancy.
That is like saying we should pay factory workers to make things by hand because they don't like operating the new machines because 'its not what they signed up for'.
Well with the GSM-R rig that is to be rolled out in concert with ETCS installation (which should, in my opinion, be accelerated and proceed with a resignalling of all remaining AB areas) the signaller already knows the location of the train to the inch.
And remember with those cut down GSM-R handsets that are simply phone handsets on the railway network the driver can engage in voice communication with control and the signaller without remaining in the cab.
Since an evacuation will only occur in the fashion you have described in an extremely serious incident (as the train is apparently disabled and something has spooked the passengers into using the door releases immediately) then the safe bet for which emergeancy services are required is 'all of them'.
That is another discussion, especially with some recent proposals of universal first aid training for every membr of the public.
The only way that the guard is likely to know that anyone has had a heart attack is if they choose to push the passcomm, at which point they can inform the driver that someone has fallen seriously ill. We have sufficient penetration of those information campaigns about the signs of a heart attack that it seems likely someone would know something very serious had happened.
I hope I am not overly naive in hoping someone else would remain with the passenger and inform the driver using the passcomm if something changes for the worse (remember the passcomm is not directly connected to the brake system any more).
Indeed there is the possibility the system could be configured to allow for the opening of a two way communications channel between the passcomm interface and the control room or even the emergeancy services if required.
Having a gaurd won't necessarily make much difference, especially if they have a heart attack due ot the trying conditions on a packed train since the guard won't even be able to reach them.
I know enough about first aid (from my previous training as a lifeguard) to knowthat a FAK is unlikely to make a significant difference to most rapid onset illnesses of sufficient seriousness to result in an ambulance call.
The best thing you can do is stay with them and attempt to keep them concious and calm.
Unfortunately ASLEF will demand increasing drivers salary payments either way - so the net cost of DOO is rather small in salary terms.
Wow, you really do have far too much faith in technology, a complete lack of understanding about a number if procedures and a huge axe to grind against railway staff don't you?!