An Unexpected Incident on a Field Trip | Satoko Oki, Assistant to the Dean, Faculty of Environment and Information Studies
2022.08.16
An Injury Occurs
This happened when I was on a field trip with about 10 students from my lab. One of the students, who had gone out to buy dinner after we finished our activities, called me while I was resting at our lodging. "Professor, there's an emergency..." In the one or two seconds of silence that followed, every possible emergency raced through my mind.
To get straight to the point, one student had tripped and fallen on the roadside, fracturing their arm. This happened as dusk was about to fall, in a seaside location unfamiliar to the students and some distance from the city center. I want to record what the students did before they called me, partly as a reflection on my own responsibility for the injury that occurred during the trip. (I have had the manuscript reviewed by all the students on the trip, including the one who was injured, and received their permission to publish it.)
According to the student walking at the front, they heard a loud noise, and when they turned around, one person was on the ground. Although they were spread out, all the students on the trip were there. There was a large rock near the student's head, so they first checked to see if there had been a head injury. Next, they asked if the student could walk and confirmed that, despite an abrasion on one knee, they were able to. Regarding the arm, which was the most painful, they asked if the student could move their fingers. When this proved difficult, they determined there was a possibility of a fracture and went to find a stick to immobilize the arm and a plastic bag to use as a sling.
Other students went to find a vending machine to buy water to clean the knee wound, while another took the water, washed the wound, and treated the abrasion with bandages they had on hand. They applied ice to the arm, which was swelling rapidly. Of course, they didn't just happen to have ice; they had to run to a nearby house and ask for some.
Some students kept asking how the injured student was feeling and offering reassurance, saying things like, "It's okay, it's okay. Falls happen." Simultaneously, they were searching for an orthopedic clinic that could see them at that hour, and they called the hospital they found to explain the situation and request an examination. And that's when the phone call I mentioned at the beginning was made to me.
Nine minutes passed between the fall and the phone call to me. In other words, it took those nine minutes for about 10 students to divide the tasks and complete all the actions described above. They weren't calling me in a panic asking for instructions; they were reporting to me as one of the necessary steps in their initial response. I didn't get all these details over the phone, but when they said, "We'll call you again once the hospital is decided," I was confident that my students could handle it. I switched my focus to what I needed to do and started preparing to go to the hospital.
Initial Response and Triage in a Disaster
As a faculty member who wasn't on the scene, I was incredibly grateful that these students, who do not specialize in medicine or emergency care, could take such action for a seriously injured friend in an unfamiliar place in under 10 minutes. Why were they able to do this? It is likely because their research has focused on how faculty, staff, and students—from elementary and junior high schools, daycare centers, and universities—should act in the event of a major earthquake.
In past earthquake disasters, there have been actual cases of injuries from aftershocks, students hyperventilating, groups of people unable to move for a time due to shock, and fainting along evacuation routes. Therefore, in the training we conduct for faculty and staff, we have run hands-on drills and simulation exercises, deliberately setting the time of the earthquake to when students are moving through the school building. Our students play the roles of pupils who have been injured from falls on stairs or broken glass, or are suffering from heatstroke or hyperventilation. The faculty and staff then determine through trial and error what actions to take, how to communicate, and how to share information during a power outage.
A particular challenge was the nurse's office becoming overwhelmed with injured people. If they were transported to the nurse's office one after another based on peacetime standards, the response to more seriously injured students could be delayed. So, we decided to first use "can walk/cannot walk" as a criterion, observe any differences from their usual condition, and if there were any students so injured they could not walk, we would prioritize sharing that information to decide whether to transport them or have them wait. This criterion helped manage the flow of information and people, allowing information to be shared much more quickly and the necessary personnel for transport to be gathered more efficiently than when there was no standard.
As we advanced this research, knowledge and skills were cultivated within our research group, with students suggesting things like, "Let's try carrying someone on a stretcher," and "Let's carry vinyl gloves for applying pressure to stop bleeding."
Evacuation Drills as a Way to Deepen Trust
That day, after the diagnosis was made and things had calmed down a bit, I asked the students again what had happened. They could all only answer in fragments about what was going on around them. It was things like, "I wonder who brought the ice?" and "Who ripped their pants to wash the wound?" In other words, it wasn't a case of one person taking the lead, giving individual instructions, and everyone following them. Rather, each person thought about what they should do in that moment and acted autonomously. In fact, several people, including the injured student, said that there wasn't much conversation—looking back, it was as if they were all acting in unspoken unison.
Among them, the words of one student, who shyly admitted, "I was the one who brought the ice," were particularly memorable. "I hesitated for a moment about whether it was okay to leave the scene to get ice, but everyone there was a trusted member of the Oki Lab. I knew it would be fine, so I ran."
This statement shows that it wasn't just about individual knowledge and skills; there was also a strong relationship of trust. This trust likely empowered each person to take responsibility for their own actions and do their best. Just as non-technical skills like teamwork and situational awareness are pointed out in the fields of aviation and medical safety as being more important than technical skills, developing the ability to handle unforeseen situations correlates with deepening relationships of trust.
Slightly changing formulaic drills to face what could realistically happen helps cultivate people who can think about what they should do in the moment and act on it. Not only that, but it also leads to building an organization based on trust. What if we reframe evacuation drills not as "time spent on the off-chance of a low-probability disaster," but as "an event to enhance trust as a team"?
I am filled with hope that these efforts with like-minded students, faculty, and staff will create a disaster-resilient organization—that is, an organization with strong relationships of trust even in normal times.