Minimizing Injury & Illness during Outdoor Trips

All outdoor trips incur risk. Trip planners must balance the severity of a potential injury or illness with the expedition members' outdoor skills, equipment choices, and the availability of outside assistance. The planner must accurately assess each member's skills and other factors with:

• the risks inherent in the activity: rock climbing, mountaineering, trekking, whitewater, skiing, caving, ocean touring, etc.
• the potential for and the severity of a hazardous weather event: flash floods, lightning, wind events, storm surges, mudslides, high water and flooding events, and wildfires
• infectious disease outbreaks
• evacuation-associated injuries should an injury or illness occur.

Program managers and trip planners often require a deeper understanding of preventative wilderness medicine strategies than most WFR or WEMT graduates possess. A medical advisor who is intimately familiar with the program or trip can recognize clinical conditions for specific medical problems and aid in developing effective mitigation strategies.
Let's take a closer look at each risk category:

​Hazardous Weather Events
Due to global warming, hazardous weather events are increasing worldwide, making a trip-related prediction of potential weather-related injuries challenging. In addition to injuries directly associated with weather events, changing microclimates are expanding disease and fauna boundaries, often increasing the range of infectious diseases and venomous creatures.
Managers and trip leaders need to:

• focus on identifying emerging weather patterns within their expedition areas and modify their routes and activities accordingly
• ensure reliable two-way field communication and increase weather check-ins
• review, field test, and update their emergency action plans
• ensure pre-season or pre-trip training that focuses on early field recognition of potentially hazardous weather events and their subsequent avoidance and mitigation strategies
• work with a medical advisor to ensure effective pre-trip screening to identify pre-disposing risk factors for environmental injuries and illnesses and develop management guidelines to mitigate them

Inherent Activity- and Terrain-associated Risks
Most activity- and terrain-associated hazards are well known within the outdoor industry. Nationally and internationally recognized professional organizations offer training and certification in numerous outdoor pursuits designed to promote best practices within the industry. Both professionals and non-professionals can benefit from these courses and certifications. Training in activity-specific rescue techniques and wilderness medicine, especially Wilderness First Responder, helps expedition members understand potential consequences should things go wrong and imbibe a conservative approach to risk and site management.

Infectious Disease Outbreaks​
Each pathogen, animal vector, and host has an optimal climate in which they thrive, with warm, moist temperate, subtropical, and tropical environments being the best. Global warming has increased and will continue to increase, both temperature and precipitation worldwide, leading to the proliferation of many infectious diseases. While this trend is predictable, the exact type and location of an emerging disease are not, and exposure to and contracting an infectious disease in an area without historical data is increasingly common. To this end, expedition members should protect themselves by treating their water, ensuring good personal and expedition hygiene, taking aggressive precautions against insect-borne diseases, and avoiding potentially infectious animals and their habitat. Avoidance equals prevention, and there are no reliable field treatments for most infectious diseases.
Do your research:

• Information about prevention, vaccines, drug prophylaxis, and treatment is available from the Department of State, the Centers for Disease Control (CDC), the World Health Organization (WHO), and the International Association of Medical Assistance to Travelers (IAMAT). NOTE: the above sources may not have current information on remote regions; confirm or update your findings with local medical professionals immediately upon arrival. 
• Common insect carriers are fleas, mosquitoes, sand flies, lice, chiggers, ticks, & assassin bugs, and proteins in an insect's saliva may cause allergic reactions. Use protective netting, clothing, and insect repellent. The most effective repellents are those with 20% DEET, picaridin, or IR3535; use them on exposed skin. Treat clothing & equipment with products that contain 0.5 percent permethrin, an insecticide.

​Evacuation-associated Injuries
​The ability—or lack thereof—to rapidly evacuate an injured or ill expedition member to definitive care may directly affect their outcome. Since the inherent risk of injury to rescue party members tends to increase with the severity of the patient's injury or illness, it is critical to diagnose the patient's current and anticipated problems accurately. In some cases, an accurate assessment may require more medical experience than expedition members possess, and a physician consult may be necessary. Any evacuation, regardless of the type or urgency, should not endanger members of the evacuation team or the patient beyond the team's capacity to manage the risk effectively.

Interested in Wilderness Medicine? Take one of our wilderness medicine courses. Guides and expedition leaders should consider taking our Wilderness First Responder course.

Looking for a reliable field reference? Consider consider purchasing one of our print or digital handbooks; our digital handbook apps are available in English, Spanish, and Japanese. Updates are free for life. A digital SOAP note app is also available.