Outdoor Injury Prevention

Emergency physicians are pretty good at taking care of people, but we’d much more prefer that people not suffer enough to need our attention. In the outdoors, and certainly when you are off in a remote wilderness area, injury prevention is critically important. Every story of rescue and survival begins with a description of how the victim got into trouble in the first place. In all too many episodes, the accident or illness was avoidable. Here are some familiar mishaps (and possible consequences):

1. I skied out of bounds and became lost. I was forced to spend the night outdoors without a shelter. (Four of my toes suffered severe frostbite and were amputated.)
2. I decided to ride my mountain bike without wearing a helmet. I hit an exposed tree root, misapplied the front brake, and flew over the handlebars. (When I awoke with a concussion, I discovered that my shoulder was dislocated.)
3. I drank a few beers before I saw a snake slithering through the tall grass. When I reached over to grab it, the fangs were in my wrist before I could jump away. (After 48 hours in the intensive care unit receiving antivenin, my doctor says that I should be able to retain part of the function in my hand.)
4. When I began my hike up the butte, the sky was blue. When the clouds darkened and I heard thunder, I thought it would pass quickly, so I kept on climbing. I don’t remember anything between the flash and when they put me in the ambulance. (My hearing will likely be impaired for at least a few months while the hole in my eardrum heals up.)
5. Roping up the last few hundred meters of the glacier, I forgot to use my sunglasses. That night, my eyelids swelled shut and my vision was hopelessly blurred. (I sat our the remainder of the ascent, and missed the summit day.)
6. The last thing I remember about that afternoon was jumping off the cliff into the quarry. Everybody except me dove feet first. (I will be in this wheelchair for the rest of my life.)

We need all the advantages we can have. It doesn’t pay to take chances, even if the thrills are huge. One poor choice – one risky crossing across an avalanche runout, one tumble onto the sharp coral in tumultuous surf, one ill-fated white-water run without a helmet – and life as you know it changes forever.

Tags: injury, injury prevention, wilderness medicine, outdoor medicine, healthline

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