Wilderness medicine: How to survive and thrive in the great outdoors


Woman and man taking kayak out of the water.
Outdoor explorers face increased risks from falls and fractures, gastroenteritis, and heatstroke if they don't plan ahead and take proper precautions.

The popularity of outdoor recreation exploded during the COVID-19 pandemic. Record numbers of people embraced activities such as hiking, camping, fishing, and kayaking. About 297 million people visited national parks in 2021 – up 60 million from 2020.

The increase in people enjoying the great outdoors came with an unintended consequence, though: a spike in wilderness-related accidents and fatalities. Media outlets from New York to China have reported steep increases in search and rescue missions amid the pandemic.

Exposure to unfamiliar geography, climate, altitude, plants, and animals can be dangerous if you are inexperienced or unprepared. The most common injuries and ailments in novice explorers include ankle sprains, broken bones, gastroenteritis from contaminated or improperly treated water, and heatstroke or heat exhaustion.

Growing up in the Kashmir region of India, I spent a lot of time hiking and camping. That turned into a passion for wilderness medicine during my residency in upstate New York, where I trekked the Hudson Valley and Adirondacks.

Wilderness medicine is a growing subspecialty that focuses on improvised care for patients in remote areas with limited resources and evacuation capabilities. My colleagues and I are considering developing a wilderness medicine curriculum within our Global Health track for UT Southwestern Medical School students, so they will be better prepared to treat urgent injuries outside the clinical setting.

Before your next adventure – whether it’s on one of the 52 trails around Dallas or in a more exotic locale – take time to prepare for any potential health emergency. Doing proper research, planning, and packing the right equipment will improve your chances of coming home with great memories of gorgeous scenery rather than a wilderness survival story.

Assessing the risks of your activity

Whether you are an experienced outdoor adventurer or just starting out, take time to familiarize yourself with potential risks related to your specific activity.

Some dangers are out of our control, but many risks can be reduced with proper planning and good judgment. For instance, avoid alcohol and drug use, which can cause dizziness, fatigue, or unexpected changes to blood pressure, blood sugar, or vision and can result in falls or other injuries. Some medications can also cause these side effects, so check the labels or talk with your doctor if you’re unsure.


Dr. Zubair Syed has combined his passion for hiking and camping with his medical knowledge to promote safety in the wilderness.

The definition of “hiking” can range from walking on a flat, groomed trail to trekking over rocks and canyons in the mountains, which means the potential for injury varies by terrain. Two of the most common causes of injury and death while hiking are falls and exposure to the elements, such as heat-related illness or hypothermia. Other risks can include:

  • Sprains and fractures
  • Cuts and lacerations
  • Dehydration
  • Drinking contaminated water
  • Lightning strike
  • Insect and animal bites
  • Becoming lost

Rock climbing and mountaineering

This sport has hit a growth spurt since the turn of the new century, due in part to the increase of indoor climbing walls. Falls are the most common cause of injuries and deaths, and other risks include:

  • Altitude sickness
  • Avalanche
  • Heat- and cold-related injuries

Approximately 3,000-3,800 mountaineers wind up in the emergency department each year in the U.S., and about 70% of climbing-related traumatic injuries are caused by falling to the ground, into a snowfield, or into a crevasse.

Water sports, such as boating, fishing, or kayaking

The main risks while using watercraft such as kayaks, canoes, or Jet Skis are hypothermia, head injury, and drowning. Approximately 4,000 people die each year from unintentional drowning.

Many fishing injuries are due to the hook piercing the body, particularly the eyes. If you are fishing from the bank or while standing in the stream, falls are possible. If you are in the water or in a boat, drowning is a risk.

Create a communication and safety plan

For many, part of the appeal of outdoor adventuring is leaving technology behind and flying solo. You can still achieve that feeling of solitude and freedom while also making smart decisions about your safety. Experienced and novice adventurers should create a communication and safety plan to prevent injuries or to get help quickly if an accident happens.

Tell someone where you are going. Especially if you are going alone, let someone know your destination, expected route, any backup routes, and when you plan to return. If possible, create checkpoints with expected time frames and a plan for what your contact should do if you miss one (such as come find you or alert the authorities).

Give your contact detailed information: For example, what you’re wearing, and the type of car you drive and its license plate. Carry a device with GPS and satellite calling capability if you’re headed into a remote area. You might also share your location through a location tracking app.

Locate the nearest hospital. Save or print directions to get there from your activity spot. This can literally be a lifesaver if you need help or encounter someone who does.

Research the climate and geography of your destination. Preparations may differ depending on whether you are heading into the desert or the mountains. Certain times of year – for example, a dry, rainy, or snowy season – will require different equipment and resources, even in a familiar locale.

Check the trail and weather conditions before you go. If the trail is not clear, for example if it is covered with snow, find another trail or try another day. If a storm is brewing, reschedule your plans to avoid a dangerous situation.

Be ready to turn back if necessary. Listen to weather announcements and follow park rangers’ advice – the trail or mountain will still be there tomorrow.

Take a wilderness medicine or first aid course. Knowing basic field medical techniques can save your life or someone else’s. Learn these key skills before heading into the wilderness: how to do CPR, clean and dress a wound, splint a limb, stabilize a neck injury, and apply a tourniquet – a simple device to apply pressure and stop blood flow from a wound.

The University of Utah School of Medicine offers free online wilderness medicine textbooks that can help you prepare, along with dozens of videos from NOLS, a national wildlife education organization.

Get a pre-adventure checkup. Outdoor activity can tax your heart, lungs, and muscles more than you’re used to or might anticipate. If you’re due for a physical, try to get one before your trip. That way, you can identify potential risks for sudden emergencies associated with exertion.

Related reading: What to do if someone collapses (or crumples) during exercise

Build a wilderness medicine kit

Your first-aid kit should be tailored to your activity, how long you’ll be gone, and how many people are in your party. Many lightweight, easy-to-carry first-aid kits can be purchased at an outdoors store or online.

Here are some basic supplies for a foundational first-aid kit:

  • Antibiotic ointment or alcohol wipes
  • Anti-diarrhea medication
  • Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Bandages, such as Band-Aids, gauze, athletic injury wrap, and medical tape
  • Bug repellant
  • Fire starter, such as matches, lighter, or flint
  • Hand sanitizer
  • Headlamp or flashlight
  • Lifejacket, even if you’re a strong swimmer
  • Map, compass, GPS unit
  • Menstrual products
  • Rain gear and extra warm clothing
  • Signal flares
  • Splint to immobilize a sprain or fracture
  • Sunscreen, SPF lip balm, and sunglasses
  • Swiss Army knife or multitool
  • Tourniquet
  • Tweezers to remove ticks or insect stingers
  • Water and extra snacks
  • Water filter, water purifier, chemical tablets, or tools to boil unfiltered water

Pack extras of your medications, such as insulin, glucose pills, EpiPens, and drugs to treat seasonal allergies and blood pressure, in case you are delayed.

One more suggestion: If you’re traveling to a locale where venomous snakes or spiders live, read up on what they look like and how they behave when agitated. While venomous bites are relatively rare, serious complications such as swelling, infection, and spreading of the venom can happen quickly. DO NOT attempt to suck out the venom, slice open the bite, apply ice or heat to the wound, or use a venom extraction device. Instead, get to the emergency department right away for proper treatment.

Accidents can happen, even among experienced adventurers. Knowing that you are prepared will help you stay calm while assessing and managing the situation.

The great outdoors is calling. Before you embark on your next adventure, do your research and learn the basics of wilderness medicine, so you are better prepared for a safe and enjoyable trip.

To schedule a visit with a primary care provider, call 214-645-8300 or request an appointment online.