Most of the time we are right. The expedition goes off without a hitch and we return home with a set of great memories and enough cell phone pictures to fill an album.
But sometimes things go wrong. Someone takes a fall, hits their head on a rock or sprains an ankle. Maybe the altitude has made you dizzy and nauseous. Maybe you stood too close to the campfire, got bit by a snake, or — like Coloradan Aron Ralston famously did for some 127 hours — got stuck in one of Utah's red rock slot canyons with no way to call for help.
"This is exactly where proper experience and planning comes in," says Scott McIntosh, M.D., a physician who specializes in emergency medicine at University of Utah Health Care. "You can't eliminate risk on a mountaineering, climbing or hiking adventure, but you can take actions that will keep the experience adventurous without being too dangerous."
McIntosh is an expert in wilderness medicine, a specialty that prepares physicians, nurses and other first responders to care for patients in any environment outside of a hospital, where conditions are controlled and the right equipment and medical supplies are available. That can include the mountains or forests, on a river or even in a city during a disaster situation.
The University of Utah is leader in the field, and has paired with the University of Colorado and the Salt Lake City-based Wilderness Medicine Society to develop the Diploma in Mountain Medicine program. The goal is to teach doctors, nurses, medics and other responders the critical, specialized skills they need to provide care in austere environments.
"It is the premier program for teaching medical professionals to be proficient in mountain medicine," says McIntosh, a DiMM instructor. "People have come from many countries to take it, including Canada, South Africa, Australia, and all parts of the U.S."
With a little luck, most of us won't ever need that kind of specialized care. And packing right — both in terms of basic skills and tools —can help ensure that you don't, McIntosh says.
Among the essentials McIntosh recommends to taking into the outdoors: a map, compass, sunscreen and sunglasses, headlamp and flashlights, firestarter, matches and a knife. In addition, packing extra clothing — for hot or cold temps and wet weather — food and water is also important, as are bandages for wound or blister care.
Of course, just having the items isn't a substitute for good experience or knowledge, McIntosh notes.
"If you are not skilled at navigating with a map and compass or firestarter, these items will not help," he says. "I believe that basic first aid skills are an essential part of society, and that everyone should obtain basic first aid skills and CPR knowledge, whether going out into the outdoors or not."
McIntosh recommends taking a basic first-aid course, which often lasts two to three days. Those interested in more extreme wilderness experiences, like deep backcountry skiing and backpacking or mountaineering might consider a week-long wilderness first responder course, he says.
Adventure-seekers with ongoing medical issues should also talk to their primary care physicians before heading out, McIntosh suggests.
"This is a case-by-case issue, because each outing or expedition brings its own unique challenges," he says. "But if a person does not have experience with the particular activity then it would be wise."
In all cases, those traveling into Utah's wilds should make sure to plan for the possible scenarios, McIntosh suggests. That includes alternate forms of communication if cell service isn't available and an action plan for handling emergencies.
That's exactly what Pearlly Ng does. An emergency room doctor and a medical resident from the University of Toronto, Ng is an avid climber, hiker and mountain biker who has just finished one year of wilderness medicine study at the U.
"If I'm out and it looks like there are clouds gathering and a thunderstorm or lightening strike coming, I look around and say, this is what we need to do, this is the safety position," says Ng, adding that in outdoor-crazy Utah consumers can find a safety course for nearly every activity.
Ng also has a "stay in touch" plan with her boyfriend, so that when he goes out backcountry skiing, she knows where he is and what time he expected to wrap for the day.
"He sends a text and lets me know," she says. "It's important for someone to know where you are, because if you don't come back in time, they can be alerted to that."
Knowing one's own limits is also key, says Ng. Many of us overestimate our skills or our fitness level and underestimate either weather conditions of the difficulty of the outdoor challenge we're trying to tackle. People should also learn to feel comfortable saying they need to stop or turn back, instead of pushing themselves to the point of injury.
Ng learned that the hard way during her first week in Utah. Excited by the state's wealth of outdoor options, she rushed out to try and summit Mount Timpanogos and found herself struggling. She failed to consider that after living at sea level, the altitude would present a big challenge, despite her health and fitness.
"I kept thinking, why am I so tired? Why do I feel like I can't breathe? Why am I so nauseous and why did I just throw up?" she recalls somewhat sheepishly. "And then I realized, oh right, this is what I came here to learn about."
Now, after a year in Utah recreating and learning, Ng finds herself better prepared for outdoor adventures.
"Just really being aware of the situation around you is important," says Ng, adding that no one should pass up a chance for outdoor fun. "I do it so that I feel more comfortable out there. It's never about not doing anything."
By Jennifer Dobner for University of Utah Health Care.