ER Doctors List Top Hiker Hazards
Emergency doctors say hikers' most serious issues are blisters, heat illness, and poor decisions, not dramatic wildlife encounters.
Three emergency room doctors who specialize in wilderness medicine say the most common causes of serious injury and illness for hikers are blisters, heat exhaustion, and the refusal to turn back. According to the physicians interviewed by Backpacker, dramatic fears like bear attacks are far less common than these mundane problems.
The Cascade of Small Mistakes
Emergency physician Dr. Chris Williams says problems often start with the feet. A hotspot ignored can become a blister, then an open wound, and eventually an infection requiring rescue. Dr. TJ Hartridge calls this a "decision cascade."
Dr. Megan Eubank advises hikers to be proactive. Covering a hotspot early and carrying an extra pair of dry socks can prevent a crisis. Wool or synthetic socks are better than cotton. Dr. Williams recommends specific training with a loaded pack, noting that running alone does not prepare feet for the stress of long hikes.
Heat, Hydration, and Hyponatremia
Heat illness is a major summer hazard. Dr. Williams, based in Tucson, cited a weekend in August where temperatures hit 107°F and local rescue teams responded to 16 distressed hikers near Seven Falls. Many had run out of water.
He warns hikers to carry a reasonable safety margin of water and not to assume every water source will be available. Dr. Eubank adds that drinking too much plain water can lead to hyponatremia, or dangerously low sodium. She suggests alternating water with an electrolyte solution.
The Trap of Summit Fever
Sometimes the best medicine is knowing when to quit. Dr. Williams identifies pride as a major killer. He has seen hikers ignore a hotspot to avoid slowing the group or press on when lost. At altitude, this stubbornness carries higher stakes.
Dr. Hartridge describes these as heuristic traps, where a fixed focus on an objective leads to poor decisions, like being caught out after dark. Dr. Eubank acknowledges the investment in a big trip but reminds hikers that "the mountains aren't going anywhere." Turning around can be the smartest choice.
Preparing for the Long Wait
Rescue is not instant. Dr. Hartridge notes that wilderness patients can wait hours for help, and a helicopter is not guaranteed. An injury that seems minor at the trailhead becomes serious miles from a hospital, especially if a stationary hiker gets cold after sunset.
He watches for hypothermia even in summer patients. The doctors stress the importance of packing extra layers and monitoring supplies. Solving a small problem in the wilderness is far easier than solving a big one, Dr. Williams concludes.
