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Before You Go
No matter how long or short your trip, make sure you have adequate travel insurance, purchased before departure. At a minimum, you need coverage for medical emergencies and treatment, including hospital stays and an emergency flight home if necessary. Medical treatment in the US is of the highest caliber, but the expense could bankrupt you.
You should also consider getting coverage for luggage theft or loss and trip cancellation. If you already have a home-owner's or renter's policy, see what it will cover and consider getting supplemental insurance to cover the rest. If you have prepaid a large portion of your trip, cancellation insurance is a worthwhile expense. A comprehensive travel-insurance policy that covers all these things can cost up to 10% of the total outlay of your trip.
Worldwide travel insurance is available at www.lonelyplanet.com/travel-insurance. You can buy, extend and claim online anytime – even if you're already on the road.
No vaccinations are currently recommended or required when visiting the national park. For the most up-to-date information, see the Centers for Disease Control website (www.cdc.gov).
In Great Smoky Mountains National Park
Availability & Cost of Health Care
Emergency rooms are required to treat all patients regardless of ability to pay, but clinics will require proof of insurance or immediate payment.
Some of the more common ailments include blisters, fatigue and sore joints. Be sure to break in your hiking boots (and build up your stamina) before you arrive, and bring along a first-aid kit to treat any minor scrapes.
To avoid blisters, make sure your walking boots or shoes are well worn in before you hit the trail. Boots should fit comfortably, with enough room to move your toes. Wear specialized walking socks that fit properly; be sure there are no seams across the widest part of your foot. Wet and muddy socks can cause blisters, so pack a spare pair. If you feel a blister coming on, treat it sooner rather then later by applying a bit of moleskin or duct tape.
More injuries happen toward the end of the day rather than early, when you’re fresher. Although tiredness can simply be a nuisance on an easy hike, it can be life-threatening on narrow, exposed ridges or in bad weather. Never set out on a hike that is beyond your capabilities on the day. If you feel below par, have a day off.
Don’t push yourself too hard – take rests every hour or two and build in a good half-hour lunch break. Toward the end of the day, take the pace down and concentrate harder. Drink plenty of water and eat properly throughout the day – nuts, dried fruit and chocolate are all good energy-rich snacks.
This parasitic infection of the small intestine, commonly called giardia, may cause nausea, bloating, cramps and diarrhea, and can last for weeks. Giardia is easily diagnosed by a stool test and readily treated with antibiotics.
To protect yourself from giardia, do not drink water from springs or streams without filtering, boiling or chemically treating it first, as the water may be contaminated. Most hikers prefer using a filter (one that has a pore size of 1 micron or less to remove giardia).
Giardia can also be transmitted from person to person if proper hand washing is not performed.
Although climbs are more challenging, your legs may feel the burn on long, steep descents. You can’t eliminate strain on the knee joints when dropping steeply, but you can reduce it by taking shorter steps that leave your legs slightly bent and ensuring that your heel hits the ground before the rest of your foot. Some walkers find that compression bandages help, and trekking poles are very effective in taking some of the weight off the knees.
Preparation and responsibility for your own safety are key to a safe adventure.
Poison ivy is widely present in the park. Learn to recognize its three-leaf pattern. Vines may not be easy to identify, and should be avoided.
Bites & Stings
Take precautions to avoid bites and stings. Young children and the elderly are particularly vulnerable to extreme reactions.
Yellowjackets, Bees & Wasps
A sting from a yellowjacket, bee or wasp can cause minor local swelling, though it can lead to life-threatening anaphylactic shock for those allergic to stings. Those with allergies should always carry an EpiPen.
If stung, over-the-counter antihistamines such as Benadryl can help reduce swelling. If bitten on the hand, remove rings immediately.
Wear long sleeves and pants to protect from ticks. Always check your body for ticks after walking through high grass or thickly forested areas. If ticks are found unattached, they can simply be brushed off. If a tick is found attached, press down around the tick’s head with tweezers, grab the head and gently pull upward – do not twist it. (If no tweezers are available, use your fingers.) Don’t douse an attached tick with oil, alcohol or petroleum jelly.
Diseases transmitted by ticks such as Rocky Mountain spotted fever and Lyme disease are not common in the park. However, if you become ill after receiving the bite, seek medical treatment immediately.
Tick bites can occur any time of year, though infections are more common in the warm-weather months from May to September.
Copperheads and timber rattlesnakes are the two species of venomous snake found inside the park. These snakes are not aggressive and prefer to avoid humans. Most bites occur from people stepping on an unnoticed snake. Those bitten will experience local pain and swelling. Death is rare even without treatment (no fatality from a snakebite has ever been recorded in the Smokies).
To treat a snakebite, place a light constricting bandage over the bite (wrapping as you would for a sprain or fracture), keep the wounded part of the body below the level of the heart and move it as little as possible. Attempting to suck out the venom and/or applying a tourniquet is not recommended. Stay calm, send for help and avoid unnecessary activity. If walking out is necessary, do so slowly, with frequent rest stops.
Cold & Wet Weather
The wintertime brings wet and icy weather to the park. Be sure to dress properly for the elements and be prepared for changing weather conditions.
This life-threatening condition occurs when prolonged exposure to cold thwarts the body’s ability to maintain its core temperature. Hypothermia is a real danger, regardless of the season. Cold, wet and wind can form a deadly combination, even with temperatures in the 50°Fs (10°C to 15°C). At higher elevations, hypothermia can even occur in the summer.
Symptoms include uncontrolled shivering, poor muscle control and irrational behavior. Treat symptoms by putting on dry clothing, giving warm fluids and warming the victim through direct body contact with another person.
Prevention is the best strategy: Remember to dress in layers and wear a waterproof, windproof outer jacket.
Summer days can bring high heat and humidity to the park. Take it slowly and don't underestimate your water requirements before setting out on a hike.
Dehydration & Heat Exhaustion
Lack of water can cause dehydration, which can lead to heat exhaustion. To prevent dehydration, make sure to drink plenty of fluids. Hikers should drink a gallon of water per day, and anyone overnight hiking should bring a water treatment system.
Take note if you haven’t had to urinate as often as usual, or if your urine is dark yellow or amber colored. These are indicators of dehydration, which can rapidly spiral into more dire health concerns. Loss of appetite and thirst may be early symptoms of heat exhaustion, so even if you don’t feel thirsty, drink water often and have a salty snack while you’re at it. Add a little electrolyte-replacement powder to your water. Err on the side of caution and bring more water and food than you think you’ll need.
Characterized by fatigue, nausea, headaches, cramps and cool, clammy skin, heat exhaustion should be treated by drinking water, eating high-energy foods, resting in the shade and cooling the skin with a wet cloth. Heat exhaustion can lead to heatstroke if not addressed promptly.
Long, continuous exposure to high temperatures can lead to heatstroke, a serious, sometimes fatal condition that occurs when the body’s heat-regulating mechanism breaks down and one’s body temperature rises to dangerous levels.
Symptoms of heatstroke include flushed, dry skin, a weak and rapid pulse, poor judgment, inability to focus and delirium. Move the victim to shade, and use whatever means possible to cool the victim, such as drenching their clothing with creek water. Send for help, as this is a medical emergency.
Remember to look up before setting up your camp. Don't camp under dead tree limbs or near standing dead trees – and with virulent insect infestations, the park has a lot of dead trees.
Lightning strikes can sometimes lead to respiratory and cardiac arrest. Victims may be saved through the prompt administration of CPR – even without medical equipment available.
When seeking shelter, avoid high trees, solitary trees and rocky outcroppings and overhangs.
Streams & Waterfalls
Heavy rain can sometimes lead to dangerously swollen streams and washed-out bridges. Don't attempt to make a stream crossing unless you're sure you can make it. When in doubt, turn back. Use a walking stick or hiking poles for added balance while crossing.
Avoid camping next to swollen streams.
Don't ever attempt to climb to the top of a waterfall. Several visitors have fallen or been swept to their deaths while clambering around on top of falls.
Tap Water & National Park Water Sources
Visitors are strongly advised to treat all water before drinking from any of the natural water sources in the Smoky Mountains. Those rushing streams look crisp, clean and clear, but the protozoan Giardia lamblia may be present in those waters. Before drinking you'll need to boil the water for one minute, chemically treat the water (ie with water purification tablets) or use a filter capable of removing particles as small as 1 micron.
Tap water from the towns and cities near the park is generally safe to drink. The exception is during occasional cases of burst pipes and water outages, which lead utility companies to issue 'boil advisories.' During such times, pathogens could be present in the water, and consumers are urged not to use tap water for drinking, brushing teeth or bathing, unless it has been boiled for a full minute.
Outside of the park, some cabins available for hire use well water, which can have a strong smell of sulfur. Inquire with the lodge before booking, or come prepared with your own high-quality filtration device.
It’s easy to become complacent when hiking in the Smokies, given the clearly marked signage and generally well-maintained quality of the trails. But hiking here can be serious business. There are numerous medical emergencies each year on the trails, and several people have died.
The best way to ensure a rewarding hike is proper planning. Learn about the trails, honestly assess your limitations and respect them.
- Stay on marked trails, both for your safety and to control erosion. It’s extremely difficult for rescuers to find a hiker who has wandered off-trail.
- Don’t hike alone. Most of those who get in trouble are solo hikers, for whom the risks are multiplied. Backcountry hikes are safer (and more enjoyable) with a companion.
- Go slow to avoid overexertion. Ideally you should be able to speak easily while hiking, regardless of the grade. Be sure to take a five- to 10-minute break every hour to recharge.
- Pay close attention to your intake of food and fluids to prevent dehydration and hyponatremia (low blood sodium level). One good strategy is to have a salty snack and a long drink of water every 20 to 30 minutes. In summer months each hiker should drink 3 to 4 quarts of water per day, sipping constantly. Eat before you’re hungry and drink before you’re thirsty.
- In addition to sturdy, comfortable, broken-in boots and medium-weight socks, bring moleskin for blisters and make sure your toenails are trimmed.
- Don’t be overly ambitious. Particularly for novice hikers, it’s a good idea to spend the first day or two gauging your ability and response to the climate and terrain. Work your way up to more difficult trails.
- Hike during the cooler early morning and late-afternoon hours, especially in summer.
Before You Go
Before departing for an overnight backcountry hike, give a contact person your itinerary, including your destination after the hike, the date of your return, and the permit holder's name. Upon completion of your hike, call your contact – if you do not return on schedule, that person should call the park headquarters at 865-436-9171.
Rescue & Evacuation
Hikers should take responsibility for their own safety and aim to prevent emergency situations, but even the most safety-conscious hiker may have a serious accident requiring urgent medical attention.
If a person in your group is injured, leave someone with them while others seek help. If there are only two of you, leave the injured person with as much warm clothing, food and water as it’s sensible to spare, plus a whistle and flashlight. Mark their position with something conspicuous.
Ankle and knee sprains are common injuries among hikers, particularly when crossing streams and slippery rocks. To help prevent ankle sprains, wear boots that have adequate ankle support. If you suffer a sprain, immobilize the joint with a firm bandage, and if possible, immerse the foot in cold water. Relieve pain and swelling by resting and icing the joint, and keeping it elevated as much as possible for the first 24 hours. Take over-the-counter painkillers to ease discomfort. If the sprain is mild, you may be able to continue your hike after a couple of days.