The key to health and safety are good predeparture preparations and common sense while traveling. While the potential problems may seem frightening, few visitors experience anything worse than a skinned knee. Much of this information covers worst-case scenarios, which can be avoided or at least dealt with more effectively if you’re well prepared.
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Before You Go
If you’re planning on doing any hiking, start getting regular physical exercise a few weeks prior to your trip. When possible, visitors from lower elevations and cooler climes should allow at least a day or two to acclimatize before undertaking any strenuous activity in southern Utah’s deserts or mountains. And remember the golden rule: if you're going into the backcountry, always let someone know where you are going and how long you plan to be gone. There's even an app for that: www.hikeralert.com.
- Centers for Disease Control & Prevention (www.cdc.gov) US government agency offers a wealth of information, from travel health precautions to environmental hazards and emergencies.
- National Park Service Public Health Program (www.nps.gov/public_health) Background information on disease and water issues.
- Utah Department of Health (http://health.utah.gov) Local advice about infectious diseases and health precautions.
- Wilderness Medicine Institute (www.nols.edu/wmi) Nonprofit organization offers wilderness-medicine training courses; the website’s ‘Keep Learning’ section offers real-life case studies, news articles and more.
Hikers, climbers, backpackers, paddlers and other off-road explorers may want to stuff one of these excellent first-aid guides into their packs.
- Backcountry First Aid and Extended Care by Buck Tilton (2007). Pocket-sized guide that's compact and lightweight, but info-packed for situations when medical help is over an hour away.
- Wilderness 911 by Eric A Weiss (2007). A step-by-step guide to first aid and advanced care in remote areas when you have limited medical supplies.
- Medicine for the Outdoors by Paul S Auerbach (2009). Hefty layperson’s reference with explanations of wilderness medical problems and practical treatment options.
The US healthcare system generally relies on private insurance, though some public healthcare options remain available. If you are traveling from abroad, it's smart to get travel insurance through somebody like World Nomads (www.worldnomads.com), as just a night in a hospital can cost you $10,000.
According to the Center for Disease Control there are no vaccination requirements for visitors to the US. If you are traveling on to other destinations, you may need to get vaccines in advance. Visit www.cdc.gov for more details on global vaccine requirements.
In addition to any over-the-counter and prescription medications you normally take, consider adding these to your first-aid kit:
- acetaminophen (Tylenol) or aspirin
- antibacterial ointment for cuts and abrasions
- antidiarrhea and antinausea drugs
- antifungal cream or powder
- antihistamines (for allergies)
- anti-inflammatories (eg ibuprofen)
- Band-Aids, bandages, gauze swabs and rolls
- calamine lotion, sting-relief spray or aloe vera
- cold and influenza tablets, throat lozenges and nasal decongestant
- cortisone (steroid) cream for allergic rashes
- elasticized support bandage for knees, ankles etc
- eye drops
- insect repellent
- moleskin for blisters
- nonadhesive dressings
- oral rehydration mix
- pocket knife (put them in your checked baggage)
- safety pins
- small pair of scissors
- sterile alcohol wipes
- sunscreen and lip balm
- thermometer (note, mercury thermometers are prohibited by airlines)
- water-purification tablets or iodine
In the Parks
Availability & Cost of Healthcare
Healthcare is available in all major towns in Utah. The smaller towns of Southern Utah may just have a clinic or no services at all. While emergency first aid can be performed by park rangers, the parks themselves do not have healthcare clinics. For high-level emergencies, you will want to make it to Salt Lake City. For minor issues, the local clinic will do. If you don't have insurance, healthcare can get costly. A typical inpatient day at a Utah hospital will cost around $3000 (yikes!).
Plaguing hikers of all ages in southern Utah, the following may not pose problems if you’re prepared.
To avoid blisters, make sure your shoes are well worn in before you hit the trail. Your footwear should fit comfortably with enough room to move your toes; shoes that are too big or too small will cause blisters. The same goes for socks: be sure they fit properly and ideally are specifically made for hikers. But take into consideration Utah's extreme temperatures – you don't want to be wearing thick hiking socks if it's hot out. Wet and muddy socks can cause blisters, so even on a day walk, pack a spare pair. Keep your toenails clipped but not too short. If you do feel a blister coming on, treat it sooner rather than later by applying a bit of moleskin (or duct tape).
A simple statistic: more injuries happen toward the end of the day than when you’re fresh. Although tiredness can simply be a nuisance on an easy walk, it can be life-threatening on narrow exposed ridges or in bad weather. You should never set out on a walk that is beyond your capabilities on the day. If you feel below par, have a day off or hop on a park shuttle. To reduce the risk of accidents, don’t push yourself too hard – take rests every hour or two and build in a good half-hour or hour-long lunch break. Toward the end of the day, take down the pace and increase your concentration. Also eat properly throughout the day; nuts, dried fruit and chocolate are all good, energy-giving snack foods.
Many hikers will feel the burn on long, steep descents, especially in southern Utah’s canyon country. Although you can’t eliminate strain on knee joints when dropping steeply, 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. Lightweight hiking poles are effective in taking some of the weight off your knees. Compression bandages may also help.
All groundwater in the desert, whether a river, seasonal stream or sandstone seep, should be considered unsafe to drink and treated accordingly.
Giardiasis and cryptosporidiosis are common intestinal diseases that stem from drinking untreated water. Giardiasis can be treated, but there is no effective treatment for cryptosporidiosis. Both can last for anywhere from a few weeks or months to several years, though neither is typically life-threatening.
The most reliable way to destroy the offending organisms is to boil water. Water purification tablets and portable water filters (0.5 microns or smaller) are good options outside meal times; ultraviolet purifiers are the newest gadget on the market, though they are battery dependent. Drinking water provided at national park visitor centers and campgrounds is reliably safe, unless posted notices indicate otherwise.
The rim at Bryce Canyon ranges in altitude from 8000ft to 9000ft above sea level, while Cedar Breaks rises above 10,000ft. A common complaint at high elevations is altitude sickness, characterized by shortness of breath, fatigue, headaches, dizziness and loss of appetite. It sounds benign, but it can actually be quite serious – drink plenty of water and take a day or two to acclimatize before attempting anything strenuous. If symptoms persist, return to a lower elevation. Ibuprofen helps.
Bites & Stings
Common-sense approaches to these concerns are the most effective: wear boots when hiking to protect from snakes; wear long sleeves and pants to prevent tick and mosquito bites.
- Do not attempt to pet, handle or feed any wild animal, no matter how cute and cuddly it may look. Most injuries from animals in the parks are directly related to people trying to do just that. For example, squirrels on Zion’s Riverside Walk are notoriously aggressive because so many park visitors have illegally fed them.
- Any bite or scratch by a mammal, including bats and squirrels, should be promptly and thoroughly cleansed with large amounts of soap and water, followed by application of an antiseptic such as iodine or alcohol. Local health authorities should be contacted for possible rabies treatment, whether or not you’ve already been vaccinated against rabies. It may also be advisable to start an antibiotic, because wounds caused by animal bites and scratches frequently become infected.
When mosquitoes are present, keep yourself covered and apply a good insect repellent, preferably one containing DEET, to exposed skin and clothing. Don’t overuse the stuff, though, because neurologic toxicity – though uncommon – has been reported from DEET, especially in children. DEET-containing compounds should not be used at all on kids under the age of two.
Insect repellents containing certain botanical products, eg oil of lemon eucalyptus, can be effective but last only 1½ to two hours. Products based on citronella are not effective.
- Despite southern Utah’s abundance of venomous snakes, fatalities are rare. Snakebites can usually be prevented by giving the animal space – when you encounter a snake, back away slowly. Most reported snakebites result from people picking up the snake, either out of bravado or mistakenly assuming the animal is dead.
- If you’re bitten by a snake, seek immediate help. Snakebites don’t cause instantaneous death, and medical centers usually stock the necessary antivenins.
- If you’re bitten on a limb, a light constricting band above the bite can help. Keep the affected area below the level of the heart, and move as little as possible. What you should not do is wrap the limb in a tight tourniquet, slash or suck the wound, put ice on it or take any alcohol or drugs. Simply stay calm and get to a hospital.
Spiders & Scorpions
- There are no particular first-aid techniques for spider or scorpion bites. Some (like tarantula bites) are merely painful, while others (like black widow and scorpion bites) contain venom. Doses are generally too small to kill adult humans, but children face a risk of serious complications.
- Cool the wound using cold water or ice, and if you’re hiking, return immediately; reactions can be delayed for up to 12 hours, and you may want to call Utah Poison Control (800-222-1222) and seek medical help.
Always check your skin, hair and clothes for ticks after walking through high brush, grasslands or thickly forested areas. If ticks are found unattached, they can simply be brushed off. If a tick is found attached, carefully grab the tick’s head with tweezers, then gently pull upwards – do not twist or force it. (If no tweezers are available, use your fingers, but protect them from contamination with a piece of tissue or paper.) Do not rub oil, alcohol or petroleum jelly on it.
Some ticks carry infectious diseases, such as Lyme disease. If you experience flulike symptoms or notice a circular red rash around the tick bite site during or after your trip, consult a doctor (diagnosis will be easier if you keep the dead tick).
Frostbite refers to the freezing of extremities, such as a nose, fingers or toes. Signs and symptoms of frostbite include whitish or waxy cast to the skin, as well as itching, numbness and pain. If possible, warm the affected areas by immersion in warm (not hot) water only until the skin becomes flushed. Frostbitten body parts should not be rubbed, and any blisters that form should not be broken. Pain and swelling are inevitable. Seek medical treatment immediately.
- While generally associated with winter hiking at altitude, hypothermia is a real danger in the desert in any season. Even a sudden rain shower or high winds can rapidly lower your body temperature. Symptoms of hypothermia include exhaustion, numbness, shivering, stumbling, slurred speech, dizzy spells, muscle cramps and irrational or even violent behavior.
- Hypothermia often strikes people hiking narrow canyons, where they must wade or swim in pools that are frigid even in summer. One such place is Zion’s Narrows, where hikers spend most of their time immersed in the Virgin River. Hypothermia is also a danger for campers from fall to spring, when overnight temperatures routinely drop near or below freezing, even in the desert or following mild days in the mountains.
- To help avoid hypothermia, don’t wear cotton clothes (which dry slowly and provide no insulation when wet). Instead wear synthetics or woolen clothing that retain warmth even when wet. Always carry waterproof layers and high-energy, easily digestible snacks like chocolate, nuts and dried fruit. Canyoneers should wear a wet or dry suit when advised.
- To treat hypothermia, take shelter from bad weather and change into dry, warm clothing. Drink hot liquids (no caffeine or alcohol) and snack on high-calorie food. In advanced stages, carefully put hypothermia sufferers in a warm sleeping bag cocooned inside a windproof and waterproof outer wrapping. Do not rub victims, who must be handled gently.
Because your body can only absorb about a quart of water per hour, it’s beneficial to prehydrate before embarking on a long hike. To get a head start on hydration, drink plenty of water the day and evening before your hike, and avoid diuretics like caffeine and alcohol.
Dehydration & Heat Exhaustion
- You don’t need to do much to become dehydrated in the desert – just stand around. If you do engage in an activity, expect water and salts to leave your body at a vastly accelerated rate.
- It’s very important to both drink water and eat salty foods when hiking in the desert. The minimum is a gallon of water a day per person, or 16oz every hour while active. Though that may sound like a lot, you’ll drink that and more if you’re active. Keep a few extra gallons of water in the car. Eating is just as important, however, and is the half of the equation many people forget. Always carry high-energy bars or trail mix.
- Dehydration (lack of water) or salt deficiency can cause heat exhaustion. Signs and symptoms of heat exhaustion, which occurs when you lose water faster than your body can absorb it, include nausea, vomiting, fatigue, headaches, dizziness, muscle cramps, heavy sweating and/or cool, clammy skin.
- Treat heat exhaustion by drinking, eating, resting in the shade and cooling the skin with a wet cloth and fanning yourself.
- Heatstroke, which can be fatal, occurs when your internal cooling mechanism breaks down and your body temperature rises dangerously.
- Symptoms include flushed, hot and dry skin (ie sweating has stopped), severe throbbing headaches, hyperventilation and a rapid pulse. Some victims may act in an uncharacteristically bizarre manner, display a lack of coordination and eventually go into convulsions.
- Immediate hospitalization is essential. In the meantime, move the victim into the shade, remove clothing and cover with a wet cloth or towel, fan vigorously and seek immediate help. Ice packs can be applied to the neck, armpits and groin.
- Hyponatremia (low sodium blood level) occurs when you drink a lot of water but don’t eat. The excess water essentially flushes electrolytes and nutrients from your body.
- Prevention is key: add electrolyte powder or a pinch of sea salt to drinking water.
- Symptoms are similar to heat exhaustion (and can become life-threatening if left untreated), including nausea, muscle cramps, headaches and vomiting.
- Treatment is to rest in the shade and eat salty foods until the blood’s sodium-level balance is reestablished. Rapidly evacuate if the victim’s mental status changes.
- You can sunburn quickly in the desert, sometimes in less than an hour, even on a cloudy day. Apply sunscreen (SPF 30 or higher) religiously every morning and reapply throughout the day. Always wear a hat, preferably one with a wide brim.
- Rabies is a viral infection of the brain and spinal cord that is almost always fatal. The rabies virus is carried in the saliva of infected animals and is typically transmitted through an animal bite, though contamination of any break in the skin with infected saliva may result in rabies. In the US, most cases of human rabies are related to exposure to bats. But rabies may be contracted from any mammal, including squirrels, raccoons and unvaccinated cats and dogs.
- If there is any possibility, however small, that you have been exposed, you should seek preventative treatment, which consists of rabies immune globulin and rabies vaccine and is quite safe. In particular, any contact with a bat should be discussed with health authorities, because bats have small teeth and may not leave obvious bite marks. If you wake up to find a bat in your room, especially if you have small children, rabies prophylaxis may be necessary.
While a change of water, food or climate may give travelers an aggravating case of the runs, serious diarrhea caused by contaminated water can be a problem in the parks, especially in backcountry areas. If diarrhea does occur, fluid replacement is essential. Weak black tea with a little sugar or a soft drink allowed to go flat and diluted 50% with water are good. In cases of severe diarrhea, oral rehydration therapy is necessary to replace lost minerals and salts. Commercially available oral rehydration salts are useful. Gut-paralyzing drugs such as diphenoxylate or loperamide may bring relief from symptoms, but do not actually cure the problem. Stick to a bland diet as you recover.
Symptoms of this parasitic infection of the small intestine may include nausea, bloating, cramps and diarrhea. To protect yourself from giardia, you should avoid drinking directly from lakes, ponds, streams and rivers until the water has been properly treated. The infection can also be transmitted from person to person if proper hand washing is not performed. Giardiasis is easily diagnosed by a stool test and readily treated with antibiotics.
- In any emergency, dial 911. Unfortunately, if you’re injured in rural areas or inside the parks, calling may not be an option; cell phones often don’t work outside the major interstate corridors, and canyon walls block signals. Satellite phones and personal locator beacons (PLBs) are your best options in the backcountry.
- Park rangers with medical training can help visitors who get into trouble, free of charge for basic first aid. For more serious ailments, drive to the nearest hospital emergency room or clinic. Search-and-rescue (SAR) and helicopter evacuations are only for truly life-threatening emergencies. Emergency operations are costly and also put the lives of rangers and other staff at risk.
- Utah Search and Rescue Assistance (https://secure.utah.gov/rescue) $25 yearly plans and $100 five-year plans work like rescue insurance, and provide much-needed funding to the awesome men and women that rescue your sorry butt from places you probably shouldn't have been. Fishing and boating licenses will also cover costs of search and rescue generally.
- Newcomers to desert road cycling and mountain biking should pay particular heed to safety. Wear a helmet, carry lots of water and bring high-energy foods. Also pack a map and keep track of your route. Don’t start out on rough trails – first get your bearings on easier rides. The vibration from rougher trails can loosen headsets, so be sure to check your fittings.
- Expect the best, but prepare for the worst. In addition to extra water and food, carry a windbreaker, a wide-brimmed hat, sunscreen, sunglasses, a patch kit, tools and matches. Avoid riding alone, and always tell someone where you’re going. The desert is unforgiving and should never be underestimated.
- Road cyclists must adhere to traffic regulations and should use caution along heavily trafficked roads, especially during the busy summer season. On Zion Canyon’s Scenic Drive, cyclists must pull over and allow park shuttle buses to pass.
- Although not required by Utah law, always wear a helmet as well as bright colors to improve your visibility to drivers. Emergency roadside assistance for cyclists is offered by the Better World Club (www.betterworldclub.com).
In the Parks
- Hiking into a desert means taking extra precautions to make sure you return safely. This is true whether you plan to be gone an hour or a week. The desert has a way of compounding simple errors in judgment very quickly, and consequences range from unpleasant to grave.
- Always tell somebody in advance where you are going and when you expect to be back.
- If you do run into trouble, don't panic – sit down (if possible) and regain your cool before making any important decisions.
- One little-talked-about risk facing hikers is their own enthusiasm. Respect your limits. Remember that even in the middle of a national park, you’re in a remote, wild place. Don’t act foolishly by tackling a trail that’s above your skill level. Twisting an ankle or breaking a leg is surprisingly easy.
- Depending on where you are when you’re injured, it could take several hours or even days before a SAR team can find you and get you to a hospital. Needless to say, if no one knows where you are, or what time to expect you back, they won’t even come looking.
- Beware of flash floods! Rain falling 50 miles away can cause a flash flood that can wipe you out. Watch the weather carefully, and in emergency, move to higher ground.
Rescue & Evacuation
Hikers must take responsibility for their own safety and plan to prevent emergency situations. That said, even the most safety-conscious hiker may have a serious accident requiring urgent medical attention. In case of accidents, self-rescue should be your first consideration, as search-and-rescue operations are very expensive and require emergency personnel to risk their own safety.
If a person in your group is injured or ill and can’t move, 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 (eg an orange tent, a large cross made of white stones laid out on the ground).
You can drink tap water in Utah. All the national parks have potable tap water. In some areas, the water may not taste great, in which case consider getting an extra large five-gallon bottle for the campsite.