Safety on the trails - essential tips from medic and elite mountain runner

'Don't let adventure turn into misadvanture' - words of wisdom from Dr David Haunschmidt, an elite athlete and emergency department medic at Wellington hospital.

Here, Dr David shares his safety advice on the trails - we recommend saving this information for easy reference: 

"The isolation and adventure of the trails and mountains are just two of the major drawcards to this sport, while also being major risks.

Regardless of whether you are new to trail and mountain running, or a seasoned veteran, it's essential to consider what can go wrong and how to navigate potentially tricky situations.

1. Prevention is always better than cure.
• Planning is Key:

Research the route, terrain and estimated timings. Read recent reviews of the route if available (e.g. Alltrails, TrailForks, Wikiloc, PlanMyWalk, Wildthings).

Take a good old fashioned paper map and compass, especially if going off trail. Phones run out of batteries.

If using a phone, download offline maps (NZtopomaps, Maps.me, AllTrails, Wikiloc), and take a powerbank.

Weather Check: Monitor forecasts, but don’t rely on them. Plan for the worst, conditions change very quickly in the mountains.

Challenge Check: Be realistic about your fitness level and choose a difficulty that matches your experience.

Safety Partner: Inform someone about your route, direction and expected return time, or use the tool on adventuresmart.nz. Run with a buddy, especially for longer or challenging trails.

Invest in a personal locator beacon or locator device for emergencies (there are also rental options at the Mountain Safety Council).

• Pack for the Unexpected:

Essential Gear: Layer up for changing weather (windproof jacket, warm layers, waterproofs), gloves, buff/hat, survival blanket.

If unsure, a mountain race’s gear requirements are a good guide.

Another great resource is to consult your local outdoor shop. You don’t have to be overladen, choose lightweight, multipurpose items and refine your kit over time in line with your experience.

Think about what you may need in possible scenarios:

What if you roll your ankle and are unable to run fast enough to generate heat?

What if this then turns into needing to spend the night in the wilderness?

This may mean carrying a bivibag to retain heat if there is a possibility you may be forced to stop on the mountain.

Nutrition and Hydration: Carry enough water and food to fuel your run, plus emergency rations.

Personal first-aid kit: Plasters, paracetamol, survival blanket. Build on race kit essentials with your own personal medical supplies, aspirin, antihistamine. If you have a serious medical condition or allergy, consider a medic-alert bracelet.

• Prehab for Performance:

Strengthen Ankles: Prevent sprains, the bane of trail runners, with targeted ankle exercises over time such as single leg and balance exercises. Adopt a strategy that will make yourself less likely to fall.

Cross-training: Reduce injury risk, build strength and flexibility through activities like swimming, cycling and running-specific strength-work.

• Upgrade your knowledge. Expertise on the outdoors should be something that you constantly develop. Taking courses or reading books on the subject can increase confidence and safety.

• Lose the ego. Be prepared to turn around. You will not be the first to let go of a goal because conditions or time were not on your side.
  
  “The people who stay alive are the ones who turn around five feet from the summit” (Jon Krakauer, Into Thin Air).
  
  This means being strict with timings, paying attention to changes in weather, acknowledging fatigue and conditions. You have to be willing to resist an attempt if the day is not right.

 When Things Go Wrong: What to Do in an Emergency

• Contact Help:

Phone signal: Call 111 immediately.

No signal: Activate your personal locator beacon, use a hut radio or notify a warden.

Satellite Phone: Slower communication but allows two-way calls.

GPS Emergency Alarms: Consider Apple phone emergency, Strava Beacon or Garmin Emergency Alarm. They only work if you have emergency signal and you have kept details up to date.

• Basic First Aid Principles:

Safety first: Always assess the scene for dangers to yourself and others before anything else. Remain calm, assess the situation, and decide on the safest course of action.

Some common problems you may encounter are as follows. These are a general guide only, and many of these you can do a much deeper dive into.

• Bleeding: Apply pressure, raise the limb, only use a tourniquet for heavy bleeding as a last resort. Once controlled, seek medical review.
  A tetanus booster may also be required.
• Twisted Ankle: Taping and ankle support can provide temporary help. Deploy rest, ice, elevation.
• Fractures: Immobilise the affected limb with splints and broad ties (avoid shoelaces).
  Open fractures, where bone is exposed, require a clean non-stick covering.
  Keep the patient warm and arrange for help.
  Remove jewellery items such as rings and bracelets to prevent them getting stuck with swelling.
• Hypothermia: Layers, windproof outerwear, replace wet clothing (avoid cotton), get off the ground if possible, use a survival blanket, shelter.
  Maintain hydration & nutrition.
  Recognise early symptoms of the condition (lack of coordination, confusion, slurred speech) and act quickly.
• Head injury. Stop, assess, take it easy. Head injury is a spectrum from very mild to life-threatening. Seek medical review if experiencing any symptoms at all, or if you take medications that thin your blood.
• Food poisoning. Replaces losses with equal amounts of fluid. Most will resolve within a few days. Ensure good hand hygiene so as not to spread to your family. If you have ingested mushrooms or foreign substances, seek medical review or the NZ Poisons Hotline.
• Sunburn: stay well hydrated, avoid more sun, moisturise.
• Heatstroke: frequent hydration, gentle cooling (fans, tepid water, take off layers, cold fluids). Seek urgent medical attention if any signs of confusion, vomiting, breathlessness or collapse occur.
• Animal Bites. Encourage bleeding initially and wash with clean water if able. A tetanus booster and course of preventative antibiotics are usually needed.
• Shoulder Dislocation: You can learn the Davos self-reduction technique, which works for some. Think of shrugging your shoulders as much as you can when performing. If successful, place arm in sling and seek medical review. If this does not work, hold against body or within a sling and seek medical help for reduction. 

• Dislocated kneecap (patella): Gently straighten the leg with pressure on the knee-cap back to its normal position. Seek medical attention.
• Fractured Clavicle: Broad arm sling (from emergency pack or improvised with a jumper) helps prevent further injury. Use painkillers.
• Frostbite: Thaw in warm water (not too hot, below 38 degrees Celsius) only when you return from your run and not before, due to the risk of re-freezing. Consult a medical professional.
• Burns: run under cold water for at least 20 minutes. Cover with cling-film/Glad wrap or burn dressing.
• Hypoglycemia: Treat with energy gels/sugar initially. It is very important to follow these with complex carbohydrates to prevent another drop (banana, sandwich, full meal). Stop activity and get off the trails.
• Bees/Stings: Remove stinger carefully by scraping sideways with a hard edge such as a credit card (don’t squeeze the end!). Antihistamine can help symptoms. Use an Epipen if airway / breathing / circulation become affected. Lay person down, raise legs. Emergency evacuation for severe reactions.
• Heart Attack. Symptoms include chest pain, arm and jaw pain, sweating, nausea, breathlessness. Sit patient down, give 300mg Aspirin. Get emergency help.
• Fainting: lay person down and raise legs.
• Unconscious: check for breathing. If breathing, place in recovery position, ensure open airway. Get emergency help. If not breathing, CPR is needed.

• Complete a first aid course. This is useful in all aspects of your life, not just on the trails. Providers in New Zealand include: Red Cross, St John, WorkSafe, or you can ask your work-place. There are also providers that run outdoor specific first aid courses such as FirstTraining, PeakSafety, TripleOneCare.

Don’t let any of this put you off. The trails and mountains are incredible places to experience some of the best days of your life. They do however demand respect and so it pays to be prepared and mitigate risks.

Dr David Haunschmidt. FACEM, DCH, PGCertCPU,

CurraNZ ambassador

Trail runner and coach with @trailathlete