June 2026

Safety first! That short phrase has been a mantra in outdoor adventure and education for as long as I can remember. In wilderness medicine, safety is also, and obviously, a top priority. 

It’s counterintuitive, but the first person you need to protect is yourself, along with other members of your team. Rushing into a scene without first assessing potential hazards can quickly turn one victim into two or three or more.

As part of our emergency medical service (EMS) training here at The National Center for Outdoor & Adventure Education (NCOAE), we are taught to perform a scene size-up before treating ill or injured parties in any situation. We check for hazards, try to determine the mechanism of injury (MOI) or nature of illness (NOI), count patients, and determine whether additional equipment or resources are needed. An example? Grabbing up a cervical collar and stretcher for spinal motion restriction (SMR). 

See our previous post “The Role of Assessment in Wilderness Medicine” for additional details.

One component of the scene size-up that’s often overlooked is the safety check. We’re all taught to check a scene for safety, but few of us perform a thorough one. Even fewer perform a secondary safety check to verify that the scene is still safe after we (more…)