First Aid Kits for Wilderness Hiking and Backpacking

The best first aid kit is one you know how to use.  It is important to understand its contents and which items can have multiple uses. It is also important recognize your first aid kit’s limitations and thus learn how to use your environment to provide emergency resources. For example, I do not carry a Sam Splint on backpacking trips because I know there are many ways to improvise immobilizing a joint using resources from the environment (i.e. trees and branches)  

I highly recommend taking a Wilderness First Aid (WFA) course.  WFA skills are important to anyone tackling local trails or planning multi-day backpacking adventures in the High Peaks. WFA will teach you the essential skills for remote first aid, help you understand decision points for care when an ambulance or ranger is several hours or days away and how to use materials in your environment to administer critical care.

Image Source: Global Emergency Medics (GEM)

Every first aid kit should have a base set of items to address basic first aid which includes wound care, medication and various “tools”. We will classify these items as Essential. Vertical Aid by Seth C. Hawkins goes over 9 considerations when building a first aid kit:

  1. Medical Knowledge of Group
  2. Size of Group 
  3. Climbing Environment
  4. Destination and Diseases/Illnesses Common to the Region
  5. Medical History of Group Members
  6. Duration of Trip
  7. Distance from Definitive Medical Care and Availability of Rescue Assets
  8. Availability of Communications
  9. Space and Weight Considerations

The quantity of Essential items is dependent on all the above factors. Including the Recommended first aid items in your kit may depend on one or more of the considerations above.

Vertical Aid recommends using the PAWS acronym as a helpful guideline for organizing the creation of your first aid kit:

  • Prevention/Procedures
  • Analgesics/Antibiotics/Anaphylaxis
  • Wound Care
  • Survival

Pre-made vs. Custom-made

There are many very good pre-made kits on the market. I recommend looking at the Adventure Medical Kit (AMK) line. They have a wide range of kits for different group sizes, lengths of trips and activities.  For example, I carry the AMK Ultralight/Watertight .5 on local day hikes and a larger kit for multi-day backpacking trips.

AMK are a very good, inexpensive way to jump start your first aid kit. The AMK Ultralight/Watertight .9 is rated for 1-4 people, 1-4 days and contains many of the Essential items we will review in this article. When you try to build your own kit, you often have to buy large quantities of some items, enough to fill several kits.

Although the pre-made first aid kits are very good, you will still want to add (or remove) trip and group specific items.  The pre-made kit may contain items you will not need for your climate or time of year.  It will most certainly not contain all of the quantities of each items needed for a group.  For example, groups with kids will need more bandaids than groups with only adults. Conversely, the adults in the group may need more supplies of Ibuprofen and diarrhea medications.

My recommendation is start with an Adventure Medical Kit.  They are the best “bang for your buck”.  I suggest starting with the AMK Ultralight/Watertight .9 First Aid Kit or AMK Mountain Series Weekender First Aid Kit.  One of the added features of the Mountain Series over the Ultralight is the included Wilderness and Travel Medicine Guide Book.   It is good resource to have in the backcountry when you cannot Google treatments and symptoms. The trade off with the Mountain Series is that its case is not waterproof, like the Ultralight’s.

The NOLS Wilderness Medicine handbook says:

There is no such thing as the perfect first aid kit, so you should consider your needs and build a kit that meets them.

Below is an extensive list of first aid items for wilderness travel compiled from a number of different sources including NOLS, REI, NPS, Alpine Institute, ARC, and Vertical Aid. Many lists are just that lists. I wanted to create a comprehensive list AND give some explanation on the uses of each item.

Essential Items

PREVENTION/PROCEDURES

ItemPossible Uses
Small Trauma ScissorsFor cutting  clothes, tape, dressings, forming moleskin, etc.
Medical GlovesBody Substance Isolation (BSI) – keep yourself safe!
TweezersRemove wood slivers, ticks.
Nail ClippersThere is a whole article on Outside about it.
Electrolyte TabletsReplenish lost electrolytes, for dehydration. NUUN tablets are are my favorite.
Aquatab water purification tabletsPurify water when other methods have failed or are unavailable.
Medical TapeAlmost as good as Duct Tape, suitable for wound care.
SPF 15 lip balmChapped lips suck! Can be used to start a fire.
SPF 30+ sunscreen (PABA-free)Packets are good for a backup to your primary bottle.
Duct TapeMacGuyver could make a stealth bomber with it and he didn’t have Gorilla Tape, can be used it to fix tents/shoes/etc, seal wounds, pad blisters, immobilize a broken bone, etc,  etc, etc…
Small notepadwaterproof penKeep track of important primary and secondary assessment data.
Hand sanitizerClean hands on the trail is a luxury, it is a good idea to sanitize your hands before and after care.
Irrigation SyringeCleaning out deep wounds without touching the wounded area, flush out an eye.
Oral ThermometerMonitor temp changes in patient, changes can be symptomatic of multiple conditions.
Insect RepellentMosquitoes suck!
VasalineChapped lips and other parts, fire starter, burns and minor scrapes.

ANALGESICS/ANTIBIOTICS/ANAPHYLAXIS

ItemPossible Uses
Ibuprofen (Advil)For inflammation, muscle strains, minor pain and cramps.
Acetaminophen (Tylenol)For pain relief, fever reduction.
AspirinFor response to heart attacks, chewing has been shown to have the fastest results.
Diphenhydramine (Benadryl)For minor allergic reactions.
Loperamide (Imodium)For diarrhea, explosive diarrhea is not fun in the wilderness.
Antacid (Tums)For upset stomach.
Glucose TabletsGood to have for low blood sugar and diabetic hikers.
Insect Sting ReliefSee Insect Repellent, bees suck too!
Tincture of BenzoinMagical serum that protects the skin and allows adhesives to to adhere better, even wet.
Burn Gel (Aloe Vera)For sunburns and minor burns
Throat LozengesAs DJ Kool said “Let me clear my throat.”
Cortisone CreamHelp with itching from poison ivy, rash or allergy
Gold Bond PowderCurb moisture, control odor, and soothe minor skin irritations, notably jock itch

WOUND CARE

ItemPossible Uses
Hemostatic GauzeStop bleeding on large wounds, has agents that assist in clotting.
MoleskinReduce friction for blister care, finger cuff.
New-SkinLiquid bandage for cuts and blisters.
Bandages (assorted sizes)General small wound care.
Knuckle bandagesShaped especially for fingers and knuckles.
Butterfly Skin Closures (Steri-strip)For closing up deep wounds, especially when junior slips with the pocket knife
Trauma padHighly absorbent dressing for deep, bleeding wounds. A maxi pad is a good substitute.
Steripads (2×2 and 4×4)Non-stick, used for dressing wounds or burns where other fabrics might stick.
Roller Guaze (2in x 5y)For holding gauze pads in place, securing splints and improvising slings.
Coban Wrap (Self adhesive wrap)Adheres to itself, but not other surfaces. Can be used like gauze, but will stay in place better on moving parts.
Sterile alcohol prep pad or Antiseptic towelettesClean wound and surrounding surface, clean your hands.
Antibacterial ointmentPrevent and fight infections in wounds, promote healing.
Triangular Bandage (cravats)Many uses, common are a sling or tourniquet.
Sam SplintWaterproof, reusable splint for immobilizing bones, can be used as a neck collar to immobilize the head on suspected spinal injuries.
Safety PinsSecuring bandages or splints to base layers, removal of wood splinters.
Elastic Bandage (ACE)For sprains or securing a splint.
Cotton SwabsClean laceration or eyes.
Eye Wash SolutionFlush eye irritants.
Tegaderm Transparent Film DressingProvides a moist healing environment while allowing wound to breathe. Good for road-rash type injuries, can be improvised for a sucking chest wound.

SURVIVAL 

ItemPossible Uses
Lighter Start a fire, sterilize needles.
Emergency whistleSignal rescuers.
6 mm cord (2 m long) (750 paracord)Lots of uses for cordage. Suggest looking at Dyneema based cord (1/8” has a breaking strength of 2,500lbs)
Survival blanket (84˝ x 52˝)Ground cloth, blanket for warmth, improvised shelter.
Signal MirrorStart a fire, signal rescuers

Recommended Items

ItemPossible Uses
CPR Mask, if training in CPRBody Substance Isolation (BSI) – keep yourself safe!
First Aid ManualKnowledge is power, there is no Google in the backcountry. NOLS Pocket Guide or NOLS Wilderness Medicine Field Guide are good choices.
Chemical hand warmerTreat or prevent hypothermia and frostbite during cold weather seasons.
Personal Locator BeaconSend distress signal and GPS location to rescuers. There are many options, see this article.
Tenacious TapeGreat to repair gear and tents.
Dyneema RopeLightweight and super strong compared to Paracord.
Figure-8 rappel deviceCan be used to lower or hoist patient from a cliff or ravine.
CarabinersMany uses, can be used to create mechanical advantages or secure a patient.
Sewing kitA needle and thread take up no space and can be very useful.
BandanaYou will look like a rock star, can be used to dress wounds, apply cold compress, improvised sling, etc, etc, etc.
Prescription MedicationsNeed is based on the group’s medical conditions.
Injectable epinephrine (Epi-pen)Need is based on the group’s allergies, Epi-pens have more medicine than a single injection, see Retrieval of Additional Epinephrine From Auto-Injectors.
Medical waste bagKeep group safe from used dressings and materials.
Emergency Bivvy sackA lightweight, must have items for 3-seasons of the year.

References

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