First aid basics for your adventure in the wilderness

By Alisha McDarris February 14, 2019

A twisted ankle waiting to happen.

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Injuries on the trail are common, be they banalities like blisters or lacerations from overgrown foliage, or serious concerns like dislocated shoulders while rock-climbing or snake bites. Outdoor lovers know the wilderness comes with risk of bodily injury. But those who know best venture boldly into the wild prepared with a knowledge of what to do if harm should befall them.

There’s no guarantee that Google will be there to help when gashes, scrapes, or broken bones arise, and medical help isn’t always just a phone call or car ride away. The best medicine for any type of injury is preparedness, so it’s important to know what to keep in your pack for everything from a day hike to a month-long sojourn, plus how to treat common injuries and frequent misconceptions about wilderness first aid.

Your first aid kit need not be as big as this.

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First aid to pack for your next outdoor adventure

The length and remoteness of your trip—a well-worn day hike trail? unmarked wilderness?—will dictate what you should put in your pack. Climate, altitude, and destination will play a part, too, but chances are, you won’t need bottles of antiseptic and a full splint kit if you’ll only be gone a few hours and the trail is easily accessible from major roads. Likewise, you should bring more than a few adhesive bandages and aspirin if you’ll be away from civilization for a days or weeks.

Tod Schimelpfenig, Fellow of the Academy of Wilderness Medicine and curriculum director at the National Outdoor Leadership School (NOLS) Wilderness Medicine department, suggests starting with a small kit. Most of the time, the kind you can get at your local outdoor store will suffice. But if you prefer to build your own kit, he suggests packing a pair of nitrile or latex gloves, antiseptic ointment, bandages, gauze, larger dressings, an Ace wrap, tweezers to remove splinters, and a blister care kit.

For longer treks, the kit Schimelpfenig recommends is similar, but more robust. “Safety pins are always helpful,” Schimelpfenig adds. Transparent dressings come in handy, too and for blisters, nothing acts like a protective second skin like kinesthesiology tape. But his number one recommendation: consider what can go wrong and what access you’ll have to medical attention, cell service, or fellow hikers. “Prevention and planning can go a long way,” he says.

As for the bulky extras, while some find packing triangle bandages and splint kits bring peace of mind, Schimelpfenig prefers to improvise with items like handkerchiefs and tree branches, things he likely already has in his pack or can easily find on the trail.

Ace wrap comes in handy for pains, sprains, and strains that pop up on the trail.

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Common wilderness injuries

Seasoned hikers aren’t often worried about snake bites and bear attacks; they know these sorts of encounters are rare at best. But broken bones, sprains, dislocations, cuts, and scrapes can pose risks that are just as serious if left untreated. According to Schimelpfenig, “There are some fundamental skills that you can learn that will help take care of people and possibly save their lives.”

The most common injuries in the wilderness are cuts and lacerations. While you might just throw a bandage on it and call it a day when you slice your shin in your own backyard, don’t underestimate how easily a small wound can become infected and cause much larger problems.

“Keeping wounds clean is difficult in the wilderness,” Schimelpfenig says. To do so, first, stop the bleeding and evaluate the situation. Is it over a joint, does it gape open, is it showing underlying structures? If so, time to call it a day and get to a doctor. If it’s small and non life-threatening, irrigate the wound with water that’s safe to drink and thoroughly clean out any debris or foreign particles. Add antiseptic and dress it with the appropriate bandage. Change the dressing and check for infection (swelling, redness or pus) every 24-48 hours.

For other injuries and accidents, Schimelpfenig recommends taking a wilderness first aid course through NOLS or at a local outdoor center. Proper training will not only teach you how to wrap a twisted ankle, dress a wound, and immobilize broken bones, but also introduce life-saving skills like administering CPR, stopping excessive bleeding, and maintaining an open airway. They also instill confidence and resourcefulness, which are necessities in the backcountry, Schimelpfenig says.