Building a Wilderness First Aid Kit

Walking through the first aid aisle at your local outfitter store can be overwhelming. While there are many excellent prepared kits on the market, often enthusiasts choose to create and specialize their own.  Your kit will be different based on where you are camping and hiking. Trips at altitude, near marine environments or canyoning, and desert trekking each have unique needs that would require you augment your kit accordingly.

Below is a “basic kit list,” to which you can add on as your number of adventurers, length of trip, level of training, or destination dictate. An asterisk marks items that you might include for your week-long trip. For your overnight, you can feel comfortable paring down the quantities.

Personal Protection:

  • Gloves (Nitrile) – Vinyl is too porous, and latex is a common allergen.  Bring a few more pair than you think you need. You use one pair of gloves each time you clean a wound, and gloves aren’t designed to be re-used. If your gloves have been in your kit for a long time, check them to make sure they didn’t degrade in heat or cold. Have these easily accessible so that you are inclined to use them when needed.
  • CPR mask and airway management- you can get a quality mask with a filter for around $12. “Keychain” masks are better than nothing, but have a short life span when put to use. If you have been trained to use airway adjuncts, include some—they are a little bit of weight for a lot of good.
  • Wound care (probably the most common supplies I use on trips):
  • 1” athletic tape- one roll per person per week for hiking/skiing/climbing trips (really). It’s good for blister prevention, blister covering, ankle taping, and much more.
  • Gauze/ dressings (4-6) – different sizes and a few nonadherent (great for burns or abrasions).
  • Adhesive bandages (8)- various styles.
  • Roller gauze or vet wrap (2)- something to keep the gauze next to the wound that won’t cut off circulation. Vet wrap lasts longer than roller gauze.
  • Waterproof/ breathable (occlusive) wound dressings (2-3)*- an invaluable addition to wound care if you will be out for a few days. On a clean wound, this can create an environment conducive to healing that lasts a couple days. These are generally 2” x 3” or larger.
  • Tweezers- invest in a good pair (sharp and pointy), which will only cost a couple dollars more than a cheap pair.
  • Small magnifier- for wound cleaning. Be sure you have a reliably bright light source for wound exploration.
  • Wound cleaning*- a 60cc syringe (check the local feed store) with an irrigation tip is cheap and lightweight and gives better pressure than anything we could improvise.
  • Trauma shears (1)- there are some cool tiny ones (4”) on the market that only cost a few dollars and work great.
  • Blister care- Moleskin, foam, gel pads, or whatever your flavor. Duct tape should not be used on open blisters.

 

Musculoskeletal injuries:

  • Compression wrap(s)- 3” works great for supporting ankles or knees.
  •  Aluminum foam splint (1)
  • Triangular bandages (2)- these are multi-functional.

 

Over the counter medications:

  • Pain management- ibuprofen and acetaminophen work in different ways. Bring what you prefer, and pack a few grains of rice if you have bottles of tablets. It keeps the tablets from becoming a paste in moist conditions.
  • Gastrointestinal meds*- antacids such as calcium carbonate, anti-diarrheal such as loperamide, or whatever works for you.
  • Antihistamines- diphenhydramine for allergic reactions. Epinephrine injectors are prescription only and should be carried by those who require them.
  • Topical antibiotic cream*- good for small, shallow wounds. No need to get a huge tube, and beware of antibiotic allergies among your group.

 

Random other things and debatable items:

  • Your Field Guide of Wilderness & Rescue Medicine
  • Timepiece
  • Extra waterproof zip bags- these can be packaged with your SOAP note, pencil, and local emergency numbers.
  • Stethoscope*- If you are comfortable listening to lung sounds, I would recommend this for aquatic or altitude trips.
  • Oral glucose gel*- If you have honey in your camp kitchen, it will suffice. Many coffee shops have honey packets available as condiments- perhaps pick up a few with your purchase.
  • Temporary dental filling*- maybe not for a week-long trip, but it’s small, cheap, easy to find in the store, and can turn a trip around to the good easily.
  • Antifungal cream*- miconazole or clotrimazole would be good for a longer trip.

 

Comfort care to be carried by individuals, depending on the environment:

  • Aloe*
  • Throat lozenges*
  • Lip balm
  • Sunscreen
  • Insect repellant
  • Contact care
  • Personal medications- asthma inhalers, etc.

 

Much of this can be bought at local pharmacies, “feed and seed” stores, grocery stores, or through online retailers.

Pick your vessel. You might be inclined to choose a zippered nylon clamshell with organizer pouches or see-through dividers. Or, if you are an ultralight hiker, you may choose waterproof zip-top bags. For paddling trips, dry bags or dry cases may be preferred if you can keep the inside dry (but I wouldn’t want to haul a dry box on a mountaineering trip!) Regardless of your outside package, it is worth the extra few minutes to compartmentalize your contents by thought- something that makes sense to you, like: big wounds; little wounds and blisters; common pills (like ibuprofen); uncommon pills (like GI meds); etc. I use a vacuum sealer when I am more worried about water seepage or risk management (this makes it inevitable to see if something’s been used, and then program managers know to seek out an incident report or replace stock).

Have a great trip!

*This assumes your survival gear (the rest of the ten essentials) is packaged elsewhere.

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14 Responses to “Building a Wilderness First Aid Kit”

  1. Jeff

    Great post! I always forget about bringing along temporary dental fill.

    Also, would you recommend Betadine swabs to help clean wounds after irrigating them with clean water?

  2. Edward Malveaux

    I like your list. Usually if I am going out for more than a night with a group, I pack 2 kits: a small trauma kit (shears, kling, tampons, large sterile gauze pads, 2-small bottles of saline, super glue)secured to the outside of my pack, where everyone in the group knows where it is; a larger kit inside the pack with everything else. I group it like that for time, not convenience-if I need the trauma kit, I need it now. Everything else can wait, at least a little while.

    traveller

  3. Julie

    Hi Jeff,
    I don’t think you need the Betadine swabs if you’ve used drinking quality water. Remember that full strength povidone iodine (packaged as 10%) is often so strong that it can also damage healthy tissue, so it can be counterproductive to wound healing. Thanks for your comment!
    Julie

  4. Chet

    Just finished the SOLO WFA course this weekend…. The instructor recommended the povidone iodine swabs for cleaning wounds like this: put one swab in 1 liter of drinking quality water, shake it up, use that in your syringe for wound irrigation. You’ve got a weak solution safe for flesh but not for bacteria

  5. John

    I always carry quick clot or equilivant. Have some in each car as well.

  6. Rob D-Ray, NP

    Great Post Julie! Taking a Venture Crew to the Keys and this is the kind of list I needed to share with the advisors. Right on with the povidone iodine! Povidone only kills the germs when it is dry. Soap and water for minor wounds works just fine.

  7. Admin

    Thank you, Rob. Have an enjoyable and safe trip. Drop us a note when you return, especially if you have some interesting observations.

  8. Admin

    Anecdotes to the contrary, there is no good evidence that these products perform any better than well-aimed direct pressure. Gauze and a properly applied pressure bandage should suffice for most bleeding, at a fraction of the cost.

  9. Admin

    I would refer you back to Julie’s reply from 2012/09/13 and our protocols (http://www.wildmed.com/pdf/WMA-Field-Protocols.pdf).

    First, if you have sufficient drinking quality water, there usually is no need to add anything else to it for wound cleansing. If you have a notably contaminated wound and you are concerned that you have not been able to adequately irrigate it clean, we recommend a 1% povidone iodine (PI) solution (1 part PI to 9 parts water). I don’t believe that one PI swab in a liter of water will come anywhere close to that concentration.

    The literature on this topic is not great. In the few prospective clincial trials reported, it has been shown that 1% PI is no worse, and in some instances better, at preventing infections in simple wounds. There is no good clinical evidence that I am aware of that 1% PI is harmful. 10% PI may be problematic; PI scrub (a soap) is.

    This is a good example of a risk/benefit issue: a highly contaminated wound and delay to definitive care. 1% PI is possibly helpful (prevent an infection) and unlikely to be harmful (increased risk of infection; harm to viable tissue).

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