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What Should Be In A Wilderness First Aid Kit?

As a Wilderness First Aid instructor and guide, the most common question I get is, “What do you carry in your first aid kit?” My answer is always the same: “it depends.” It’s no surprise that people seek clarity around this topic more than any other in class. During a Wilderness First Aid course, folks get introduced to a variety of skills, tools, and information that help prepare them for responding to medical emergencies in remote environments. So when you put together a first aid kit, it can feel like you’re supposed to load up a full backpack of medical supplies if you want to be prepared—which understandably feels daunting and unreasonable. In order to simplify the process, I’ve put together a list of tips and guidelines to follow when you’re thinking about what to bring in your first aid kit.


If it’s your first time, buy the kit.


Don’t make life hard on yourself by trying to re-invent the wheel. Go online and buy a pre-made kit to start with. Or if you are old school, go to an actual store and check out the different options in person! In a store, you can get a better idea of the kit’s weight and bulk as well. In the next few tips, we will talk about how to make adjustments, but a premade kit is a good starting point when you’re planning your trip. There are some great options out there for a variety of different adventures—from one-day lightweight kits to heavy duty full-on expedition style kits with all the bells and whistles. One of the brands I recommend to my students is Adventure Medical Kits.


Open the kit before you need it.


I once worked for a prominent outdoor education organization that sent First Aid kits into the field sealed with zip ties. Obviously, I was a little confused about this and when I inquired, the answer came back that it was easier to account for medical supplies if they were certain that a first aid kit had either been opened or unopened. This sounded to me like creating a field problem to solve an office problem. So every time I got a kit, I cut the zip tie and cracked it open to physically see what was in there and decide if I wanted anything else. Apologies to the office staff that had to re-inventory, but you don’t want to be looking at the contents of your first aid kit for the first time in an emergency. I tell people to familiarize and refamiliarize yourself with the contents of your kit every time you go out. You will be a much more effective first aid provider if you know exactly what’s in there and where everything is when you need it.


Make changes to your Wilderness First Aid kit.


A first kid kit for the backcountry should be dynamic. You want to adapt to the environment that you’ll be in and plan for the most likely emergencies. As the old saying goes, “if you hear hooves, think horses not zebras.” Unless of course you are planning a trip to Africa, then you can think zebras. But that’s the point! Use critical thinking when adding or removing things from your kit. Don’t waste a bunch of weight and space planning for the most catastrophic, least-likely type of injury. Think about what you will be doing and what type of supplies are appropriate. If you are going to be on a glacier with a bunch of sharp objects like ice axes and crampons, bring some bleeding control and trauma supplies. If you are taking your 8-year-old on their first backpacking trip, stock up on the band-aids and blister care. Too often people use the “set it and forget it” approach to first aid kits when the best practice is to regularly modify your kit for each outing. Make a regular practice of going to your grocery store’s first aid section to supplement or restock supplies in kit that you have.


If you don’t know how to use it, don’t bring it!


You would think that this one is pretty obvious, but medical supplies have a way of hanging around in your kit even if you’re not quite sure or have forgotten how to use them. Remember that being prepared during a wilderness medical emergency is not about what you have, it’s about what you can do with what you have. Don’t waste weight on something you’re not sure about. But this rule cuts both ways! If you’re particularly adept at using something for multiple different treatments, then go out of your way to make sure you bring plenty of that item. I personally like to bring a lot of roller gauze with me in my kit because I can do all sorts of things with it, from severe bleeding control to splinting to routine wound care. Everyone eventually finds those tools that they love and can use to MacGyver just about anything. With experience, you will develop your own special list of “go-to” items that serve a wide range of purposes.


Think about items that are hard to improvise.


There’s nothing more fun than thinking up creative ways to improvise tools in the backcountry—you can use the foam pad in your backpack for a splint, a shirt or jacket for a sling, or a piece of fabric and a carabiner for a tourniquet (yikes!)—but it’s good to identify the items that are both important and hard to improvise. The things that come to mind are:

  • Gloves. Gloves are an imperative piece of equipment to protect yourself as well as anyone you might be responding to. I have yet to find a good substitute for gloves and trust me, zip lock bags don’t cut it. Gloves take up almost no room and go a long way. Make sure you load up on multiple pairs of gloves in your kit!
  • Irrigation syringe. Again, this is something that is just hard to mimic. Since wound care is often the treatment you’re most likely to administer out there, it is well worth it to have a syringe to thoroughly clean that wound and make sure you don’t have to deal with any infections.
  • Good pair of shears. Nothing drains your confidence in someone like watching them try and gnaw through a piece of tape or cloth or gauze, spitting and bunching up material while they needlessly jostle whatever wound their working on. You’ll save time and your pearly whites if you just bring along a nice pair of medical shears.
  • Writing utensil. When you’re responding to something in the backcountry, you’re going to be getting a lot of information and you’ll likely need to pass that info along. Even if it’s just a short pencil, having a writing utensil with you will help you organize your medical response by keeping track of whatever you find in your patient assessment.


Practice, practice, practice.


Admittedly, this is probably the hardest tip to keep up with, but it might be the most important. Like I mentioned previously, the supplies in your kit are only as good as you are at using them. Additionally, most of us spend our time in the backcountry having fun and avoiding using our first aid skills so it’s easy to get rusty or out of practice quickly. There’s no number of videos or amount of online research that can replace hands-on practice when it comes to first aid treatments. I recommend that every once in a while, (especially leading up to a trip) you should break out your medical supplies and practice those skills you learned in your Wilderness First Aid course. The more practice you have, the more useful that first aid kit will be whatever you decide to put in it!


The author Sean teaches Wilderness First Aid classes for CPR Seattle and has worked in the guiding and outdoor education industry for over 11 years.

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Published on February 5, 2021