How to build a hiker’s first aid kit

Do you hike with a first aid kit? And if you carry one, have you taken inventory of it lately?

A first aid kit is one of the Ten Essentials you should always take on a hike, and it’s especially important on an overnight backpacking trip. Some of the stuff inside you’ll use fairly regularly and should replace often (moleskin for blisters, bandages, aspirin), while others are rarely used but may be critical in an emergency. Each person’s kit should vary depending on the medical conditions of the hikers in the party, the length and duration of the trip and the area you’ll be hiking into.

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A bright red first aid kit is being unzipped on trail with a mossy log and green leaves in the background. A well-loved container of Neosporin and other assorted contents are poking out. Photo by Erika Haugen-Goodman.

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You can purchase prepackaged kits, like those from Adventure Medical Kits, but you may need to supplement these kits with additional equipment, like any prescription medications you’re taking and medications for conditions specific to the hikers in your group (epinephrine pen for those allergic to bee stings, for example).

Organize and waterproof your kit with small resealable bags and plastic bottles. Label medications. You can also include other commonly used items in your first aid kit: lip balm, sunscreen, insect repellent, multi-use tool, and a small roll of duct tape (which is extremely handy for any and all repairs).

Supply checklist

This checklist is by no means comprehensive, but an overnight first aid kit could include the following items:

• Bandages: Assorted sizes for small cuts, blisters, etc.
• 4-inch closure strips or butterfly closures: For closing large wounds. 4-inch strips are more effective than butterfly.
• 4 inch by 4 inch sterile dressing pads (5 to 10): To apply pressure to a wound and stop bleeding
• Non-adherent sterile dressing (2 inch by 2 inch): Use these or Second Skin to cover blisters, burns or lacerations.
• Gauze roll: Holds dressing in place.
• Small roll of 1-inch adhesive tape: Holds dressings in place.
• Multi-use tool or knife: Should include knife, scissors. A scalpel and blade are also useful for first aid.
• Forceps or tweezers: For removing splinters, ticks, and removing debris from wounds.
• Scissors: Trauma scissors, which have a blunt end to protect the patient, can be used for cutting away clothing from injury, cutting medical tape, etc.
• Thermometer: Digital is generally more accurate, but batteries do wear out.
• Malleable splint: Lightweight foam-covered aluminum, such as a SAM splint.
• Irrigation syringe (35 cc): Used to flush and clean wounds.
• Suction syringe (65 cc): Used to clear mouth of fluids when giving CPR.
• Safety pins: Can help remove splinters, fasten arm sling, or make a hole in a plastic bag for improvised wound irrigation.
• Cotton-tip swabs: For removing foreign objects from eye, or applying antibiotic ointment.
• Resealable plastic bags: Many uses, including icing a swollen joint or creating wound irrigation device.
• ACE, Coban or other rubberized bandage: Can be used as outer wrap on splints, wound dressings or support for joint injuries. Be careful not to wrap too tightly.
• Antiseptic towelettes: For cleaning small wounds.
• Cleansing pads with lidocaine: For cleaning. Includes a topical anesthetic for abrasions, stings, etc.
• Topical antibiotic ointment: For application to wounds. Simple Vaseline can also be used in dressing a wound.
• Moleskin: Prevents blisters. Cut and apply a section to your foot as soon as you discover a “hot spot.” Duct tape also works for this purpose.
• Povidone Iodine USP 10 percent, 1 oz.: For preventing infection. Bottled PVD iodine 10 percent solution should be diluted to a ratio of 1 percent or less for flushing wounds.
• Aloe vera gel: Found in packets or small bottles for relief of minor burns.
• Pain relievers, including aspirin and Ibuprofen: Provides relief for minor aches and pains, reduces fever, helps reduce inflammation of sprains and other injuries.
• Antihistamines: For relief of pollen allergies, or to reduce reaction to bites and stings.
• Immodium 2 mg capsules or tablets: For relief of diarrhea from intestinal infections.
• Pepto Bismol or antiacid tablets: For relief from general diarrhea, abdominal upset.
• After Bite or hydrocortisone cream USP 1 percent: Relieves skin irritation from bites, poison oak, stings, or allergic reactions.
• Latex or nitrile gloves: Protects against blood-borne diseases and infection.
• CPR microshield mask: A compact flexible barrier with a one-way valve for rescue breathing, which protects user from blood, vomit or saliva.
• Oral rehydration salts: Packet of electrolyte salts and glucose for treatment of dehydration, heat exhaustion, or loss of fluids from vomiting or diarrhea.
• Space bag/blanket: Lightweight emergency shelter. For treating hypothermia victims.
• Paper and pencil: For recording medical data such as body temperature, pulse, time and date of symptoms, injuries, medicines administered, etc. Most repackaged kits include accident report forms.
• Wilderness First Aid booklet: Many prepackaged first aid kits contain one. An excellent pocket guide is the Wilderness Medical Handbook by Paul Nicolazzo, available for $20 from Wilderness Medical Training Center, www.wildmedcenter.com or (509) 996-2502.

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Some of the items above are not commonly found in standard first aid kits (including forceps, CPR masks, trauma scissors, and suction syringes) but can be purchased online from Wilderness Medicine Training Center.

In addition to a fleshed-out first aid kit, taking a Wilderness First Aid course is a great idea for folks who hike often. Wilderness Medicine Training Center and the National Outdoor Leadership School both offer two- and three-day Wilderness First Aid courses. Local groups like The Mountaineers and the Washington Alpine Club offer more advanced Mountaineering First Aid courses.

This article was written by Andrew Engelson. It first appeared in Washington Trails magazine.

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