There is no such thing as the perfect first aid kit. There are too many variables to consider, too many things that can or can not happen. The best first aid kits are those that are tailored and thought through before each outing. There are three major things to consider when building or buying a first aid kit: the activity, the environment, and the group.

1. Activity
Consider the activity and the most likely injuries and emergencies related to that activity. Maybe you include more blister care items for hiking, and more trauma material for mountain biking. You also wouldn’t carry heavy cold packs on your winter cross country ski trip. But you would want to have handwarmers or thermal blankets.

The duration of the activity is another consideration. You do not want to carry less or more than you need.

Take these two very different examples:  
Kerr is a mountain guide. His activity of mountaineering will increase the likelihood of high altitude and cold related illness. His next trip is 21-days long. Kerr will add to his kit the medications used to combat the high altitude illnesses and he will have enough supplies to get him through his long trek.

Will is a backpacking trip leader. His trips are usually 2-3 days in length. His kit includes items that will help with blister care and sprains. He does not need to an entire bottle of ibuprofen, a few individually packaged doses should be enough for his trip.

2. Environment
Next is environment. This includes climate, terrain threats and obstacles, the accessibility to medical care in relation to the location you will be in, and the resources available. Resources may be helicopters, ambulance, personnel, clinics, communication devices, shelters, etc.  

Again, our two examples: 

Kerr plans to climb a 25,000ft mountain in Pakistan. The climate will be extremely cold, the terrain encountered will be steep slopes and cliffs of falling ice, snow, and rock. Medical rescue or access to medical care is unlikely or multiple days away. The available resources are limited to what he will have in his pack. 

Will he is planning a two day trip in Yellowstone National Park. The climate is warm with occasional thunderstorms. The terrain is relatively flat with areas of grass and mud. Medical rescue or access to medical care is easily reached by cell phone or within a few hours of walking. The available resources are plenty and may include an ambulance, helicopter, and nearby clinic.  ​

3. Group
And finally, the group you are adventuring with must be considered when planning your first aid kit. Here we need to look at: group size, the people themselves and their individual needs or issues, their age and experience. 

Kerr is climbing with a team of 5 healthy and fit people, ages 25-35 years old. They are all very experienced in mountaineering, but one member suffers from headaches when he reaches a certain elevation. Kerr is sure to have extra headache medication in his kit. 

Will, however, is backpacking with a group of 20 first time backpackers. The youngest of the group is 75 years old. While most are healthy enough to hike, many have medical issues such as diabetes, high blood pressure, and coronary artery disease. Eighteen members of the group take aspirin daily and one member is severely allergic to multiple foods. Will carries a bottle of aspirin, extra benadryl, an epi pen...and maybe some denture adhesive... 

Good luck to both Kerr and Will. It seems like each them of have considered their activity, environment, and group and have adequately prepared their wilderness first aid kits. Keeping an inventory will make it easier to restock a kit. Focus on items that are multipurpose and lightweight. Do not carry anything that you do not know how to use or is above your level of training. For a jumpstart on which items to carry in your wilderness first aid kit, see this article: I am wilderness medic and this is what I carry in my wilderness first aid kit

The single, most useful and effective tool that should always be included with a wilderness first aid kit is your brain. Very few item in a wilderness first aid kit are truly life saving. The difference between life and death will often come down to your knowledge and preparation. If you want to learn more about how to be safe in the wilderness and how to handle any kind of emergency, take our online Outdoor Safety course. 

For only $35 bucks, you get lifetime access to the latest wilderness safety knowledge and the video lectures will show you all the skills needed for your next adventure. It also comes with free printouts for your wilderness first aid kit. Your knowledge may save the life of your partner.  

And if you are knowledge, like if you are a wilderness first aid, wilderness first responder, or WEMT, awesome! But do not let that knowledge get rusty. Medicine changes everyday. Stay certified. If you are having trouble finding a recert class in your area, you can recert here online: Recert Courses
 
Stay safe! ​

2. A large trash bag or 2 - Again multipurpose and compact. These can be used to help keep an injured person warm and dry, which is very important if they are in shock. Two can be cut open and taped or sewn together for a DIY tarp and shelter. They be used to dispose of waste, to collect water, as a diaper, and so on.
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3. Ibuprofen or Tylenol - From minor aches and pains to more significant pain or fever. I suggest buying the individual single dose packages. That way you do not have to carry a whole bottle, it will keep longer, and you have all the info about dosing on the package (very important to have).

4. Gauze Squares and Rolls - These can be used from minor cuts to large bleeds, for splint making, wound care and cleaning, splint padding, etc. I have even used gauze rolls to make an improvised mitten or beanie for my patients. I suggest individually packaged gauze to keep it as clean as possible. Two gauze rolls are suggested. And be sure to have at least 1 or 2 non-adherent  gauze squares. These do not stick to the skin, making them ideal for use directly against a wound or burn.  

5. Tape - Medical cloth tape is standard and is the same as climbing tape. You make a bandaid with a piece of tape and a small gauze square. You can tape an ankle, wrist, even a knee. It’s helpful in wound care, splint making, labeling things, so on. Duct tape is good too. I usually have duct tape wrapped around my water bottle and a small flat roll of med tape in my first aid kit. But if you are going to be in a very wet environment, then I suggest Coban Tape or some other similar self adhesive wrap. It doesn’t have glue that will break down with moisture contact.  

6. Syringe - For wound cleaning, especially if it’s a longer and remote outing. The most important aspect of wound care in the wilderness is irrigation with clean drinkable water and good pressure. At least 1000 ml. And, no, a plastic bag with a small hole is not as useful and is difficult to work with. A small irrigation syringe does not cost much and is lightweight. It’s worth it.

​7. A wire or SAM splint - I only bring this if I have nothing else in my pack that I can improvise a splint with. Or least nothing I would want to sacrifice to creating a splint ;) A wire splint is very lightweight and compact. But it can have sharp edges, so I use gauze and tape to pad it. A SAM splint (or C Splint), is basically a wire splint covered with foam padding. It’s bulky but still lightweight. I have used it to splint wrists and legs, and as an improvised c-collar for neck injuries. But I have also seen it used as a canoe paddle and on pets!  

8. Space Blanket - To be used with the trash bags to warm someone up. This helps reflect and retain the person’s body heat when used correctly. A space blanket should be large enough to fully wrap and enclose a person to lock in heat. Like a burrito! Then add the trash bag tarp and you have a very effective warming system, especially if it’s used over a sleeping bag and there’s ground insulation, like a sleeping pad. Very cozy. A space blanket can also be used as a signal too.

9. Gloves - Your safety first! Wear gloves, to protect yourself against blood borne pathogens and other germs that are in spit, vomit, blood, etc. It is also better for the patient because it’s cleaner. If it’s during the winter, pack gloves that are a size larger so you can wear your warm liner gloves underneath.  

10. Trauma Shears - (scissors) Really, I never go anywhere without these. When you need to stop or find a bleed fast, these are your best friend.  I don’t like to use a knife...that can cause more bleeding and does not work as well. Cut tape, gauze, splints, a section of a t-shirt or sleeping, etc. Shears can also be used for as a windlass for an improvised tourniquet.

Now, of course, these are my top 10 most useful items. This doesn’t mean I do not bring anything else. And it does not devalue other items. Again, it really depends on the activity, the trip length, the environment, and the group. On longer outings I may bring a wound care and cleaning kit bundle (#12), or a blister care kit bundle (#11). If it’s a climbing trip I may pack more trauma supplies. If it’s trail running, I strip the kit down to the bare essentials. To learn more about the three aspects to consider when building a custom wilderness first aid kit, see this article: 3 things to consider when customizing a wilderness first aid kit. 

Besides these 10 items, there is one other wilderness first aid kit component that is the most useful of them all. And it’s the most lightweight and compact. It will make the difference between life and death in most emergencies. But it can be applied to minor injuries as well. 

What I am talking about? I am talking about your brain! Knowledge is the foundation of safety. Without it, you are not truly prepared for a wilderness emergency. If you want to learn more about how to be safe in the wilderness and how to handle any kind of emergency, take our online Outdoor Safety course. 

For only $35 bucks, you get lifetime access to the latest wilderness safety knowledge and the video lectures will show you all the skills needed for your next adventure. It also comes with free printouts for your wilderness first aid kit. Your knowledge may save the life of your partner.  

And if you are knowledgable, like if you are a wilderness first aid, wilderness first responder, or WEMT, awesome! But do not let that knowledge get rusty. Medicine changes everyday. Stay certified. If you are having trouble finding a recert class in your area, you can recert here online: Recert Courses

Stay safe!  
Teal Brooks. Wilderness Paramedic


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Assessing circulation, sensation, and movement gives us information about the extent of damage and seriousness of that damage. Lack of circulating blood will lead to tissue death or the eventual loss of limb. Lack of sensation and movement at the site of injury or below indicates nerve damage.

To assess circulation:

• Feel for a pulse below the injury site. No pulse is a very bad sign and means there is no circulation of blood in that limb.
• Assess skin: pink, warm skin is a positive sign of good circulation. Pale, blue, purple, or black skin, and swollen areas are a sign of poor circulation

To assess for sensation and movement:

• Gently pinch fingers or toes below injury and ask the person if they can feel it. If they can not feel the pinching or touching, then this is a sign that there is possible nerve damage
• Ask the person to slightly move or wiggle their toes or fingers. If they can not, be sure to determine if it because of pain or because they really can not move those digits.
• Ask the person if they feel any numbness or tingling sensations in the areas of the injury or below. If so, this is another sign of possible nerve or circulation damage. This may not develop until much later.

 
Check CMS before and after splinting or wound care, and periodically afterwards.