If everything goes to plan on your outdoor adventures, you might not need a first-aid kit. But we all know that isn’t always the case. In most situations, a first-aid kit can easily make an outdoor experience more comfortable. And in some cases, that kit can save a life by stopping a bleed, keeping you warm, or calling for help.

Wilderness environments create special situations that you won’t usually encounter in an urban or suburban area. When you’re in a remote setting, you’ll likely have limited resources and longer response times for EMS during an emergency.

There’s no such thing as the perfect first aid kit, so you should consider your needs, including the length of your trip, the size of your group, and where you will be travelling, and then build a kit that meets your needs. You should never pack anything in a first aid kit that you don’t know how to use. It’s wise to go through each item and familiarize yourself with how to use each item before going into the wilderness. And consider taking a Wilderness First Aid course to learn even more about how to use first aid kit supplies to manage common outdoor injuries and illnesses.

My first aid kit changes all the time. If I’m on a day hike with friends it fits into a small first aid bag. If I’m teaching a river rescue course and moving around by kayak my kit is usually in a 10L drybag (not including my rescue gear). Whereas on a remote, week-long mountain expedition with a group of 15 people or more, I will carry a medium-sized responder bag with enough stock and a variety of emergency supplies.

There are things to consider and is a good reference as a starting point in creating your pack list, so use your judgment and add and remove items based on:

• where you’re going

• how long you’re going for

• the environmental conditions

• how many patients you might be treating

• how you’ll be carrying the kit

Though it’s not practical to list each item that should go in every type of medical kit, some general items are helpful to have. The acronym PAWS is an excellent way to remember the category of items to include in a first aid kit.

P - Prevention / Procedures

A - Analgesics / Antibacterials / Antiseptics

W - Wound care

S - Survival Prevention/Procedures

Prevention

These are items for the prevention of illness and potential problems:

• Water filter and water purification tablets

• Gloves

• Sunscreen/lip balm

• Sunglasses

• Blister prevention and treatment

• Insect repellant and barriers (netting / treated clothes)

Procedures

There are specific tools of your trade that may be used in a variety of situations:

• Wound care material: steri-strips, tape, gauze, Medi-honey, sutures, etc.

• Scissors

• Dental repair material: Cavit, eugenol, etc.

• Blood pressure cuff and stethoscope

• Flashlight/Torch

• Syringe

• Flexible splints

• Safety pins

• Needles

• Tweezers

Analgesics, Antibiotics, Anaphylaxis

There should be medicine available in each kit that covers pain and infection that could be encountered. You should know what diseases are common in the area you’re headed. As well, you should know the diseases and chronic conditions of the people travelling in your group.

Analgesics

Paracetamol belongs to a class of drugs that relieves pain and lowers fevers. It does not prevent the clotting of blood, so it is safe to use in head injuries.

Aspirin prevents blood from clotting, which promotes bleeding. Therefore, it should not be used in any kind of head injury. Aspirin, also known as acetylsalicylic acid (ASA), is a medication used to treat pain, fever, and inflammation.

Ibuprofen is used to relieve pain from various conditions such as headache, dental pain, menstrual cramps, muscle aches, or arthritis. It is also used to reduce fever and to relieve minor aches and pain due to the common cold or flu. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body's production of certain natural substances that cause inflammation. This effect helps to decrease swelling, pain, or fever.

Antibiotics

Select antibiotics that cover a broad spectrum of pathogens. Here are some common broadspectrum antibiotics to consider taking:

▪ Doxycycline: lung, skin, and tick/mosquito-borne infections

▪ Ciprofloxacin: HEENT, enteric, lung, skin, and urinary infections

▪ Amoxicillin /clavulanic acid: HEENT, lung, skin, enteric

▪ Azithromycin: HEENT, lung, skin, enteric organisms

Anaphylaxis

Anaphylaxis is one of the true medical emergencies that one may see in the wilderness. You should always be prepared to treat an anaphylactic patient.

• EpiPen®

• antihistamines

• salbutamol inhaler

• oral steroids

• Ranitidine

Wound Care

Regardless of the activity, abrasions and lacerations are among the most commonly experienced injuries. As a result, appropriate and adequate supplies for wound care is one essential part of a medical kit. Having each person on the trip bring their own necessary wound supplies will help to ensure that enough wound care supplies are available. Below are different treatment options for primary wound care:

• Gloves

• Alcohol swabs, antiseptic wipes

• Gauze

• Steri-strips, benzoin

• Tape

• Ace bandages

• Irrigation equipment

• Band-aids

• Antibiotic ointment, Medihoney

• Gauze wrap

• Cotton buds

Survival

The potential for the group members to be separated, and other worst-case scenarios need to be considered. Below is a list of items each group member should carry at all times.

• Map, compass, knife, fire starter, matches

• Communication equipment: satellite phones

• Space blanket

• Knives

You should also look through each topic in your Wilderness First Aid manual. For each medical problem, consider which items or medications you wouldn’t want to do without versus what can be improvised. Over time, you’ll get more comfortable making adjustments.

Taking that into consideration, the general wilderness first aid kits depend on 5 different expedition types:

• Small personal kit

• Group kit for outdoor day trips

• Expedition group kit

• Expedition group kit – when weight and space aren’t limited

• Search and rescue team kit or vehicle/large boat/base support kit

Before each trip, check the contents of your wilderness first aid kit. Restock any missing supplies and add necessary items unique to each person in your group. Use common sense with how much you should pack. When in doubt, it’s safest to lean on the side of excess. Over time, you’ll likely start to hone in on what you use most.

Just remember that even if you don’t use something often, the one time you do need it may be worth carrying it on all the other trips too.