What Outdoor Industry Pros Recommend You Keep in Your First-Aid Kit

Having a first aid kit handy is always a good idea, but what should it contain? The answer to this question really depends on what you plan to be doing. There are different considerations for a kit that you carry in your car versus one that you grab up for a mountain bike ride or take with you on an overnight or multi-day backcountry expedition. 

Of course, you could purchase pre-stocked first-aid kits for a variety of purposes. Retailers and companies like REI, Adventure Medical Kits, and even Amazon and Target all sell first aid kits that may be right for your purposes. These can be convenient, and many are vacuum sealed to save space. However, they can be expensive and may contain less useful items for your purposes.

Putting together your own first aid kit lets you decide how many and what kinds of things you want. It also gets you thinking about what you’ll have on hand should a backcountry emergency occur. 

Pro Tip: Make sure your backcountry first aid kit is waterproofed and check it regularly to make sure things haven’t been damaged or have expired. 

Here are some things to consider when creating your own backcountry first aid kit:

What injuries/situations are likely to occur?

• Are you making a first aid kit for your house or a white-water rafting trip? 
• Will there be children? 
• What about pets? 
• What will the weather be like? 
• Does anyone in the group have a known allergy or medical condition? Are you putting a kit together for your car in case of an unforeseen accident on the roadway?

How long will it take for help to get to me?

If you’re at home, emergency medical services (EMS) are most likely a phone call away.   However, if you’re hiking, mountaineering, rock climbing, or paddling in the remote wilderness, you will need to deal with things like general illnesses and extended wound care. If that is the case, you should consider taking a 2-Day Wilderness First Aid (WFA) course or 5-day Wilderness First Responder (WFR) course that will help you think about and plan for all of the contingencies you could encounter. Our WFA and WFR courses have a hybrid component, allowing you to complete a significant part of your training ahead of time through online study and testing, in combination with a practical on-site training.

WFA and WFR training and certification like those available here at The National Center for Outdoor & Adventure Education (NCOAE) focus on not only teaching you to prevent, identify, and treat medical emergencies, but how to lead and think critically during one as well. Under our industry-best instructors, you gain the skills necessary to become certified in Wilderness Medicine, which will only be of benefit to you and the people you enjoy sharing outdoor adventures with.

How much equipment can I reasonably bring/carry?

The first aid kit you keep in your car can be big and bulky. The one you put in the pouch under your bicycle seat must be small and light. You’ll have to be pickier about what you take on a hike or overnight backcountry adventure than what you keep in your house. 

Many of the off-the-shelf options — like those curated by Adventure^® Medical Kits — take the backcountry and its inherent risks into consideration. Still, don’t fool yourself into thinking an off-the-shelf first aid kit has everything you may need. By answer the questions posed above under what injuries/situations are likely to occur, you’ll be better prepared for what may occur.

What am I legally allowed to do as a basic rescuer?

It’s important to understand the laws wherever you are. Just because you have medical training — for example, an EMT or WFR certification, or even training and a degree as a physician — doesn’t necessarily mean you are allowed to use all of those skills at all times. In general, lifesaving basic first aid is always allowed. More advanced skills like starting IVs, medication administration, or even suturing might not be. The good news is, it’s the basics that save lives, so focus on being ready for those.

To get you started, here’s a list of must haves for your backcountry first aid kit:

Exam gloves: You will very likely have to deal with someone else’s body fluids and you need to protect yourself. If the COVID-19 health pandemic taught us anything it’s that disposable medical gloves don’t have to be expensive, but they do need to fit. Buy a box for the house and pull out 10 to 12 pairs for your first aid kit. Pack them in a zip-lock baggie and you’re all set.

Trauma shears: Some are foldable to take up less space, some are more like Swiss Army knives or a multi-tool. What’s most important is that you purchase a solid pair that can cut through clothing, boots, and webbing. And in case you’re wondering, more expensive isn’t always better, but don’t go so cheap that they bend instead of cut.

Tape: Cloth tape is a good choice for a variety of situations, but duct tape is another option and you probably already have some in your garage. To save space, you can wrap shorter lengths of duct tape around a water bottle, pencil, or even just itself. Coban from the manufacturer 3M is another outstanding product if you have some extra space. Remember that the adhesives on tape don’t last forever, so inspect your tapes regularly. 

Bleeding Control Tools: These are likely among the most important items you will carry. Basic gauze- rolled gauze is versatile, simple, light and doesn’t take up much space in your backpack. If you have more space, then add in some larger gauze pads (5” x 9” or similar size). Maxi-pads are also a great option. You want something that is a little bulky that you can use to cover a sizable area or pack into a wound.

Hemostatic gauze: QuickClot’s Combat Gauze^® product is a well-known version, but other products are available. You want the rolled or Z-fold gauze type that comes in a vacuum- sealed package. If you can afford it, purchase the version with the x-ray detectable strip. It enables doctors at an urgent care clinic or hospital find (and remove) the gauze in a timely manner.

Tourniquets: Tourniquet application can be life-saving, especially with proper training on their use. There are a number of commercially available tourniquets on the market. When choosing a tourniquet, make sure it will fit on the people for whom you need to use it. For instance, some are too big to work on small children and pets.

Wound care: You’ll want to have adhesive bandages in a variety of sizes and probably some antibiotic cream. A blister kit is critical if you’re hiking. And if you’re going to be more remote, then you want to start thinking about iodine drops or tablets you can use to make an aseptic solution. You can use that and a syringe to clean wounds.

Foil blanket: These are cheap, small and amazing when you need to keep warm in an emergency.  

Basic over-the-counter medicines: Depending on your purpose, you should consider stocking a few simple medications. Remember to always use them as indicated on the packaging. For example:

• Acetaminophen, ibuprofen, or other similar medications for pain and fever control
• Antihistamine/allergy diphenhydramine, cetirizine, loratadine or another similar medication for allergic reactions
• Aspirin: Chewable 81mg. tablets are best. Great for pain control and critical if someone is having a heart attack (for adult use only)
• Tums, famotidine (Pepcid) or other similar medication for stomach upset relief
• Topical creams for rashes, sunburns, or insect bites

Additional things to consider:

EpiPen: If you or someone you are going to be with has a known allergy and is prescribed an epinephrine autoinjector, you need to make sure one is available. Keep it in an easily accessible location and make sure everyone in your group knows where it is.

Splinting material: A structural aluminum malleable moldable splint, like the SAM^® Splint, is a great choice if you will be out of immediate range of emergency medical services. They are light and versatile and can be cut to any length with a good pair of trauma shears.

Prescription medications or antibiotics: If you are going to be traveling to a more remote location, you’ll want to talk to your healthcare provider about getting some prescription antibiotics to take with you. Your healthcare provider can give you guidance on what makes the most sense for what you are planning, as well as dosing guidelines.

The most important consideration when buying or putting together your own backcountry first aid kit is to identify the exact areas you’ll be traveling through, and with those attributes in mind, answering the question What injuries/situations are likely to occur. If you’re flummoxed by this, run a Google search on the area you’ll be in, and look at the news stories from those areas. Local news reports about state parks, local forests, and national parks may contain information about incidents and accidents in the backcountry.

Similarly, consider checking in with your local chapter of the Sierra Club or with the American Hiking Society to see if they have area-specific recommendations when it comes to what to include in your first aid kit for a specific backcountry adventure.

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About the Author: Kate Javes is a North Carolina Paramedic and Level 2 EMT Instructor at The National Center for Outdoor & Adventure Education. A former two-sport NCAA Division I athlete at Rutgers University, Kate received her Bachelor of Science degree in math, and a second bachelor’s degree in history from the United States Naval Academy in Annapolis, Md.