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Gear List || Backpacking First Aid Kit for soloists & groups

Medications

Medications

Wound care

Wound care

Tools

Tools

What I carry in my backpack is not a substitute for what’s between my ears. This is especially true with my first aid kit when hiking and backpacking in the wilderness: rather than thinking of this collection of items as a get-out-of-jail-free card, I’m much better served by having researched beforehand the environmental and route conditions I will likely encounter, and then using common sense in the field: identifying risks, respecting the limits of my group, and making conservative decisions.

On each trip, I hope to avoid medical situations completely. In the instances when I have, I’ve been humbled by how few things I can fully treat in the field — minor cuts, burns, and scrapes; overuse aches and pains; minor allergic reactions, diarrhea, and acute mountain sickness; plus a few other things. For anything more, I’m looking at a self-rescue or an assisted evacuation.

Gear list: Backpacking first aid kit for soloists and groups

My DIY first aid kit has been field-tested by and refined over hundreds of solo and group trips, throughout the Appalachians, High Sierra, Desert Southwest, and Rocky Mountains. To download it as a PDF or editable spreadsheet, go here.

  • Critical = A must-have, no exceptions
  • Suggested = A valuable addition, few reasons not to bring
  • Optional = Not critical, but worth consideration
  • Depends = Contingent on trip objectives, conditions, and/or other selections
  • Unnecessary = Unlikely to need and/or can be improvised

Medical training

A first aid kit does not translate into medical know-how. For that, consider some training — at least CPR certification, but ideally Wilderness First Aid or Wilderness First Responder (especially for trip leaders and avid soloists) through organizations like WMI (NOLS), WMAI, and SOLO.

DIY or commercial first aid kits?

Commercial first aid kits like the AMK Ultralight are convenient, but I’d recommend assembling your own. A DIY kit will be less expensive (at least for what you get, especially in the long run as you need to replenish items) and it can be better tailored to the unique medical needs of your group, activities, and environment.

You may be forced to buy amounts in excess of what you need. With the leftovers, create additional first aid kits for your home and vehicle(s).

Solo versus group kit

On a group trip, medical situations are more likely and more diverse in nature, simply due to there being more people, each with a unique medical history. Appropriately, then, my group first aid kit is more robust than what I carry when solo — I bring more items and greater quantities of each item.

My solo kit is a slimmed-down version of my group kit. For example, I leave behind aspirin (which I don’t need, but which I might give to an older group member with symptoms of a heart attack) and disposable gloves (since it’s okay for me to be in contact with my own body fluids), and I bring a smaller utility tool because I likely will not need it as often or as much.

Amounts

The amount of each item I carry is a function of the trip duration, group size, and my sense of its importance. My philosophy is this: If I really need an item, I want to have enough to address fully the medical event.

For example, if I come down with iliotibial tendentious (“runner’s knee”) I want enough anti-inflammatory medications so that I can take full dosage until I exit or arrive at the next town with a drugstore. And if I were to badly cut myself, I want enough wound dressings and tape to treat it properly.

Kit weight

I have never weighed my first aid kit. If you do, you are welcome to share what you get. But, frankly, its weight is irrelevant: my kit has what I need and not much extra (or any extra), and knowing its weight would not prompt me to reconsider its contents. If I were striving to be an “ultralight” backpacker (whatever that means), my approach towards first aid would be no different.


Disclosure: This post contains affiliate links, which help to support this website.

102 Responses to Gear List || Backpacking First Aid Kit for soloists & groups

  1. Vadim Fedorovsky August 22, 2015 at 8:18 pm #

    Andrew – first some feedback: comprehensive post such as this one are simply priceless. These kinds of posts have completely flipped my perspective on backcountry organization.

    A question: in the last image (showing the communication devices) I see that the recharging power pack is not the goal zero. What kind is it and how do you like it?

    Thank you.

    -Vadim

    • Andrew Skurka August 22, 2015 at 11:03 pm #

      With rechargers it’s more important to consider storage capacity, weight, and price rather than the brand. Like with some of the other links I provided, the Goal Zero Flip 10 was offered as a worthy example, but not necessarily exactly what I have.

      For context, the battery in my DeLorme inReach battery is 2450 mah; my Nexus 5 smartphone, 2300 mah; and my Suunto Ambit 2 GPS watch, 480 mah. So a battery charger with 2600 mah capacity can fully recharge the first two items once, and my watch about 5x.

  2. James Taylor August 22, 2015 at 9:02 pm #

    “I have never weighed my first aid kit.”
    Ultralight heresy, but good advice. I’ll remember this in the future. Meds always seem to be worth whatever they weigh.

  3. Melissa August 22, 2015 at 9:26 pm #

    We really enjoy watching your webinars, thank you! We used the coupon code too.

    The blood clotter will be added to our bag, we live in Pinedale near the Winds and went backpacking a couple weeks ago when one of our dogs was injured and had a pretty bloody wound on her leg. We compromised with gauze and duct tape and neosporen but having a blood clotter would have been very helpful. It was the first time we had to use anything in our first aid kit (besides the pain relievers and stuff for foot care)!

    Maybe a cooking system webinar would be good, we use a home made alcohol stove but sometimes struggle when it’s windy (we are looking into the cone). It may be a good webinar as you already did the food one.

    We take a PLB (McMurdo Fast Find) with us when we are backpacking, as there is no on going fee and it would only be for dire circumstances. We bought it 5 years ago and have not paid any service fees. Pretty soon we will have to send it in and get the battery changed but it definitely is a cheaper solution if you do not care about messaging.

    If you find yourself in Pinedale we would love to meet you! P.S. The dog is fine now and hobbled out of the Winds wagging her tale!

  4. RenegadePilgrim August 23, 2015 at 12:23 am #

    Love the post! Great to see what other people pack.

  5. Dana August 23, 2015 at 8:37 am #

    Thanks for the good info. I may be in the minority, but I don’t take my cell phone on trips due to poor battery life, lack of cell signal and I have a dedicated camera anyways. You mentioned you don’t leave it behind for security; not sure what I’m missing?
    2 “bandage is something I could add; I’ve only taken bandaids.

    • Andrew Skurka August 23, 2015 at 8:46 am #

      I only take my cell phone because I’d rather have it on me than leave it behind in my car, where it was be an easy target for theft. Plus, I have found the battery life to be sufficient on wee-long trips for occasional use as a GPS, which thus saves me the weight of that device.

    • Mindy March 21, 2016 at 7:53 am #

      We’ve found with the addition of Text to 911 that more people are able to get a signal that will allow texting, but not calling. Cell phones are a great tool to have if needed in an emergency.

      • Sean September 6, 2016 at 3:58 pm #

        Additionally, if you’re using the Delorme Inreach, you can bluetooth pair to the Delorme and text through it. Which is way, way, WAY faster than using the little cursor arrows on a tiny text keyboard on the delorme. I estimate it’d take minutes to type out a single emergency message on the delorme itself. I could do it in seconds on my phone. It’s worth it to me to have it nearby.

  6. Vadim Fedorovsky August 23, 2015 at 10:56 am #

    Andrew I really like those zip lock bags you use for the pills – they look very tough and they are a good shape.

    Where do you buy those?

    • Andrew Skurka August 23, 2015 at 11:03 am #

      I bought of a bunch of them a long time ago, can’t remember the vendor. They are tougher than standard snack/sandwich bags, a bit stiffer even than freezer bags. Try Amazon.

      • RenegadePilgrim August 23, 2015 at 2:09 pm #

        Try craft stores. They’ll have them in the jewelry making section. People use them to put their finished necklaces in and they are pretty cheap.

        • Vadim Fedorovsky August 23, 2015 at 7:52 pm #

          Thank you.

          • Sean August 27, 2015 at 12:51 pm #

            Amazon has them too. I buy them in lots of 100-500 as bits baggies for board games.

    • Curtis Cox August 30, 2015 at 4:02 pm #

      I think that most R.E.I. store sell them too.

      • Bill September 6, 2016 at 6:05 pm #

        You can get small zip seal bags in various thicknesses from McMaster-Carr Supply Co. I have 3″ X 4″ and 4″ X 6″ in 2 mil and 4 mil thicknesses and 5″ X 8″ in 4mil thickness. The 2 mil bags will hold up for a while, but the 4 mil bags hold up better. I normally carry pills in 2 mil bags and use the thicker ones to hold the smaller ones. The 5″ X 8″ bags will hold a wallet or the 4″ X 6″ bags can replace a wallet. It depends on what I’m doing. I don’t want to get in a boat without bagging my wallet. IDs and credit cards are also best left at home or carried with you.

    • Laurie September 4, 2015 at 12:06 pm #

      I found “pill” bags at a Safeway Pharmacy. They are ideal in size for meds and spice/sundried tomatoes/bacon bits that you want to keep separate in food packages.

    • Tony March 29, 2016 at 9:41 pm #

      Remember, Ziplock style bags are not water proof and they are air permeable, ie, your meds will absorb moisture over time. Be sure to discard and replenish.
      You can buy any size bag from a catalog company such as U-line.

  7. Travis August 23, 2015 at 11:24 am #

    Good kit set up but I’d ditch the CPR face mask. I work as a Paramedic and several years ago the AHA removed the “mouth to mouth” portion of CPR for the lay person. Now essentially CPR only consists of compressions for the lay person. Will help you shave a few ounces potentially.

    • Walter Underwood August 28, 2015 at 11:49 am #

      Agreed.

      A dozen years ago I was on a Boy Scout hike with a thoracic surgeon and he talked about the research on compression-only CPR.

      The breathing creates positive pressure which forces blood out of the lungs, reducing the oxygen pickup. The chest compressions create enough air circulation for oxygenation. After all, the person is not running a marathon, so they don’t need that much oxygen.

      • Joe November 18, 2015 at 10:57 am #

        Last spring during a WFA class I was shown how to improvise a barrier mask using a vinyl glove..involves clipping the tips off of the middle and ring finger and inserting them partially into the patients mouth and then stretching the glove from chin to nose…not perfect but a pretty good solution in a pinch and some level of protection is better than nothing especially if rescue breathing is required. Great Post Andrew. Hope to see you in Chelmsford again soon.

  8. ilgar August 23, 2015 at 3:51 pm #

    A very nice rundown and gave me a whole bunch of ideas that are currently missing from my kit.

    No Quikclot sponges for group trips? Not sure if those Sawyer dressings serve the same function or not.
    I have Quikclot in my car, in my range bag, and in my hike kit. Along with a large surgical trauma pad, large gauze pad, and large nonstick dressing.

    One of the route condition checks I do is seeing if any areas I may hike thru are in state game lands proximity and during hunting season. If so, an orange cap and vest will be taken and worn.

    I bring a 1 oz bottle of calamine lotion when during mosquito season; relieves the itching after a bite. Even when expired it still worked for me.

    I also bring a small signal mirror. It helps make it easier to look for ticks in your nether regions. Also helps to see if something is stuck in your eye.

  9. Stephen August 23, 2015 at 4:11 pm #

    As a physician, I agree with Travis, dont need the cpr face mask. My kit is very similar, just added a little suture material and a tiny vial of epinephrine, but would not recommend either for most people. Leukotape is the cat’s meow for so many things.

    • Andrew Skurka August 23, 2015 at 8:21 pm #

      My most recent CPR training still included mouth-to-mouth, though the instructors made sure to point out that there had been changes at other training levels.

      If I were a physician, I’d carry an epi pen and suture kit, too. But as someone with relatively little medical training, there are some legal issues with using either in the field without physician authorization.

      • Sabra September 4, 2015 at 8:14 pm #

        American Heart Assoc. is still training people who take CPR courses mouth-to-mouth. The compression-only CPR is for the lay-person in the general public, in which case an ambulance is about 7 minutes away in an urban setting. Chest compressions until paramedics arrive (approx 7 minutes) should be sufficient for oxygenation. However, if higher level of care is not available after a few minutes of CPR, the person will need breaths. CPR mask is legit weight, in my RN opinion. Especially if you are the only responder in the backcountry and you are certified in CPR.

        • Mr-Yellow January 11, 2016 at 1:17 pm #

          There was a case in Australia which involved some kind of bite, stinging plant, or reaction (can’t remember the details), but the guy was breathing for his wife for 4-5 hours until the paralysis subsided, occasionally running up to the road and back to check for rescue arriving. Compression only would never have cut it, she was damn lucky to come out without overly serious brain injury.

    • Perry November 4, 2015 at 9:17 am #

      Hands-only CPR is only valid in a setting with relatively immediate access to higher level care, and assumes the patient has not been consuming lots of oxygen before arrest. CPR with breaths is the standard of care for both drowning and lightning strike victims. In fact, for drowning the standard is breaths first, then compressions, as the victim is guaranteed to have burned through their oxygen reserves during their struggle.

      If you have a drowning or lightning strike situation, you can very easily kill an otherwise salvageable patient by denying them breaths.

  10. Stephen August 23, 2015 at 4:15 pm #

    one more thing, superglue for fussured and cracked skin at the corners of the fingers. Dermabond is also nice for superficial cuts, and a little more durable than steristrips and benzoin.

    • Andrew Skurka August 23, 2015 at 8:16 pm #

      Super glue is part of my repair kit, so I wouldn’t be SOL in this situation. In fact, I’ve used it for exactly this. There are a few other things in my repair kit that I suppose play double-duty too, like duct tape and Tenacious Tape.

      • Vadim Fedorovsky August 24, 2015 at 10:48 am #

        Andrew please consider making another post on what’s in your repair kit.

        Thank you.

        -Vadim

  11. Joe August 23, 2015 at 9:21 pm #

    Diphenhydramine has been found to cause Alzheimer’s. I’d recommend melatonin. You could try getting over the counter allergy medicine and then you wouldn’t need caffeine since Pseudoephedrine is an upper.

    • Andrew Skurka August 23, 2015 at 10:19 pm #

      That was mentioned on Facebook, too. Had never heard of that — pretty remarkable, scary actually, that such a widely used drug would have that affect.

      • Bill August 24, 2015 at 7:13 am #

        From what I can see, long term Diphenhydramine use has been associated with increased risk of dementia, along with numerous other drugs. I don’t see a risk in carrying Diphenhydramine for bites, stings or allergic reactions when it is just a short term use. I can’t take Diphenhydramine for more than a few days because it makes me too drowsy in the middle of the day. Most of mine goes unused til well past the expiration date.

        http://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-201501287667

        • Andrew Skurka August 24, 2015 at 7:41 am #

          Right. I don’t think you want to give up short-term relief against, say, a bee sting in order to reduce your risk of having dementia in 40 years.

          • Travis August 24, 2015 at 9:58 pm #

            While I can appreciate evidence based medicine, the study that was published regarding Benadryl only applied to long term use. Benadryl is the #1 over the counter medication for treatment of anaphylaxis. It’s a very safe and effective drug for treatment of mild-severe allergic reactions. An Epi pen, while useful, is not typically warranted unless you’ve got a known allergy. I would certainly make sure when planning an expedition or guided trip that you make sure people bring their Epi pens.

            As a side note, Benadryl is also a great anti-nausea medication and can be utilized to treat migraines as well. It’s a fantastic, safe, inexpensive drug with many purposes.

            Good article!

            Makes me want to teach a wilderness first aid course. Let me know if you ever need a medic! lol

  12. Megan Worrell-Lupton August 24, 2015 at 9:54 am #

    Such a great list! Love it!
    The only major additions I always have are:
    *Heartburn meds—if you have bad heartburn, it’s difficult to sleep. And that’s a bummer 😛
    *Hand/foot warmers–I tend to get cold Very easily, and these little buggers can make a big difference if your layers are not enough. Everybody knows, once you get cold out there, it’s hard to warm back up.
    *Emergency blanket–also helps in extreme cold-but also in a shock situation, this can be essential, though bulky, I like having this in a group situation for sure.

    Thanks for the article! It’s so great seeing everybody’s lists. The backbacking community is the best! Happy camping all 🙂

    • Andrew Skurka August 24, 2015 at 10:13 am #

      For a day-hiking first aid kit, I could see an emergency blanket, since you may be without extra clothing layers, sleeping bags, and/or a stove. But for overnight trips, the warmth-providing gear you have in your backpack is far superior to an emergency blanket, and it’s intentionally not part of my kit.

  13. Maeglin August 24, 2015 at 1:47 pm #

    Thank you for the list, that’s a great first aid kid. A couple new things, like Bonnie’s Balm, Leukotape and the Tincture of Benzoin, but otherwise similar to my kit.

    What are you using with the syringe to irrigate wounds? Water? I’ve always want to find something like a powered Chlorhexidine that could be mixed with filtered water and used on burns or wounds.

    I’m finding band-aides to be pretty useless. They don’t seem to last more that a few hours of sweat. Maybe, I’m just using the wrong kind.

    Additional items that I carry. Comments welcome as to their appropriateness:
    Tums – heartburn

    Lidocaine – burn pain relief and antiseptic.

    Docusate sodium a stool softener – rarely needed, but vital when it is.

    Eagle Brand Menthol concentrate Menthol 14.5% for strains, sprains and works pretty well on bug bites (certainly better than Hydrocortisone). This stuff has a strong smell that doesn’t go away, so make sure it is on an an air-tight container, especially if you fly.

    Needle – Mostly for slivers, but also a for repairs.

    • Maeglin August 24, 2015 at 2:02 pm #

      That’s Lidocaine instead of Lidocaide, in case it wasn’t obvious.

    • Andrew Skurka August 24, 2015 at 2:07 pm #

      The current recommendation on wound irrigation is to use plain water, purified first if it’s from a backcountry source.

      Have a needle as well, but consider it part of my repair kit. Sounds like I’m going to have to write up a post on that topic, too, since there have been several items mentioned as having overlap.

  14. IT August 24, 2015 at 8:25 pm #

    Yo Skurks what ROM you running on that sweet sweet Nexus 5?

    • Andrew Skurka August 24, 2015 at 11:15 pm #

      16 GB. The only memory-intensive program on the phone is Gaia (downloaded maps), which I regularly clean out so it’s never an issue.

  15. Daniel August 27, 2015 at 6:36 pm #

    Andrew, I love the list, but what do you use to pack the components in for your individual and group kits so it’s organized/easy to access? Thanks.

    • Andrew Skurka September 3, 2015 at 8:43 am #

      Inside of quart-sized freezer bags, inside of a larger nylon stuff sack.

  16. Walter Underwood August 28, 2015 at 11:56 am #

    Lithium batteries are also lighter than NiMh rechargeable batteries. I’m sure there is a crossover point between bringing rechargeables and a charger, but that would be for much longer than a week.

    Lithium AAA are 0.3 ounce (7.6g), AA are 0.5 ounce (14.5g).

    http://data.energizer.com/PDFs/l92.pdf
    http://data.energizer.com/PDFs/l91.pdf

  17. EricF August 31, 2015 at 3:30 pm #

    If your whistle ain’t louder than your yell, either you’ve got nuclear vocal cords or a pretty pathetic whistle. My storm whistle is quite painful if you don’t plug your ears. These are the ones I give to kids when we wander into the forest for our New Year’s Hike.

  18. Keith September 1, 2015 at 7:38 am #

    I’m curious about the insect repellent. In the past you’ve recommended Sawyer Maxi-Deet spray but it looks like they are phasing that out and replacing it with the “Premium Picaridin” spray. Do you have any thoughts on the difference? I’m considering purchasing one or the other and you have to pay a shipping premium for the Maxi-Deet where you can find it.

    • Andrew Skurka September 3, 2015 at 8:41 am #

      I need to confirm the specifics with the Sawyer folks, but I think their data shows that that DEET and Picaridin work similarly, though a little bit differently. The bigger advantage for Picaridin is that it does not destroy synthetic materials. There is nothing prompting Sawyer’s product change (e.g. federal legislation against DEET) so I’d have to assume they think that Picaridin is at least as good.

      • Don Bushek December 14, 2015 at 4:30 pm #

        And Picaridin is more effective against black flies than DEET.

        • Andrew Skurka December 14, 2015 at 4:31 pm #

          First-hand experience, or just what the lab data says?

      • Mr-Yellow January 11, 2016 at 1:28 pm #

        Both are surely toxic with long-term exposure. It will be decades before there is any data of note on these kind of things, if ever.

        Don’t know a lot about Picaridin but DEET is very effective. You can use tiny amounts (we can get 80% in Australia). It’s only for use once mozzies become oppressive, before that you can get by with smoke, tree branch swatter, moving faster etc.

        QLD Uni study shows 90% reduction in landings from 1 gram applied to arm after 15 hours and still 80% reduction after 19 hours.

        Given the tiny amounts needed, keeping it for emergencies and the effectiveness, I believe DEET is worth the risk when your in the presence of mozzie borne diseases.

  19. Jim Dean September 2, 2015 at 10:33 am #

    To extend cell phone battery life when you only use it infrequently, turn on “airplane mode” and make sure bluetooth and wireless are both shut off when not in use. The phone stays on and when needed, it’s quick and easy to reactivate for Cell and GPS use. The battery life extension is unbelievable. I keep my personal phone on airplane mode when traveling overseas on business (using my work cell), and a charge lasts approx 3-4x as long- as long as a week.

    • Aginor April 27, 2017 at 8:21 am #

      If you have an iPhone, battery save mode is pretty amazing. I’ll go 3 full days on a trip taking pictures without needing a charge by just putting it in battery save mode and airplane mode.

  20. Ed September 6, 2015 at 11:19 pm #

    Great stuff, I haven’t done any serious hiking in a while (getting older), but I am getting my stuff together and needed some double sided Velcro to hold some cords together. I purchased some 1/2 inch that met my needs. It is 3M One-Wrap and after I used the 1/2 inch I returned to the fabric store and purchased several feet of Inch and a half size. This size is wide enough to wrap an ankle (it holds better than stretch bandages) and could also be used to hold a splint. While the use of tourniquets is discouraged without a doctor’s supervision they could also be used to at least apply pressure to a wound if you needed they extra hand. I figure to carry about 2, 3 ft. lengths of 1-1/2 inch with me wrapped around almost anything in my pack. 1 should be enough to wrap an ankle and 2 this size could hold a splint around most folks thighs and certainly around a knee and lower leg. Wrapping for storage make sure the fuzzy side is inside the roll to keep it from getting full of lint, dirt, and brush clippings.

  21. brian September 18, 2015 at 9:22 pm #

    For cactus I would actually suggest white glue. When someone sits on a cactus its messy. White glue it, peel it off when dry and out comes all the needles.

    • Andrew Skurka September 19, 2015 at 12:07 pm #

      Good too. Sounds like you may be a desert specialist.

  22. Harry September 21, 2015 at 3:17 pm #

    Great list and site. I may have missed it, but type of stuff sack or bag do you carry all of this stuff in?

    • Andrew Skurka September 21, 2015 at 10:40 pm #

      I group the items by category into plastic bags, and then put all of the plastic bags inside of a stuff sack. The specific stuff sack type changes — I have a few that are about the right size.

  23. John October 3, 2015 at 10:11 pm #

    Thanks for the list. It’s funny that we can’t get the blood clotting sponges in Canada. I’ve always wondered why. Is there precautions you have to take with them to prevent further injury?

    • Ethan November 12, 2015 at 11:27 pm #

      It’s probably because ER docs and surgeons hate that stuff. From what I’ve read, it is extremely difficult to remove from wounds, and people are using it in non-life-threatening situations. It should only be used as a life-saving resort.

  24. CJ November 28, 2015 at 4:25 pm #

    Great blog – and I watched the SD Live video, which I enjoyed a lot. Wondering if you have plans to talk about what’s in your foot care and repair kits. I’ve been an avid day hiker and camper, but hope to start going out on more remote and longer trips in 2016. I haven’t had a lot of foot problems on my day hikes, but not really sure what to anticipate on a longer trip. Thanks again for all of your knowledge and information – I’ve read your book and much of your blog over the past year or so.

  25. Vitaliy December 14, 2015 at 6:20 am #

    I’m interested in solo do you use Victorinox Classic and Tweezers? There is tweezer in Victorinox you think it doesn’t work good enough? Because Tweezers by it self weigh about 6 grams.

    • Andrew Skurka December 14, 2015 at 9:42 am #

      The tweeezers included with the Classic are not very useful. For an extra few grams, a good pair of tweezers is very worthwhile.

  26. Mike January 3, 2016 at 11:42 pm #

    Nice list, I need to double check my own. However, after reading another example of first aid contents, I include an oral anesthetic, tooth picks and floss. Got to look after the pearly whites.

  27. Natalia March 30, 2016 at 3:11 am #

    Hi,

    Looks like a great list – I’m relatively new to hiking, but am a nurse so when I travel I could almost start a pharmacy. Do you carry a snake bite kit? I live in Australia – its an essential over here, but not sure what sort of wildlife you would be encountering.
    It’s quite simple, 4x bandages e.g. if you have to bandage a long limb & a marker pen to mark the bite site for emergency staff to be able to find the envenomation site quickly. I would use sticks or something from the environment to splint the limb if needed.

    Cheers,

    Natalia

  28. Alex April 3, 2016 at 7:50 am #

    Hi Andrew,
    two remarks
    I’ve also some thoughts about the CPR mask. I definitively do see the need while ventilating someone but do you know about the CPR foils? Just around 10g and significantly smaller in volume.

    I carry most of the times a 5-7cm wide cutoff from a new roll of cling film.In a first aid context it serves as wound dressing also with compression if necessary. Applied directly on skin (scrapes and burns) or e.g. on a bandage it protects the area from the elements keeping the it warm and dryer. It’s translucent hence you’ll see how the wound develops afterwards. Building an arm sling or other fixations is perfectly doable, too.
    Yes, this stuff can reduce the circulation so be smart

  29. Stephen Booth April 10, 2016 at 7:54 pm #

    Andrew,
    Thank you so much for your notes, lists, recommendations, etc. They are very helpful.
    I have a question about your recommendations for satellite communication. I’m not new to wilderness trips (many multi night trips to the Boundary Waters, for example), however, I’m planning my longest solo hike for June: Superior Hiking Trail, 300+ miles. I have never taken more than a cell phone, but your satellite communication recommendations have me second guessing. I’ll be alone, I will have cell communication when I’m up on ridges so I know I can send the “I’m doing fine” texts I need to send. The satellite device would be an extra $400 added to my budget (phone plus subscription). So, why is there a double asterisk next to the device for your solo trips? What has convinced you that this is an essential item?
    Thank you!
    Steve Booth
    Laporte, Minnesota

    • Andrew Skurka April 11, 2016 at 11:49 am #

      A satellite device is critical for me because many of my favorite locations are beyond the range of cell towers. And even the trips where I do have occasional service, there is at least some chance (maybe high, maybe low, depending on the area) that I would need communication from a location where my cell phone is not working.

      In the specific case of the SHT, I would not characterize a satellite device as absolutely critical. There are many road intersections, many people, and frequent cell access. Plus, the route is not especially dangerous — you won’t find talus, grizzly bears, alpine summits, etc.

  30. Wayne April 16, 2016 at 8:48 am #

    For trips at high altitudes, it might be worth adding some Ginkgo Biloba (and taking some pre-trip as well):

    http://www.basecampmd.com/expguide/amspremed.shtml

    Great discussion, by the way.

  31. Cory Ingram April 28, 2016 at 4:06 pm #

    I am traveling with my family to Ear Falls Canada this summer for two weeks. Much of the area has limited cell phone coverage. I am trying to figure out if I should get a messenger or a sat phone? I am leaning towards a messenger and wonder if there are recommendations between DeLorme inReach SE and inReach Explorer?
    Thank you

  32. Connor September 6, 2016 at 1:48 pm #

    Great list Andrew.

    I’d recommend adding a triangular dressing for slings and stabilising various bone/joint injuries, and dressings such as roll dressings for penetrating wounds or protruding foreign objects.

    The triangular dressing can also be used to create other dressings such as the roll dressing.

  33. Katherine September 6, 2016 at 2:12 pm #

    Q 1: Are special burn-specific bandages worth it? Luckily never had to use one, but seems like a relevant first aid risk.

    Q 2: Bears and Bonnie’s Balm: when you have to hang/canister your food and smellable toiletries, do you include that? Love the stuff, but it’s got that strong herbal smell! (then of course, if you slather your feet up with before going to bed you’re…)

    • Andrew Skurka September 6, 2016 at 3:54 pm #

      1. I’ve never needed one, for me or for a group member. If someone got badly burned, I would cool it down with water and cover it up with roll gauze, then get them out because of the infection risk.

      2. According to a bear’s nose, you reek of odors. He can smell your BO, your dinner, your morning breath, and, yes, your Bonnie’s Balm. I don’t think what you do with the balm is going to make a huge difference in the scheme of things. If you can hang it or put it in a canister, great. But you’d have much better luck in avoiding a bear incident by avoiding areas where bears make nightly rounds.

  34. Ito September 6, 2016 at 6:52 pm #

    A perhaps dual-use item would be Magnesium tablets.

    Magnesium is involved in ATP synthesis, muscle relaxation and many other enzymatic processes (as I’m sure many know).

    Many people taking a Magnesium Citrate supplement report it has a mild laxative effect.
    I take Magnesium Malate as a supplement and though personally I never have any digestive issues (eating plenty of veggies helps), I do find a small but noticeable difference there.

    Not sure how it compares to the herbal laxative of choice, or that it would negate bringing that. But certainly for a personal kit it might be interesting to try out.

  35. Walter Underwood September 6, 2016 at 10:19 pm #

    Not sure why you pack so many different drugs for anti-inflammatory and pain relief. I pack Advil, period. It works for pain and inflammation. No point in packing Advil, Naproxen, Tylenol, and Aspirin. Why? How do you decide?

    For benadryl, I always pack capsules instead of tablets. If someone has an anaphylactic response, I can break a capsule under their tongue and get it into their bloodstream faster.

    • Ito September 6, 2016 at 11:19 pm #

      Walter, I’m not presuming to speak for Andrew of course, but you can take Acetaminophen in top of the NSAIDs, maxing both dosages. Things would have to be pretty bad, but if fever or pain is really bad this way you could take or administer more medicine – without going over the recommended dosages for either.

      I don’t know what the reasoning is between the two NSAIDs (Ibuprofen and Naproxen).

      I bring only Ibuprofen too, but there is something to say for the alternates. I think it’s pretty smart, especially since it doesn’t have to weigh (much) more.

      Many people bring Aspirin just for aiding the possible heart episodes, in which case Ibuprofen wouldn’t have worked as well. Of course neither might the Aspirin, but I guess it can be better than nothing. I don’t bring Aspirin either, but I might when I am a decennia or two further on.

      • Andrew Skurka September 7, 2016 at 9:04 am #

        > you can take Acetaminophen in top of the NSAIDs, maxing both dosages. Things would have to be pretty bad, but if fever or pain is really bad this way you could take or administer more medicine – without going over the recommended dosages for either.

        Correct. Bad situation becomes more tolerable. My understanding is that it’s almost as good as a Rx pain killer.

        The two NSAID’s are more redundant, but there are differences in terms of dosages and time. On a personal trip, I only carry the iburpfen. On a group trip, the additional naproxen gives me another option, and it weighs nothing.

        Aspirin is the non-Rx recommendation for heart attack symptoms. I don’t carry it on personal trips or trips with a bunch of young people, but for commercial trips with relatively unknown clients, it could be needed.

        • Tim September 10, 2016 at 11:21 pm #

          The differences between naproxen and ibuprofen have to do with pharmacokinetics: ibuprofen works faster, but does not last as long. Conversely, naproxen works more slowly, but last 12 hours. They have the same target, so once you take a maximum dose of ibuprofen, taking naproxen will not lead to any additional analgesia, the receptors being saturated, but will increase your risk of unwanted side effects.

          Given that the efficacy (“strength”) of both drugs has been shown to be the same, how do you choose which to bring?

          As the maximum dose of naproxen is 500 mg every 12 hours, this can be approximated by 4 x 220mg tablets to cover a 24h period. The maximum recommended dose of ibuprofen is 600mg every 6 hours, which is 12 x 200mg tablets to cover the same 24 hour period. You end up needing to carry three times more ibuprofen for the same therapeutic benefit.

          As a physician, when I go into the backcountry, I take naproxen.

          • Bill September 11, 2016 at 5:33 am #

            I have both Naproxen and Ibuprofen. For aches and pains, my doctor recommends that I take Naproxen, which I do. For me, the pain relief from Naproxen is barely perceptable. I try to limit my use of Naproxen to one or two tablets in 24 hours. As I grow older, I have more and more joint pain, which my doctor says is caused by arthritis. I try to manage this with minimal use of NSAIDs, because of the GI irritation risk.

          • Andrew Skurka September 11, 2016 at 8:07 am #

            Excellent explanation, thank you.

  36. Jody September 8, 2016 at 10:13 pm #

    When using Super Glue; once it is applied spray or lightly drip water on it for faster setting. Used it constantly at work and tan water over it to set it up faster. FYI

  37. Eugen September 15, 2016 at 3:32 am #

    Interesting how some first aid principles differ across countries/continents. In Europe the Antibiotic ointments (like Neosporin) are not available. Some official first aid guides even recommend not to use any salves on wounds at all, just some antiseptic solutions (containing iodine or octenidin). I usually carry a small bottle of Octenisept.

  38. Ronnie Spitzer September 22, 2016 at 10:36 pm #

    On Naproxen vs. Advil–I learned the hard way, from my doctor, that some people can respond better to one of these medications. So now bring Naproxen for me and Advil for everyone else on group outings. Worth considering.

    • Andrew Skurka September 23, 2016 at 4:36 pm #

      Do you remember the specifics? I feel like I have heard that it’s worth having both as well, and had been carrying both in my group kit for that reason, but I can’t find the original information.

      • Ronnie September 23, 2016 at 5:08 pm #

        Doctor at UCSF Medical Group said that some people do not respond to one or the other, possibly due to genetics or because a tolerance had been built up. At that time, Advil had not lessened the inflammation from a frozen shoulder and the prescribed Naproxen worked immediately. Usage since then show that I simply respond best to Naproxen.

        • MarkL October 6, 2016 at 11:40 am #

          Anti-inflamatories (asprin, naprozin, ibuprofin) can potentially interfere with the effectiveness of SSRIs used to treat depression, anxiety, etc (Zoloft, Prozac for example). There is also some indication of increased risk for upper GI bleeding. There are a lot of people, including kids, on SSRIs. Acetaminophen is preferable in conjunction with SSRIs.

  39. MarkL October 6, 2016 at 10:07 am #

    Interesting stuff. I’m a backcountry ski patroller, so this is of direct relevance. I am also an AHA CPR instructor. A couple notes regarding the CPR mask comments:

    In CPR you are expected to perform to your training. If your training is compression-only, that’s what you do. If your training includes breathing, that is what you should do. If you start freelancing based on what you’ve heard instead of what you were trained, you are asking for trouble.
    – A mask is useful for rescue breathing for an unconscious patient as well as CPR.
    – CPR and choking/drowning, etc. often involve vomit. I like the surgical glove option (never heard that) but it is no substitute for a one-way valve.
    – A mask makes a much more reliable seal.

    I carry a device called a NuMask http://www.numask.com/, which is essentially a one-way valve attached to a flange you insert in the patient’s mouth. It is smaller, mostly makes its own seal, and stays in place while you do compressions, minimizing transition time which is one of the critical issues with breathing.

    • MarkL October 6, 2016 at 11:18 am #

      Just to clarify: when a barrier device is not available it is up to the caregiver’s discretion whether to include breathing. But according to the AHA even barrier devices do not significantly lower the already low chance of infection. From the current AHA guidelines: “In addition, if the trained lay rescuer is able to perform rescue breaths, he or she should add rescue breaths in a ratio of 30 compressions to 2 breaths.”

      My point was mainly that if you are trained and have a device and are heading into a high-risk situation, they aren’t that heavy or bulky. In a school or commercial situation this is a no-brainer for me. I would have a difficult time morally justifying leaving it behind if I needed it. That’s an extremely heavy few ounces to walk around with for the rest of my life.

  40. Nick November 22, 2016 at 10:57 am #

    Hello Andrew,

    Before replenishing my med kit after several long hikes, I made sure to reread you pertinent blog post on the matter (very helpful).

    For a change, I wanted to bring up for your consideration the use of Hypafix dressing retention tape:
    http://www.smith-nephew.com/professional/products/advanced-wound-management/other-wound-care-products/hypafix/
    (I’m not in any way associated with this website or the product; I’m just a customer that bought it)

    I’ve personally found it very useful to make custom shape bandages in tandem with a roll of gauze. I was introduced to it after a toe surgery. It was the only product that really worked for that application.

    At any rate, if you were not already familiar with this product, perhaps it can be of use to you in the future and become part of your kit.

    Cheers,
    Nick

    • MarkL November 22, 2016 at 1:25 pm #

      Interesting looking stuff. I didn’t see whether it is latex free or not.

      • Nick November 22, 2016 at 1:45 pm #

        Yes, you can find it latex-free.

        Pharmacies in Canada do not generally carry it in the isles. You have to ask the Pharmacist for a given length or for a whole role — I imagine that it’s the same States-side.

        I should add that Hypafix stretches and conforms well to the skin, but SkinTac may be necessary if the skin is dirty or wet. Also, it may not be strong enough for applications such as blister treatment in the heel area. In such instances, you may want to double it with some Leukotape.

    • Andrew Skurka November 22, 2016 at 3:23 pm #

      Always appreciate good recommendations, thanks.

      What is the advantage of Hypafix over Leukotape or medical tape? When I have needed a custom bandage (only a few times ever), I have used a piece of roll gauze and then tape over it. Trying to understand if there is redundancy, and what the superior product would be in that case.

      • Nick November 22, 2016 at 4:15 pm #

        5 benefits:

        1) it breathes much better than other medical tapes (airflow + moisture management): better when maceration is a concern; fewer dressing changes needed.

        2) it shears easily in-plane (non-woven unlike other tapes): much improved drape-ability over double-curved surfaces such as fingers, toes and elbows; does not restrict movement unlike other tapes that are design to add rigidity.

        3) It is very light, packable and practical (paper backing, no re-rolling required). You will not notice the added weight or volume.

        4) It is easier and less painful to remove if like me you are on the hairier side of things

        5) You can buy exactly the length that you need if pharmacies operate the same in Colorado as in Quebec (makes things cheaper although it’s not expensive compared to other tapes).

        I’ve found it most useful in keeping small wounds clean on my fingers while letting them dry and scab over quicker. I’ve also used this stuff on my toes to treat bad blisters overnight. I would generally wake up with a dry and clean blister site. (I also used a small thread through the blister to keep it from closing back up.) I still carried a bit of leukotape with me (less than before) in order to reinforce areas such as my heels (although I very rarely get blisters there).

        Definitely think about it if traveling with groups. Hope it helps!

        • Ronnie November 26, 2016 at 11:11 am #

          I’ve started using Mepitac under Leukotape for blisters or other wounds. The thin silicone helps cushion and promotes healing.

  41. MikeO December 6, 2016 at 10:40 am #

    I’d recommend the victorinox swiss army knife signature 2. Same size as your swiss army knife but has a tiny pen. Cheesy video but gives specs https://www.youtube.com/watch?v=g_r7SLG6f-g
    Why carry the large sizzors and the small ones of the swiss army knife. Why carry tweezers when could use the victorinox ones? Do you use these items a lot? Is the larger size useful?
    Thanks,
    Mike

  42. Chris Miles April 29, 2017 at 4:42 pm #

    I was interested tat you are using a lighter weight stretch bandage. I tend to use a heavier weight in Australia as more effective for snake bite compression, but also reasonable for ankle injuries etc. I imagine like other choices it is a consideration of the environment and personal susceptibility to ankle injuries, but would be interested in thoughts from others – the weight penalty is not huge but enough to warrant a discussion.

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