Gear List: Backpacking First Aid Kit for soloists & groups

A first aid kit is rightfully considered by most backpackers to be a must-have item. To check this box, you have two basic options:

  1. Purchase a prepackaged commercial version like the Adventure Medical Kits Ultralight that has been vetted by medical professionals; or,
  2. Create your own, based on the specifics of your group, itinerary, and environmental conditions.

Commercial kits are convenient, but they’re expensive for what you get and they don’t necessarily address all of your needs. A DIY kit is research-intensive and more time-consuming, but it’ll be perfectly optimized for you.

If a DIY/MYO kit seems preferable, keep reading.

Gear list: Backpacking First Aid Kit for soloists and groups

Over the past twenty years, I have backpacked solo over 30,000 miles and have led 100 guided groups with nearly 800 clients, in locations throughout North America, primarily the Rocky Mountains, High Sierra, Appalachians, Desert Southwest, and Pacific Northwest.

My solo and group first aid kits are based on what I’ve encountered during these experiences, which I’ve detailed previously. My selections are not based on fear or first aid training simulations.

Open this list in its own window.

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

What can you actually treat?

With your first aid kit, you should be able to manage or treat fully:

  • Minor cuts, burns, and scrapes;
  • Overuse aches and pains;
  • Minor allergic reactions, diarrhea, and acute mountain sickness; and,
  • A few other minor things.


A first aid kit is not a get-out-of-jail-free card. In any medical scenario that would be considered more than “minor,” you’re looking at a self-rescue or an assisted evacuation. It’s wise to have small-scale overview maps and a satellite messenger/phone for these situations.

Also, a first aid kit is not a substitute for being smart! You’ll be best served by researching likely environmental and route conditions before you leave, and then using common sense in the field by identifying risks, respecting your limits and those of your group, and making conservative decisions.

Finally, carrying a first aid kit does not translate into knowing first aid. For that, consider getting some training through organizations like Red Cross, NOLS, WMAI, and SOLO.

  • CPR certification, at a minimum, for everyone; and,
  • Wilderness First Aid or Wilderness First Responder for trip leaders and avid soloists


The list above is my definitive/recommended kit, and it’s updated every spring at the start of my guiding season. The photos below were taken a few years ago, and some items or form factors have changed since then.

Wound care
Wound care

Cost of a DIY kit

A DIY kit may be a greater up-front investment than a commercial kit, because you often have to buy more than you need. For example, a bottle of ibuprofen normally has 50+ pills, but you’ll need just 10 for an upcoming solo weekend trip. However, a DIY kit will be less expensive in the long-run as you replenish items that you use.

With the unneeded quantities of a DIY kit, 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 bodily fluids), and I bring a smaller utility tool because I likely will not use it as much.


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 tendonitis (“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.

What do you think of my first aid kits? What other items do you take (or leave behind)?

Disclosure. I strive to offer field-tested and trustworthy information, insights, and advice. I have no financial affiliations with or interests in any brands or products, and I do not publish sponsored content

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  1. Vadim Fedorovsky on 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.


    • Andrew Skurka on 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 on 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 on 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 on August 23, 2015 at 12:23 am

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

  5. Dana on 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 on 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 on 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 on 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.

    • Pliny on October 13, 2020 at 3:50 pm

      I don’t take a phone for a number of reasons. Poor signal strength is one. Another is that there any number of devices I could take but do not because i believe in being somewhat independent. Perhaps I am a minimalist. Also, over many years of climbing and hiking I have never needed them in the strict sense of the work. I do take my GPS when we are exploring areas in the wilderness that do not have trails, or routes on the little mountains we climb that are not in the climbing guide. I also take a watch and a headlamp, but not much else. I experimented with an I-pod, but I’m not sure I will take it again. Consider the early explorers that had only map and compass and what they accomplished. is it really an adventure if you can make a call and get rescued if you get in trouble. If so perhaps we are becoming wimps.

      • robby on October 16, 2020 at 12:50 pm

        Gaia gps app on a phone is head and shoulders above obsolete GPS units. Give it a try you will see. Navigation with Gaia on your phone and all the maps available is way advanced and is killing the GPS market. You said you use a GPS, not just map and compass like the early explorers, I bet a smart phone is lighter than your GPS and also replaces a camera and several other things (has plant or bird identification, first aid and whatever else you want on it).

        • James Pliny Morrison on January 4, 2022 at 4:16 pm

          I finally (2022) did get a smartphone and have three apps. on it that shows me my location and track. So I agree with you, Robby.
          I suspect there are even better apps that I could be using, but so far so good. Perhaps I am paranoid, but I still carry an 8.5 x 11-inch paper copy of a map (from At times it has shown me details and even trails not shown eleswhere. for some reason, I still enjoy sitting on a log and figuring out where I am looking at a paper map. thanks for our comment Robby…. a couple of years later.

          • robby bradbury on January 5, 2022 at 1:52 pm

            Yes gaia has smoke and snow levels, slope incline shading for avalanche awareness, 3d rendering so you can actually see the climb you are planning on doing, private and historical land which can be interesting, and so much more. I usually plan a route and print off paper maps so I have both. But gaia lets you zoom in and out and figure out mileage and feasibility of a route if you change your route while in the backcountry. I def think a paper map and compass is important as a backup, and I use Gaia for that as well.

  6. Vadim Fedorovsky on 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 on 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 on 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 on August 23, 2015 at 7:52 pm

          Thank you.

          • Sean on 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 on August 30, 2015 at 4:02 pm

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

      • Bill on 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.

        • MTN on October 9, 2020 at 3:09 pm

          thanks. that was a very helpful response

      • Jon on March 9, 2020 at 1:28 pm

        First to say: thank you for the post. Always helpful to go through the med kit and make sure you have the most important items!!

        I’m a medical professional (PA) with experience in Emergency Med and Trauma surgery. A few things I would recommend that i usually include in my kit:
        1. I would argue Tylenol (acetaminophen) should always be included. You can add with ibuprofen simultaneously (as you mentioned) for additional pain relief. Maybe overkill as hikers are generally young and healthy but also safer for older hikers or with other medical problems where NSAIDs are contraindicated (NSAIDs can increase risk of bleeding and blood clots).
        2. Betadine/iodine for wound care — very helpful to clean very dirty, deep wounds. Although unlikely to be needed, this is helpful especially if you’re far from rescue. A couple years ago I had a buddy slice his abdomen with a ski while we were deep in Canadian backcountry and this was very helpful. (You can just apply to gauze and slap it on the wound and dress it normally with gauze wrap until rescue, or just pour over/wipe with a piece of soaked gauze).
        3. Sterile cotton tipped applicators. We have these in 4-5 inch lengths in the hospital. For that abdominal wound i was glad to have these for probing the wound. *sterility is important* and betadine used first, but this gave me an idea if the wound penetrated into the abdominal cavity or just into the subcutaneous tissue. Obviously my medical background helped with this, but if you are far in backcountry it’s helpful to be able to identify how serious the situation truly is. If you’re on a day trip and <24hrs from tertiary care this doesnt matter as much. But if you are multiple days out, this could be critical knowledge.
        4. I have a few more medical provider specific items that I'll leave out reasoning here but i usually include (i.e. medications- antibiotics, scalpel, suture kit, injectable lidocaine, etc.) — probably overkill depending on trip size/duration.

    • Laurie on 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.

      • Jim Morrison on March 9, 2020 at 9:59 am

        Thanks all. I do replace my pills occasionally as the expire, but I didn’t know about the better alternatives to Zip Lock bags.

    • Tony on 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.

    • Mike Kiernan on March 9, 2020 at 9:08 am

      Most pharmacies carry these, usually next to the pill/dosage reminder cases, finger splints, ect.

    • George on August 16, 2021 at 9:08 am

      Although not as small as a plastic bag, I use the travel-size containers that come with Tylenol, Ibuprofen, etc. with a twist-off top. They are the size of a chapstick container. They are very durable, and I put half a cotton ball in them to help with moisture build-up.

  7. Travis on 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 on August 28, 2015 at 11:49 am


      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 on 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.

    • Alan Davison on November 18, 2019 at 6:00 am

      Cone snails (worldwide) and blue ringed octopus (Japan to Australia) can cause respiratory depression. Assisted breathing for potentially hours are needed. Patient will appear dead / coma but will actually be fully conscious in many cases.

      Reports about respiratory depression for some snake and spider bites too, I guess death causes the ultimate respiratory depression… aka the pressure bandage failed and the patient is being flooded with venom. But the recommended approach is still to call for help, immobilise with a pressure bandage and then CPR if required.

    • Dashielle Vawter on January 4, 2022 at 1:17 pm

      Isn’t that only if you’re within a few minutes of advanced medical care? My understanding with wilderness medicine is that rescue breathing is indeed still a part of wilderness CPR because we may be performing it for prolonged periods of time.

      In my WEMT course the recommendation was to use rescue breathing if you anticipate medical care is more than 8 minutes away (8 minutes being about the amount of time it takes for the oxygen in the blood to run out from the last breaths taken).

      This of course does not answer the question about the mask, just a curiosity/clarification of the rescue breathing portion of CPR. It seems like a mask is a personal choice based on who you’re traveling with. I travel with students and staff so I’ll continue to take a mask with me. On trips with friends I might leave it.

  8. ilgar on 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 on 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 on 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 on 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 on 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 on 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 on 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 on 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 on August 24, 2015 at 10:48 am

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

        Thank you.


  11. Joe on 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 on 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 on 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.

        • Andrew Skurka on 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 on 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 on 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 on 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 on 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 on August 24, 2015 at 2:02 pm

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

    • Andrew Skurka on 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 on August 24, 2015 at 8:25 pm

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

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

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

  16. Walter Underwood on 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).

    • langleybackcountry on February 12, 2019 at 6:00 pm

      If we are counting the tenths of ounces of our spare batteries I think we may have lost the plot a bit. 🙂

  17. EricF on 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 on 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 on 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 on December 14, 2015 at 4:30 pm

        And Picaridin is more effective against black flies than DEET.

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

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

          • Don Muchow on September 8, 2019 at 4:25 pm

            Ran across Iowa in summer 2018. Worst black flies in decades according to locals and newspapers. Truly awful. You couldn’t stand still for even a minute without getting bitten by hordes of these things, about the size of horse flies, and the bites are painful and burn. Deet was 100% useless. If anything, it attracted them. Picaridin was markedly better than nothing, but not wildly effective. Best answer = Picaridin + bugnet over my hat + long sleeves.

      • Mr-Yellow on 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.

        • Don Muchow on May 3, 2021 at 12:28 pm

          I have a severe allergic reaction to DEET. The symptoms I described to my allergist led him to believe it was a neurotoxic effect of some sort, but I’m not really sure. The big net is pretty effective. And agreed that Picaridin is a weak sister…just not a toxic one as far as I can tell.

  19. Jim Dean on 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 on 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. […] There are as many ways of putting together a first-aid kit as there are hikers to tell you about them. Andrew Skurka, a seasoned thru-hiker with more than 30,000 miles under his belt, has some of the best information I’ve found on the subject of DIY ultralight first-aid kits. […]

  21. Ed on 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.

  22. brian on 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 on September 19, 2015 at 12:07 pm

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

  23. Harry on 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 on 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.

  24. John on 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 on 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.

  25. CJ on 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.

  26. Vitaliy on 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 on 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.

  27. Mike on 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.

  28. Be Prepared | City to Trail on January 10, 2016 at 9:18 pm

    […] found some great content on Washington Trails Association, Outdoor Herbivore, Outside Magazine, and Andrew Skurka’s website. All of these reads are worthwhile, and I highly recommend them if you’re interested in […]

  29. Natalia on March 30, 2016 at 3:11 am


    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.



  30. Alex on 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

  31. Stephen Booth on April 10, 2016 at 7:54 pm

    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 on 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.

  32. Wayne on 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):

    Great discussion, by the way.

  33. Cory Ingram on 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

  34. Connor on 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.

  35. Katherine on 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 on 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.

  36. Ito on 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.

  37. Walter Underwood on 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 on 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 on 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 on 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 on 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 on September 11, 2016 at 8:07 am

            Excellent explanation, thank you.

  38. Jody on 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

  39. Eugen on 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.

  40. Ronnie Spitzer on 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 on 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 on 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 on 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.

  41. MarkL on 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, 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 on 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.

  42. Nick on 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:
    (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.


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

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

      • Nick on 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 on 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 on 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 on 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.

  43. MikeO on 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
    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?

  44. Chris Miles on 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.

  45. Jim M on October 10, 2018 at 12:55 pm

    I loved you first aid kit list suggestions. I will pass it along to my friends. I have treated people on the trail quite a few times and almost all have been simple abrasions, lacerations and contusions from falls or encounters with sharp objects. I therefore think that cloth tape, roll gauze and perhaps some 4×4 gauze pads are critical to have along. Moping up blood can be done with a clean bandana too, but the patient really starts better when you clean the wound well and put on a professional looking dressing and bandage. You are right on. Knowledge of how to use a first aid kit is more important than exactly what equipment you have. I happen to think that is true of all of the ten essentials.

  46. City-ot on February 12, 2019 at 4:21 pm

    What do people think about taking along a compression bandage of some kind? Especially for solo tripping or if your group is hunting. Some method for controlling blood loss quickly would make me feel better. Especially on a solo trip.

    I have read a lot about “Israeli” compression bandages. Basically a pad, strap and plastic-buckle bandage that allows you to reverse the strap direction onto itself and really get some leverage on the pad to stop bleeding. The whole thing comes sterile and vacuum-packed and some of them even come with a clotting agent already applied to the pad. (I don’t work for the “Israeli bandage industry” I just think that they’re clever)

    Has anyone had experience or training with these? Do you think that it is a good idea? (they do not weigh much but are fairly bulky) Would you take them along and under what circumstances or trip conditions would you think they are appropriate/inappropriate?

    I am interested to hear your opions.


    • langleybackcountry on February 12, 2019 at 4:43 pm

      In the SAR circles I know, clotting bandages – and especially clotting agents like Qwik-Clot – can elicit some strong opinions. Basically the concern is similar to that of using a tourniquet: lay-person responders using it when it isn’t really necessary and causing unnecessary problems. Not sure about the ability or efficacy of trying to apply one to yourself since they are often seen as a “weapon of last resort” for truly significant injuries.

  47. Ann on February 19, 2020 at 5:46 pm

    As a first aid instructor I’m really happy to see that you remind people that injuries and sickness might happen on a trip and that it’s good to be prepared.
    What seems really strange to me is the carefree use of medicine. Most of the mentioned things can cause a lot of harm under certain circumstances (which can include undetected genetic defects or other medication, even a long flight in combination with some antibiotics is risky), especially when a diagnosis somewhere in the wild can be hard without being a physician and without diagnostic devices.
    …just my two cents.

  48. Mike Kiernan on March 9, 2020 at 9:20 am

    The diphenhydramine (“Benadryl”) is not really necessary. The 2nd-generation antihistamines (loratadine and cetirizine) do a better job of relieving mild allergy symptoms and are superior in managing more severe allergic reactions than diphenhydramine. They are now recommended to replace it for this purpose. For severe allergic reactions (anaphylaxis), an epinephrine auto-injector is needed. Antihistamines may be used in addition to the epinehrine but are not a substitute.

    The effects of 2nd-gen antihistamines last up to 24 hrs so you do not need to take many pills (1 pill/day compared to diphenhydramine 8 pills/day). These meds do not cause drowsiness which is a big plus for daily use during allergy season.

    • Andrew Skurka on March 11, 2020 at 5:11 pm

      Good to know about diphenhydramine v the second-gen antihistamines. I don’t recall that distinction being made in my WFR recert last year, and for some reason I was thinking that it was actually diphenhydramine that had the edge in dealing with severe reactions.

      Diphenhydramine will stay on the “maybe” list, however. It’s a pretty effective sleep aid, and I’ve used it on multiple occasions if I’m jet-lagged or have had a really stressful evening.

    • Jon on March 11, 2020 at 5:28 pm

      I would actually disagree with that. Diphenhydramine is still used in conjunction with steroids for severe allergic reactions and/or anaphylaxis once a patient hits the ER. They are not replacing this in the clinical world with any of the 2nd generation antihistamines as far as I am aware of. But yes, in general they do cause less sedation.
      @Mike Kiernan I’m curious where you got the information that 2nd gen are “superior in managing more severe allergic reactions than diphenhydramine.” I would love to be corrected on this one but from a hospital/clinical prospective i have never seen this to be the case!!

      • Mike Kiernan on March 12, 2020 at 9:21 am

        Jon and all,

        It is imperative to understand that ANAPHYLAXIS should be treated with injectable epinephrine. Antihistamines ARE NOT EFFECTIVE in the treatment of upper or lower airway obstruction and shock due to anaphylaxis but can be given as an adjunct to help relieve other symptoms if the victim is conscious and able to swallow and, of course, can be used to manage symptoms of seasonal allergies, allergic rhinitis and chronic urticaria (hives). See citations below.

        I agree that few patients, and many physicians, are unaware that the newer H1 antihistamines are superior to diphenhjdramine in the management of acute allergic reactions. There is still a lot of diphenhydramine sold.

        CSACI position statement: Newer generation H1-antihistamines are safer than frst-generation H1-antihistamines and should be the frst-line
        antihistamines for the treatment of allergic rhinitis and urticaria Fein et al. Allergy Asthma Clin Immunol (2019) 15:61

        Anaphylaxis Emergency Treatment

        Abella BS, William B, Michael B, Ian S, Moellman J, Klausner HA, Caterino J, Suner S, Kessler A, and Du J. Intravenous injection cetirizine vs intravenous injection diphenhydramine in treatment of acute urticaria. Acad Emerg Med 2019; 26:S121.

        Allergy Asthma Proc 28:418 –426, 2007; doi: 10.2500/aap.2007.28.3015)
        Diphenhydramine versus nonsedating antihistamines for acute allergic reactions: A literature review

        • Andrew Skurka on March 12, 2020 at 10:35 am

          Thanks for this citation.

          Re epinephrine, it’s no doubt essential for those at risk of anaphylaxis shock, but it gets caught in a weird area of legal liability and I therefore don’t include it in my recommended kit. As a prescription drug it can’t be in a group first aid kit for general administering, unlike OTC meds like ibruprofen. If an organization has prior medical authorization, it’s then okay; but it’s not okay without that authorization. It’s also not legally okay to use your own epi injection on someone else, though I think most patients would be pretty excited to have had their life saved, so in most cases this would be a moot point.

        • Jon on March 12, 2020 at 11:43 am

          Thanks Mike!!! Definitely 100% true that nothing is a substitute for epinephrine for anaphylaxis. Sorry, I should have been more accurate in stating that in my previous post. (And also that steroids don’t have a role in initial/acute management of anaphylaxis).

          Very interesting articles. It seems like the main barrier to replacement with these newer H1 antihistamines for first line treatment is cost. Thanks for the info!

          • Mike Kiernan on March 13, 2020 at 9:52 am

            Youy are welcome, Jon.
            Cost should not be an issue. These are all OTC meds and available as generics and very inexpensive. And remember, you only need 1 pill/day vs 4-8 if using diphenhydramine for allergies.

  49. Eric on March 9, 2020 at 3:28 pm

    Great kit Andrew. Current “Stop the Bleed” recommendations are for early tourniquet use in extremity injuries with massive bleeding. This can turn a fatal injury into a survivable situation obviously with appropriate evacuation.

    I would add a tourniquet to your kit otherwise not much I would add. Massive extremity bleeding is a low frequency, high consequence, survivable event with rapid treatment.

    • Andrew Skurka on March 11, 2020 at 5:06 pm

      For my primary outdoor activities (mostly hike, some run), I struggle to imagine a likely scenario where we would have trauma on such a level to warrant a commercial tourniquet. Even on my personal hunting trips, when we have firearms and sharp knives, it just doesn’t seem that likely. In the really odd case where we needed one, which is not completely impossible, we could improvise (though obviously with some loss in efficiency).

      • Miles on March 11, 2020 at 6:32 pm

        Commenting for the sake of others seeing this:

        So long as you use decently wide webbing (~ >1″) like the kind frequently found on backpacks as well as an improvised windlass, (any rigid piece of material that you pass within the tied circle of webbing and turn to tighten the tourniquet) you should be able to apply enough pressure to control an otherwise uncontrollable bleed. Apply tourniquets high and tight (upper arm, upper leg) above the injury and tighten until the bleeding has stopped. It is possible that you may need to apply a second tourniquet. The windlass is key.

        This conversation of carrying and even using tourniquets in the backcountry just came up with a close friend of mine. I largely agree that given most of our activities, carrying a commercially available device does not make much sense. That said, TQ application can be lifesaving, they are easily improvised and if there is truly concern of loss of life, it is not worth worrying about the potential loss of limb.

  50. Eric B. on March 9, 2020 at 7:28 pm

    Thanks Andrew, this was a good update on “what to carry and when to carry it”.

    As a former ski Patroller, both Nordic and alpine, I have had a lot of training and some 16 years of experience as well. What constitutes a first aid “kit” can include avalanche snow study kit, rescue gear and of course at least an Avalanche 1 course. That’s part of a winter snow country “first aid” kit.

    River & ocean kits will be far different. And so will the training. Knowing how to rig a river rescue pulley system (and having said gear) is just part of the story. And these days having a satellite rescue beacon is a requirement.

  51. Phillip Smith on March 10, 2020 at 11:57 am


    as always, thanks for taking the time to compose these posts! From inception through rough draft, to final draft and proofreading, it’s a lot. Add to that, your prompt responses to questions, and respective input to dialogue.

    It’s for the greater good of the hiking / outdoor/ front-backcountry communities.

    I’ve been in situations where I’m in Forest Park (large urban park next to Portland) training, and infrequently need to exit with a headlamp for an hour, maybe more. Most of the time, very few are around. Add to that, spotty cell coverage. I may be on the shoulder of a large urban city, but those specific times I may as well be in a remote wilderness. Complacency gets me every time.

    I’ve been on a few Gorge hikes when someone twisted their ankle only a mile or less from the trailhead and it’s dusk. You may be able to hear the roar of traffic on I-84, but immobility puts you a thousand miles from help. Pending carrier, cell coverage can be nothing.

    That said, the list applies across all genres of being “out there.” As well, the continued discussions themselves generate even more good information. I went back through my kit for refinements, immediately.

    Another home run, out of the park!

    • Andrew Skurka on March 11, 2020 at 5:03 pm

      For the exact reasons you mentioned, I always carry a light (and lighter, for firestarting) on long day-hikes and adventure runs when there is some uncertainty about my exit time. But I consider these items to be normal gear, not really a first aid/emergency kit.

  52. ian reed on August 12, 2020 at 9:16 pm

    This post is gold.

    I just used it to build my own First Aid kit for an Alaska Trip at the end of this month. The only addition i made was a 2L UL Dry Bag to store it all in. I fit all your recommended items plus a SAM splint.

    Some of your items links go to REI, but i was able to find variations on Amazon to avoid an extra trip to the store.

  53. Eric B. on August 13, 2020 at 1:53 pm

    In my post above I mentioned avalanche kits and river rescue rope and pulley kits as “First Aid” but really they are Rescue Kits.

    The term First Aid should probably only be applied to physical aid for injuries and illness. My fault for mixing the two.

    Maybe we could have a separate section on Rescue Kits.

  54. Sam on August 28, 2020 at 5:07 pm

    Super helpful, as always!

  55. Andrew on May 2, 2021 at 9:13 pm

    The spreadsheet cannot be found in Google Drive. 🙁

    • Andrew Skurka on May 3, 2021 at 9:48 am

      Looks fixed now. Can you confirm?

      • Andrew on May 5, 2021 at 9:48 pm

        All good now.

  56. Andrew on May 3, 2021 at 10:05 am

    Still no dice.

    • Andrew on May 5, 2021 at 9:49 pm

      All good now.

  57. Amy GB on January 4, 2022 at 10:31 pm

    Two things I like to add are 4-6 capsules of activated charcoal and one decaf black tea bag. The charcoal is useful for so many stomach issues: gas, bloating, diarrhea, and I’ve even used it for food poisoning at home (some even claim it’s useful for treating giardia). The tea bag can be used after brewing, while warm, as an eye compress for pink eye and other eye irritations. With allergies comes eye-itching; sometimes unavoidable. Also, if I decide to brew the tea on a cold night for drinking enjoyment, I save the used tea bag in a sandwich baggie in case I need it as an eye compress later. I’ve treated and cured my childrens’ pink eye with this many times when they were little. I couldn’t believe it worked! Of course, when you’re at home, you would do it more often, but on trail, even using it once can promote healing and remedy some of the discomfort until you can get proper treatment.

  58. Amy GB on January 4, 2022 at 10:36 pm

    I also add a few potassium supplement pills for muscle cramps. Of course electrolytes, proper hydration, proper meal planning, etc., can help prevent this, but nothing is worse than getting leg cramps in the middle of the night.

    Thanks for updating these lists. I use them for every trip.

  59. James Pliny Morrison on January 5, 2022 at 2:41 pm

    I know it is not uncommon to hear people recommend electrolytes and hydration for muscle cramps, but I have never been able to find any real evidence that potassium supplements help with muscle cramps. There was one study done some time ago, but when I looked into it I found it was sponsored by GaitorAid and so it may have had a bias.

  60. isaac mouser on April 14, 2022 at 7:13 pm

    Why don’t you carry a tourniquet? What will you do if someone falls down hill and lands on a sharp piece of wood or rock? It’s heavy but I couldn’t imagine not having one.

    • George on April 14, 2022 at 7:29 pm

      I’ve thought about that too. They are relatively lightweight, and I have a few for other settings, but don’t plan on taking one backpacking. I think the possibility of that happening is pretty slight, but then again, when it happens, you’d be wishing you had one. I guess it’s a risk vs. reward type of thing.

    • Andrew Skurka on April 14, 2022 at 8:13 pm

      1. Very unlikely to need one while backpacking.

      2. If I really need one, I can improvise one pretty easily, like with part of a trekking pole shaft, guyline or webbing or 1-2 bandanas.

  61. MTN on April 14, 2022 at 7:49 pm

    Lots of things can double as a tourniquet: belt, coiled shirt etc. just have to learn how to properly apply it.

  62. Logan on August 28, 2022 at 6:05 pm

    As someone who’s taken multiple Stop the Bleed courses, a tourniquet has become part of my first aid kit. A good alternative to packing a CAT (Combat Applied Tourniquet) in a first aid kit is to carry a couple of heli straps (aka Voile straps) wrapped around the kit. CATs are very effective, however they can only be used once and they take up space in the kit. Large heli straps (i.e. Voile XL 32” straps) can not only function as a tourniquet, they’re reusable and can be used to replace broken or shredded pack straps.

    As a surgeon, I can tell you that QuikClot is a pain to remove from wounds in the OR. A reasonable and cheaper alternative is to use ABD pads as part of a pressure dressing (another use for heli straps). ABDs (Army Battle Dressing, not abdominal pad) will absorb 1L of blood. You can get ABD pads at Walmart or Amazon.

  63. Andy on June 17, 2023 at 5:05 am

    I always carry Compeed blister patches and usually they are the most used and often only used items from my first aid kit. They seem to stay stuck long enough for blisters to heal and provide continued protection from further abrasion.
    I also carry Inadine iodine patches which are designed to go under a wound dressing to prevent infection, a nurse suggested I carry one . Despite the instructions to never use a patch from an open package she said squares can be cut from a large patch to fit the wound and the rest re-wrapped and taped into it’s packaging .
    The same nurse said I should carry steri strips as the cut I gave myself slicing an orange looked like it would have bennifited from a couple of stitches and steristrips would have done the job.
    I think it’s worth checking Tetanus vaccination is up to date but I realise the necessity of vaccination is dependent on political affiliation.

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