Winter Backpacking First Aid Kits

Types of First-Aid Kits

Putting together a first aid kit is a process that often involves modifications depending on many considerations. Priortize safety. Think about your first-aid risks before each trip and adjust your first-aid strategy based on:

• Activity and environment
• Duration and distance
• Group composition
• Pre-existing medical needs
• Weight

How do these considerations affect what goes in your first-aid kit? Activity and environment matters because if you are doing high velocity activities such as mountain biking or skiing, there will be a greater need to carry items such as a Tactical tourniquet or an emergency dental repair kit. There is less need for such items if you are snowshoeing. Likewise, there is little to no need for insect repellent or mosquito nettingin winter or snake bite concerns. Duration and distance effects how often you may need to change bandages (number of bandage changes you need to pack). Group composition matters because if there are children or women, this can affect medications and issues such as unexplained abdominal pain. Pre-existing medical needs, such as allergies to bee stings (Anaphylaxis risk) or diabetes (Hypoglycemia risk) involve packing prescription items such as an EpiPen and Insulin. 

Your pack weight itself affects safety, especially on steep icy slopes. Ideally, a first-aid kit only includes what is necessary for the type of activity and environment and duration involved in the hike. In order to minimize weight it is important to focus only on first-aid supplies that are essential for getting through the hike or until an emergency rescue is possible. Most of our backpacking trips in the Pacific Northwest are two to three days long with a few up to five days. It is unlikely that we are more than a day or two away from some level of medical assistance if required. This reduces the need to pack a large amount of first-aid supplies. The total weight of my first-aid kit is typically 5–10 oz.

While weight matters, take care to not compromise safety but cutting back too much and omitting important items, medication labels and instructions.

In all my years of backpacking I have been fortunate to not need my first-aid kit apart from dispensing bandages for blisters and pain relief medications to other hikers. Blisters and joint pain are the two most common issues.

The First-aid Kit Container

There are many types of ready-made first-aid kits available for sale, some tailored for backpackers. Some include an almost indestructible case and others that are lighter. Many backpackers use a plastic zip-lock bag or Dyneema stuff sack to reduce weight. If you are making your own container consider these three things:

• Look and location
  • You can use red duck tape to put a red cross on both sides of the container so that anyone in the group can quickly identify the first-aid kit.
  • Place this kit in the font outside pocket or pack lid so that it can be easily found and accessed.

• Durability (water exposure)
  • Take care to use a waterproof container. 
• Kit organization
  • Using multiple zip-lock bags can help organize the contents
  • Distribution: I don’t put every first-aid item in the kit. I put chewable Aspirin and sunscreen in my hip belt pocket. Someone who needs Aspirin is less likely to ask for it if they think you are going to have to take your pack off or look for it in a first-aid kit.

What’s in My Basic Winter First-Aid Kit

List of items (purposes explained below):

• Disposable Nitrile Gloves (2 pair)
• Leukotape (10–15) (precut strips)
• ABD Pads (3)
• Female hygene pads (multi-purpose)
• Band-Aids (6 medium and large)
• Burn jell packets (2, for stove burns)
• Triple Antibiotic Ointment packages (2)
• Providone-iodine Pads (2)
• Sanitizing wipes (2–4)
• Syringe (for irrigating wounds)
• Scissors or knife (to cut fabric)
• Duck tape (part of gear repair kit)

Sometimes I will also pack a trash bag that is pre-cut into a rain cover. This weighs only an ounce and can help protect a person from hypothermia.

First-Aid Strategy 

First-aid is a strategy that has three parts: 

• Prevention
• Managing minor injuries for the brief duration of the trip
• Managing major injuries until emergency help arrives

Prevention

Winter Backpacking is more challenging than three-season backpacking. In winter conditions, most gear has an important personal safety component. A stove, for example, can help in preventing and remedying hypothermia. Your tent eliminates the need to pack an emergency shelter blanket. For winter backpacking, prevention falls mostly under the category of the 15 Essentials. This includes items such as a headlamp, fire-starters, UV clothing, UV goggles, sunscreen, bright clothing, helmet, avi-gear, appropriate traction, and for three season events, water filtration, etc. The first-aid kit is a subset of the 15 Essentials. To better understand prevention strategies, please see the Winter Backpacking Safety Protocols Project.

Managing Minor Injuries

The first-aid kit contains prevention items for minor injuries — bandages for blisters and minor wounds and pain and inflammation relief drugs.

Blister prevention and treatment

For prevention and treatment see Blisters: A Guide to Prevention and Treatment and Footwear for Winter Backpacking

• Needle or safety pin (to drain blisters)
• Leukotape (Application must be even. Don’t wrap tape around foot or toe because this can lead to blood pooling.)
• Band-aids
• Spenco 2nd Skin for open blisters

Wound care

• Disposable Nitrile Gloves (Or, improvise with ziplock bags or plastic. This is a crucial dual purpose item for protecting the first aider from potential contamination by bodily fluids (like blood or vomit) and preventing the transmission of infectious diseases from the injured person to the first aider or vice versa. I pack two pairs because in a serious situation I will likely need assistance.
• Syringe (For irrigating wounds and blisters with high pressure water to prevent infection.)

Bandages

• ABD Pads (Army Battle Dressings, are a type of large, sterile, highly absorbent dressing used to cover and protect large wounds, especially those with heavy drainage)
• Alcohol pads (primarily used to disinfect the skin before bandaging the wound, burn, or bug bite)
• Band-aids (For blisters and minor cuts)
• Dressing pads (Primarily serve to protect wounds, absorb drainage, and create a moist environment conducive to healing)
• Gauze roll (replacements for each day of trip: Primarily to cover and protect wounds, absorb excess fluid, and secure dressings)
• ACE wraps (Stands for “All Cotton Elastic”: compression bandage used to provide support and compression to injured or sore areas of the body, helping to reduce swelling and pain)
• Burn dressing (Mainly for camp stove burns)
• Women’s hygene pads* (multi-purpose)
• Antibiotics (Bacitracin)

*It may seem odd for a guy to pack these items in a first-aid kit, but periods are a common occurrence and a person without supplies can experience discomfort and anxiety in a wilderness setting. These items only weigh a fraction of an ounce. There are commercially available female first-aid kits for periods that include individually wrapped pH-balanced, unscented wet wipes, panty liners, maxi pads with wings, and scented disposal bags. If you have a female partner, it is simple enough to ask for a few pads to include in your first-aid kit. In a first aid situation, women’s hygiene pads can also function as a makeshift dressing for wounds when other supplies run out or are unavailable. While not sterile, they offer absorbency and can help to stem bleeding and protect the wound. However, proper sterile dressings like gauze pads are preferable. 

Managing Major Injuries (until emergency help arrives)

When there is a major injury you have to focus on stopping the bleeding, reducing pain, and keeping the victim warm and comfortable until help arrives. In the Pacific Northwest, expect rescue times to be a minimum of 3–12 hours and sometimes longer. In high winds, helicopter rescue is often not possible and a ground effort has to be organized.

Seasonal Gear

• Chest seals (Consider packing during hunting season. You are 1000 times more likely to be shot by a hunter than attacked by a bear in the U.S. Wear bright hiking clothing when possible.)
• Tactical tourniquet (When using crampons or ice axe.)
• Mosquito netting and bug repellant

Medications

There are three basic first-aid medication categories: 

• Analgesics (Pain and inflammation relief)
• Antibacterials (Medications designed to combat infections caused by bacteria)
• Antiseptics (Used to cleanse wounds and skin to prevent infection)

Pain and inflammation relief

• Tylenol
  • Benefits: Relieves pain and lowers fevers. Doesn’t affect blood clotting making it useful for patients suffering head injuries, internal bleeding, or active bleeding.
  • Cons: Not an anti-inflammatory. Avoid if you have severe liver disease or liver problems, are taking Warfarin (a blood thinner) or you have phenylketonuria (PKU)

• Aspirin
  • Benefits: Anti-inflammatory and pain relief.
  • Cons: Not for use when there is a head injury or the person has stomach ulcers or a history of gastrointestinal bleeding or high blood pressure. Never give aspirin to children under 16. 
• Ibuprofen
  • Benefits: Anti-inflammatory, pain, fever, and inflammation relief.
  • Cons: Increased risk of heart problems. Avoid if you have conditions like asthma, high blood pressure, heart disease, stroke, or inflammatory bowel disease.

Antibiotics

• Doxycycline: Lung, skin, tick and mosquito infections (risk of tendon rupture)
• Cipro: Head, throat, lung, skin, and urinary infections
• Amoxicillin: Clavulanic acid: head, throat, lung, and skin

Other medications

• GI meds: Oral rehydration salts
• Stimulants (to stay awake): Caffeine pills
• Sleeping: Benadryl

Pocket first-aid books or ebooks

You can carry pocket-size wilderness first-aid books or download first-aid ebooks and resources to your phone. The Alaska Cold Injuries Guidelines (2014) is available as a PDF or as an ePub here:

Let us know your thoughts and suggestions

Please share your ideas, experiences, and challenges below. Your comments and questions are welcome.