Walking Well: A Guide to First-Aid Preparation for the Trail

Credit: Mike Powell/Allsport
How can a hiker be best prepared for major trail medical emergencies? Fortunately major injuries are rare. They are difficult to treat and include bleeding, respiratory arrest, shock, fractures, tissue damage, anaphylaxis, and heat and cold exposure. What can a hiker do to prepare for these emergencies?

  • Take a wilderness emergency medicine course
  • Read a good wilderness emergency medicine book.
  • Take one of the following books along on the trail.
  • Read articles like this and remember its good advice.
  • Carry a simple first aid kit. However, it will be useful mainly for minor problems.

Wilderness emergency medicine courses are advertised in hiking journals such as AMC Outdoors. There are three major groups offering this training in the USA. They include (1) Solo Wilderness and Emergency Medicine in Conway, New Hampshire, (2) Wilderness Medical Associates in Bryant Pond, Maine, and (3) Wilderness Medical Institute in Pitkin, Colorado. These groups offer several basic and advanced courses. Most appropriate for hikers with no medical background are one- to two-day courses in wilderness first aid that cost from about $50 to $200.

These courses include lectures, manuals, demonstrations, and hands-on field exercises. They are bound to help a hiker emerge better prepared to help others more confidently and with a broader perspective. More general trail training, such as that supplied in hike workshops sponsored by outdoor organizations and hiking clubs is also appropriate, especially for less experienced hikers who may need to be alerted to hazards.

Useful books include: Medicine for the Backcountry by B. Tilton & F. Hubbell (ICS Books, Inc., 1990); Mountaineering Medicine by F. Darvill (Wilderness Press, 1992); and Emergency/Survival Handbook by R. Brown (The Mountaineers, 1987). The first of these is the most detailed and stresses the step-by-step approach to diagnosis and treatment. The second is a more compact and useful general guide. The third is a handy pocket-size outline of procedures for most emergencies.

Would you carry a first aid book? Would you read it before or during an emergency? Is the utility worth carrying the weight? Each hiker should consider these questions.



Here is what I use to deal with minor emergencies:


  • Cortaid (Hydrocortisone 1% ointment); chafing, rash, bites, & stings
  • Antifungal (Tinactin cream); Athletes foot
  • Antihistamine (Benadryl, etc.); allergic reactions, insomnia
  • Antibiotic (Dicloxacillin, etc.); skin infections
  • Antibacterial (Bactrim, etc.); urinary infections
  • Anti-inflammatory (Ibuprofen), inflammation, pain
  • Analgesic (Tylenol and Codeine); pain
  • Antacid (Tempo); GI upset
  • Multivitamin tablets; nutrition supplement
  • Antihypertensives; personal blood pressure control
  • Sedative (Lorazepam); insomnia
  • Potable Aqua; iodine water treatment


  • New Skin in small plastic bottle; cuts, abrasions
  • Band-Aids, 3 sizes; cuts, abrasions
  • Adhesive coverlets; toe irritation
  • Moleskin and molefoam; blisters, irritation
  • Adhesive tape 1/2"; strapping
  • Duct tape on water bottle; repairs*
  • Scissors and tweezers on Swiss Army knife; surgery*
  • Qtips; swabs
  • DEET (Ben's); insect repellent*
  • Mouse hang; protect food bag*
  • Katadyn filter; water purification*
  • Weight of first aid kit in plastic bag = 7.5 ounces (not including * items)

Other related items carried

  • Sewing kit: cotton and heavy nylon thread, needles, safety pins
  • Krazy Glue
  • Repair kit, Clevis pins and rings

Optional items

  • Lip balm
  • Elastic bandage (Ace)
  • Knee supports
  • Gauze bandage
  • Antibiotic ointment
  • Antidiarrheal drugs
  • Snakebite kit
  • Foot powder
  • Antiseptic
  • Second Skin
  • Sunscreen

For more on trail safety, check out Trailside 911 on GORP.com

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