HIKING FIRST AID

You are hiking your bucket list trail of the National Park that you’ve waited a lifetime to see when you slip on a rock, twist your ankle, and lacerate your knee. What do you do? Do you have the hiking first aid knowledge to provide yourself care? Do you have the necessary supplies?

There are many sources for hiking first aid care and many different concepts regarding what supplies you should have on you while exploring the outdoors as well as a basic road trip. As a pediatrician with an interest in preventative medicine and outdoor adventures, my goal is to provide advice that works at just that, preventing a bad outcome from occurring as best we can, but also being equally prepared mentally and having the supplies in your pack to deliver first aid while working at contacting emergency services.

I will review a few concepts regarding rendering aid, supplies to have in order to achieve that goal and some questions to ask yourself (or your group) to prepare well before you hit the trail for what may come. This does not serve as, nor do I intend it to be, specific medical advice or an all-encompassing discussion of the infinite outcomes that can occur while in the wilderness. You may have a medical condition(s) that you need to speak with your physician specifically about prior to any activity.

Personal Preparedness

The best way to avoid using our hiking first aid knowledge, is to know our limits. We all must understand our abilities and thus individual limitations. Sometimes we may even need to consider the abilities of our group who is traveling together. With that, plan with the weakest member in mind – not the strongest. Take our family for instance, when we are planning any of our outdoor adventures, we consider what the abilities of our youngest child are and use that as the gauge for what we can or should accomplish.

Questions to Consider

1. Are you physically capable for what you are planning to do?
2. Do you have enough individual hiking experience for the trail(s) you want to hike?
3. Do you have adequate experience with the terrain or environment you are about to set off into? i.e. Have you hiked at altitude before? Have you been to the desert? Etc.

Don’t be ashamed if you have to answer no for any of those for the adventure you have planned. We all have that “first” time for things and there is nothing that says this one trip cannot be that. Just be sure that you are not overextending yourself, or your group. Consider a shorter or easier version of what you would like to accomplish, but that is in the new terrain element for you. Additionally, only add in one new thing at a time. Meaning, don’t plan for your first more than 10 mile hike your first time at an elevation over 10,000 feet.

There is no better time than now to say it. Take breaks while enjoying nature. Plan for them, and take them.

Plan (so you don’t need hiking first aid!)

If you have read through our blog, you will find that planning is an integral part of who we are and it has a very important place in helping to prevent significant injury while out exploring as well. Research the area you will be traveling to as well as the trails you want to explore and if there are any other points of interest around.

When planning our National Park adventures, we make sure we plan for the trails that are “can’t miss” for us, some way to take in some of the history of the area, cultural immersion when it is possible, if there are other nearby points of interest outside, and a way to see anything that we feel strongly about but happens to be outside of our abilities on that trip.

I’ll say it again, plan hikes or any outdoor activity, that is within your (or your group’s) skillset. Working within your physical means is a key point in preventing unnecessary injury while enjoying the great outdoors.

Points to check off when planning

• Make somebody outside of your immediate travel group aware of your trip plans.
  • Give them an itinerary, including locations you intend to be and the expected date(s) for being there. Including points of interest you will visit and times or locations where you fully expect to be without cell services. This helps because if Aunt Samantha knows she should have heard from you by June 10th, but that June 8th you were hiking to Fern Branch Falls on the Porter’s Creek Trail, she knows where to send the search party.
• Do you have a hiking buddy?
  • It is best to not hike alone, but sometimes that may be what is planned. Do you have any ability (or desire) to try and find other single party hikers at your destination? If not, that’s fine, I get it. True solitude is important at times. But that is a scenario where it is incredibly important to not only have a detailed itinerary you have shared with someone else, but that you also stick to it so that if disaster should strike the people sent to help are able to get to you.
• Where is the water?
  • Do you have your water jug packed? Do you have your water jug with you as you go on your hike? Are you purchasing bottled or purified water at your destination or are you taking all you need for your entire trip plus reserves with you? Have you scoped out where potable water sources are within the National Park system (it is not always at every visitor center or trail head) or wherever your adventure is taking you? What is your backup plan if you forget your water at your vehicle or somewhere else? If you find yourself asking “I wonder if I will need my water on this hike?”, the answer is, YES, take your water.
• Where will you seek medical care if it’s needed?
  • In case you or another group member are driving yourself to seek care, do you know what city or town is the closest hospital or medical center in? Do you know the route to take to get there? (In case it is a bit of a drive before your GPS will work)
• Can your phone make satellite messages to emergency services?
  • Certain phones have this capability. iPhone14 and later as well as Google Pixel 9s have the ability to connect to a satellite with others working on this too.
• Is a dedicated satellite phone worth it for you?
  • There are many levels of consideration in reaching this answer for yourself. Researching their capabilities and cost as well as how much you intend on using one will help you decide.
• Know the weather.
  • Be prepared to turn back. No trip or location is worth risking your safety on the weather. Visitor centers and campground registration locations or site hosts often have information on the weather forecast if you have not already written it down or printed it out when you are in those areas of limited service.

Supplies for Rendering Hiking First Aid

Below you will find the ten essentials that I believe everyone should have in their hiking first aid kit. You can purchase pre-prepared first aid kits or build your own. Even if you take more things with you, be sure these are in your kit at a minimum. Having these items in a single, contained bag or kit eliminates some of the “where is that one thing” that can happen when your brain starts into frantic mode after an accident has happened and you are attempting to provide care.

Ten gear essentials

1. Antiseptic wash
2. Adhesive bandages
3. Antibiotic ointment
4. Elastic bandage (ACE^TM)
5. Nitrile gloves
6. Gauze – rolled and pads (2” x 2” and 4” x 4” sizes)
7. Forceps/tweezers (add in a tick removal device if traveling in an area of high prevalence)
8. Tape – paper, silk (cloth), and plastic (transparent) – each are used for different applications
9. Bandage/trauma scissors
10. Moleskin

Medication and Medical Conditions

Make sure you have your personal, prescribed medications packed including planning for a few extra days beyond what you think you will need, just in case your trip is unexpectedly extended. You may need to request a refill from your prescriber sooner than usual, ahead of your planned departure.

Know what medical conditions your traveling partners have. Depending on the relationship, sometimes sharing this may not be as comfortable as we may like, but knowing this information can be critical. This helps in that preparedness concept and preventing unfavorable outcomes. If your travel partner has diabetes, knowledge of what hypo- or hyperglycemia symptoms look like can be critical for their safety. The same is true if you have seizures, your traveling partner knowing the location of your rescue medication is imperative to your health.

Have a small assortment of over the counter (OTC), even select prescription (Rx) ones, for whatever small ailments may arise. Having these contained in a single location is important as well so you aren’t searching aimlessly when they are needed. Give these travel boxes a try. There are two sizes depending on what your needs may be. We have one of each. We absolutely love them as they are small enough to throw in your backpack for the really long trails and include a set of stickers to label each bin.

Medications to consider having in your hiking first aid kit

1. Ibuprofen
2. Acetaminophen
3. Aspirin (DO NOT give if <18 years of age)
4. Cetirizine, loratadine, or fexofenadine^†
5. Diphenhydramine^‡
6. Antacid – i.e., TUMS (calcium carbonate)
7. Loperamide^«
8. Simethicone
9. Bismuth subsalicylate – treats a variety of gastrointestinal symptoms, could be used instead of the three prior list items
10. Melatonin
11. Zofran® (ondansetron) – Rx only

If you have children – consider children’s chewable medications, as available, for any of the above listed items.

DO NOT forget your EpiPen® (or other epinephrine auto-injector) if one is prescribed to you.

Consider a dose or two of short acting, or emergency, medication that may be prescribed to you for a variety of conditions. For example, Amber and I both have migraines so in our box is two doses of Nurtec®.

Brush Up on your Hiking First Aid Knowledge

Depending on how much time you are spending outdoors and what goals you may have, improving your hiking first aid knowledge is a good skill to consider. There are infinite books out there to help, including a guide from the Red Cross. You might consider a course from the National Outdoor Leadership School (NOLS) if you plan on extending outdoor adventures and/or very remote treks.

Treatments

Simple Wounds:

• Clean and bandage – Clean with the antiseptic wash (iodine or chlorhexdine) in your kit and bandage. Remember to keep the wound clean and dried until healed.

Bleeding:

Sprains:

• Wrap with an elastic bandage as needed.
• Rest, Ice, Compression, Elevation (RICE) therapy is the mainstay of management.
• Weight bearing activity as tolerated. Meaning, do not specifically avoid use of the sprained joint just because. You can do activities to your ability or limitation – typically pain is the limitation for most of us.
• If you cannot bear weight on the joint you sprained, this is an indication to have it examined. For sprains, bearing weight, even if limping, is expected.
• Reduce strenuous activity for the remainder of your trip.
• Know your limitations following the sprain.

Fractures or Dislocations:

• Stabilize with splinting if you know how to, but DO NOT extend beyond your training or comfort.
• Contact emergency services immediately.

Hypothermia or Exposure:

• Remove wet clothing so long as you have another means to cover the skin from additional exposure.
• Cover with a blanket (many pre-made first aid kits have a reflective blanket of sorts in them) or multiple blankets if you can.
• Contact emergency services as needed. Certain times this will be an immediate need, in some situations this may not be needed at all. This is very much a judgement call. Err on the side of caution.

Injuries with Questionable Spinal Injury:

• Keep the injured individual as still as you can while also notifying emergency services.
• You may have to stay with them to help keep them calm and still. We aren’t packing back boards and cervical collars with us on the trail, so we may need to be right there to help talk sense into our travel buddy to lay still and not get up until the trained professionals arrive.

Cardiopulmonary Arrest:

• Early and effective cardiopulmonary resuscitation (CPR) improves outcomes from cardiopulmonary arrest.
• I am an advocate for everyone to achieve, and maintain CPR certification with the hopes of you never actually needing to employ it. Find a class through the American Heart Association, the American Red Cross, or other certified agency in your area.

When all else fails or you are questioning yourself or what to do, contact emergency services. Please do not get in over your head.

Bottom Line: Hiking First Aid

Do you feel confident that you could care for a sprain or laceration now? I hope this post has given you points for planning and helped you devise a plan of action so you feel the most prepared should disaster strike while you are trying to enjoy your time outdoors. I also hope, ultimately, you never have to use any of this. As always, leave no trace, pack out what you pack in, wrappers for supplies and disposable supply items included. Have fun, be safe, pack your hiking first aid kit, and go enjoy the great outdoors while you Wander More Together.