May 20, 2024

Gear Guide: Backcountry First Aid Kits

By Becky Fuys, FOW

One of the most frequently asked questions during wilderness medicine courses is, “What do you carry in your first aid kit?” Unfortunately, there really is no “one size fits all” when it comes to first aid kits for backcountry adventures.

I’ve also yet to find anything sold online that truly fits my needs either… So instead, I use the following basic principles when building out a first aid kit:

What is the activity I’m participating in, and what are the potential risks?
Prep for the worst, hope for the best.
Where am I going / how long am I going for?
Dual purpose everything!

Get prepared with the equipment and skills for wherever you're headed. Wasatch Range, UT. Photo: Bo Wagner (@bo_wagner)

What is the activity / What are the potential risks?

Although we always venture into the backcountry with great intentions of “playing it safe,” the reality is that we’re often participating in risky activities and things don’t always go as planned. So when you’re packing before a trip, take a second to really consider the worst case scenario and instead of just hoping for the best, be ready for it.

Using splitboarding as an example - when I’m headed out on a day tour, the most severe incidents may involve: avalanches, accidents resulting in trauma, or any event that requires you to spend more time in the field than anticipated.

Wasatch Range, UT. FOW: Becky Fuys // Photo: Pep Fujas (@pepfujas)

Prep for the worst, hope for the best

With the potential risks listed above, how can we prepare for the worst?

Starting with avalanches, someone may either need CPR or rescue breaths, so I always carry a CPR mask in an easily accessible pocket while touring.
If someone is involved in a trauma related accident, I need to be ready to handle a major bleed or a broken bone, so I bring a clotting agent like QuikClot, gauze, medications (ibuprofen & heavier duty pain killers) and bandaging material (tape, triangle bandages & voile straps).
To prepare for staying in the field longer than anticipated, I also always pack an extra puffy, headlamp, gloves, lighter, extra Gu packet / energy source, a packet of hot hands, homemade fire starters, and a space blanket or bivy in case we stay in the field late or even overnight. My full list of first aid supplies is below.

All of this (other than the headlamp, puffy, and gloves) collectively fits into a waterproof bag roughly .5L big and weighs only a couple of pounds.

Wasatch Range, UT. Photo: Pep Fujas (@pepfujas)

Where am I going / how long am I going for?

This is where my kit really fluctuates depending on the location of the trip. Those of us here in the Wasatch are fortunate to have fairly reliable cell signal and access to resources while touring. However, when traveling to other mountain ranges, it’s often a different story.

Whenever I’m recreating in an area outside of cell signal or further from accessible roads / hospitals, I always make sure to have a communication device such as an InReach or something similar (my InReach is pretty small, so it lives in my pack all winter long). I’ll also usually bring the bigger of my extra puffies, extra gloves, a full emergency bivy rather than a space blanket, an extra ski strap or two, ace wrap, battery pack for the InReach & a phone charger, and additional repair items (duct tape, zip ties, etc). It’s also not a bad idea to carry some sort of rescue bivy if you have one available. Rescue bivvys are great because they can be used to create shelter, help someone who’s suffering from hypothermia, or even build a rescue sled for evacuating a patient.

Wasatch Range, UT. Photo: Bo Wagner (@bo_wagner)

Dual purpose everything!

We have enough weight on our backs already; we don’t need to add to it by bringing single use first aid items. Things such as bandaids and the myriad of antiseptic wipe packets that are stocked in traditional first aid kits are pretty useless in any true backcountry emergency. If it’s not going to save someone’s life or make an evacuation drastically more efficient, then in my opinion, it’s not worth hauling around with me.

This concept is also why I usually leave the SAM splint at home unless we have assisted access on our trip. We already have items with us, such as our patient’s shovel, probe, ski poles, or ice axe, to build a splint with if needed, so a SAM splint isn’t worth the additional weight to me. Instead I like to carry multipurpose items like tape, triangle bandages, voile ski straps, etc. Keep in mind, there are some items that can’t and shouldn’t be improvised like clotting agents, tourniquets, or CPR masks.

To simplify this, general rules that I fall back on are:

If it will save someone’s life, it’s coming with.
If it’s not a life saving tool, but would be really helpful if needed, and is lightweight / multipurpose, then it can come too.
Everything else can stay at home or be left in the car.

Ski straps: the poster child of multipurpose equipment. Wasatch Range, UT. Photo: Pep Fujas (@pepfujas)

Tips for Stocking Your First Aid Kit

As stated before, there unfortunately aren’t many great first aid kits on the market for backcountry use. As wilderness medicine becomes more prevalent in the outdoor industry, specialized first aid kits are becoming more available, but be sure to do your research before purchasing these kits.

Below are a few tips to consider when looking for first aid supplies online:

Tourniquets: When looking for a tourniquet online, purchase the tried and true CAT tourniquet. There are plenty of cheaper options from other brands available on Amazon that I’ve personally seen break when practicing with them in classes. If you see a tourniquet that’s sold for under $20, it’s likely a knock-off and may not be reliable in an emergency.
Hemostatic Agents: Hemostatic agents are essentially a powder that helps speed up the body’s natural blood clotting process. Brands like QuikClot Combat Gauze, Celox Gauze, and ChitoGauze Pro are great because this powder comes impregnated in gauze, which is critical. Try to avoid using the cheaper powdered hemostatics that come in small bags that look like sugar packets. Although these are tempting because they’re small, light, and affordable, they give you very limited control of where the hemostatic is applied, and can be dangerous for both the patient and the rescuer if the powder causes clots in unintentional areas.
Bandaging Supplies: Items like tape, ace wraps, triangle bandages, wound cleaning supplies, etc can be found pretty much anywhere. These are typically cheapest to buy in bulk, so grab a few friends and order them together!

Knowledge & Training

Similar to avalanche gear, owning and carrying a beacon, shovel, and probe is only the first step to being prepared in the backcountry. Knowing how to use your first aid equipment is equally as important and can be the life-saving difference during those first critical moments of serious situations.

If you’re looking for the first (or next) steps in learning about wilderness medicine, I highly recommend taking an in person Wilderness First Aid course. These courses are 2-3 days long (roughly 16-24 hours) and provide a baseline for understanding how to care for a friend who’s involved in any sort of accident in the backcountry. You’ll learn how to thoroughly assess a patient, identify & stabilize life-threatening injuries, initiate an effective rescue, and provide continued patient care while resources are on their way. More than anything, you’ll gain hours of hands-on experience with these skills, enabling you to feel more prepared when faced with a real incident in the backcountry.

If you’re interested in taking a course, refreshing your skills, or just learning more about wilderness medicine in general, scroll down and discover BackcountryReady.

Packing Lists by Activity

Side-Country / Beginner First Aid Items:

2 triangle bandages (or ace wrap)
*Quick Clot and / or 4x4 gauze
Tape
Meds - ibuprofen, electrolyte packet, energy source (could be an extra cliff bar, gu packet, etc)
Lighter
Ski Strap(s)
Hot hands & extra gloves
Multi-tool (with knife)
Radios (bonus item if you have them)

Basic Day Tour First Aid Kit / Rescue Supplies:

First Aid Supplies:

CPR Mask
Hemostatic agent / QuikClot Gauze
Sterile Gauze (1) & Non-sterile 4x4
Tape
2 triangle bandages (these are great for making splints or packing wounds)
Medical gloves - I always have extra in my hip pocket and / or top loader too!
Meds - ibuprofen, heavy duty pain killers, electrolyte tablets
Inside a small plastic bag -

Safety pins
Super glue
Electrolyte packet

Emergency Supplies:

Space Blanket - inside plastic bag (Replace these often! They disintegrate over time)
Gu gel for calories (Glucose gel works well here too)
Hot hands
Lighter / fire starters
Headlamp
Map & Compass or equivalent (if using your phone, make sure to have sufficient battery or a small charging device)

Utility / Repair Supplies:

Multi-tool (with pocket knife, make sure it fits your binding screws!)
Zip ties / small roll of duct tape
Extra ski strap(s)
Batteries to fit beacon and headlamp
Paracord

Other Essential Equipment:

Radios
Communication Device: In- Reach, Spot Device, Sat Phone, etc.

Even when traveling to places with cell signal, I still always bring my inReach. The reason being, if I’m in a really bad incident, I can hit the SOS on my inReach without taking much time to do so. I can always call 911 and get connected on the phone later.

Water - do you have extra in case you’re stuck out there longer than expected?

I always pack 1-2 Liters minimum depending on length of tour / distance from trailhead or escape route. For longer tours (5+ hrs) or when traveling to remote areas I have 1 L with electrolytes and 1 L of plain water.

Multi-Day or Remote Tours:

(i.e. Tours with limited to no cell signal, or further from outside resources, roads, hospitals, etc)

First Aid / Emergency Items:

All Items listed under “Day Tours”
Sam Splint (optional, 1 per group is plenty)
Additional Ski Strap(s)
Ace Wrap or equivalent
Emergency bivy (instead of Space Blanket)
Extra warm gloves / mittens
Extra puffy
Extra beanie / warm hat
Wilderness First Aid Field Manual
Battery pack & charger cord for phone + sat phone

A note on recreating in places without cell signal- If you are in an incident, still try to dial 911 with your cell phone - depending where you are, the call may still go through!

Items left in the car:

Fully Stocked Trauma First Aid Kit
Extra Water
Extra headlamp & Lighter (these live in all my vehicles year-round)
Blanket & Shovel (during winter months)
Jet Boil & Fuel when recreating in very remote areas if not already in my pack for overnight trips

Mountain Biking First Aid Supplies:

QuikClot Gauze
1-2 Triangle Bandages
Glucose gel or Gu / Snacks
Gloves (medical)

Meds (ibuprofen, antihistamine, chewable electrolytes, heavy duty pain meds, etc).
inReach / communication device
Tape & 4x4 gauze stored inside a plastic bag - the bag can be used for puncture wounds in the chest
I’m definitely carrying 2 triangle bandages on remote rides as opposed to 1 in the list above

Broken collar bones are one of the more common bike injuries, and with 2 triangle bandages you can make a really great sling. You can get away with only having 1 bandage, but then you also have to use some of the patient’s clothing, and since they’ll be walking down the rest of the trail they may need all of their layers to stay warm.

Optional: SAM Splint -You can also make a pretty good splint with a handheld bike pump or stick & water reservoir or extra clothing layer if you don’t want to carry a SAM Splint.

Wound cleaning supplies: povidone iodine packets, syringe, extra 4x4 gauze, steri-strips, tincture of benzoin, non-stick dressing, sterile dressing or Tegaderm
I would also consider a tourniquet and CPR mask for these trips too

Tourniquet - if someone falls and severs a major artery in their arm or leg, sometimes a hemostatic agent isn’t enough to stop the bleed.
CPR mask - this can be helpful if someone crashes and has a high spinal cord injury and needs assisted breaths while waiting for an evac. These are sometimes needed for very severe traumatic brain injuries too.