A good first-aid kit ranks highest among the gear that you never want to use. Still, taking the time to research and assemble the best first-aid kit is a must before you venture into remote areas. A good place to start is with a pre-assembled wilderness first-aid kit. Then remove whatever you don’t need from the kit and replace it with the items you will need.

Will this cost more than your run-of-the-mill first-aid kit? Yes. Will this customized kit be more useful in treating a serious injury in the backcountry? Hell yes. After you’ve assembled your first-aid kit, the next step is learning how to use the items inside it to treat common outdoor injuries. This story covers some of the most common of those injures. But before we get started, I should warn you:

Graphic images ahead…


Jim Baird with a bad burn
The author cut away dead skin from a popped burn blister. Jim Baird

Few meals are more satisfying than a shore lunch at fish camp. This might seem like the last place you’d encounter an injury—but accidents happen. Especially when hot oil and fire are present. Here’s how to deal with a nasty burn:

  1. If possible, get the burn on ice. Otherwise, dose it with cool water.
  2. Blisters will form; don’t pop them. The fluid under the blisters is sterile and, when left intact, your chances of infection are less likely. 
  3. When the blisters pop on their own, you face a serious chance of infection forming between the dead skin of the blister and your body. Using a sharp, small, and sterile pair of scissors, trim the dead skin off as close to the outside of the burn as possible. 
  4. Wash the wound thoroughly. Soap and water will disinfect the wound as well as anything, but make sure to boil your water first. 
  5. Keep the wound covered. Dirt or other debris or unsterile water can lead to infection. Keep these things out of the wound by covering the burn thoroughly and changing the bandages daily. Non-adherent gauze pads will create less pain and won’t open the wound when changing bandages. Duct tape can help secure and waterproof bandages. Remember to bring lots of bandages in your first-aid kit. 
  6. Bring clindamycin—the type of antibiotic most commonly used for treating infections. If the burn starts to become infected, begin taking the antibiotic right away and make immediate plans to get out. 


When temperatures drop, inadequate or damp boots or gloves are common causes of frostbite. In extreme conditions, taking your gloves off for even a short period of time can be all it takes to cause frostbite. On windy days, your face is equally at risk. Prevention is paramount. Being prepared with the right clothing and keeping it dry is your first defense against frostbite. But if conditions get the best of you, here’s what to do:

  1. Find shelter out of the wind. Set up a tent and get inside. No tent? Duck behind some sort of natural wind block—or build one. Do whatever it takes to get your frostbitten skin out of the cold.
  2. Gently warm the frostbitten area. Keep in mind that rubbing the frostbite or walking on it (if it’s your feet) to warm up the frostbite can create further damage. Use warm water or body heat to warm the frostbitten area. For example, tuck frostbitten fingers in your arm pit. Refrain from using a hot pad, stove, or hot water to warm the area, because frostbite makes the area numb, you could burn it.
  3. Continue to keep the frostbitten area warm and dry. Elevating it will help curtail any painful throbbing, and consider taking ibuprofen.

Post Frostbite Tips: An area of your body that has suffered frostbite never fully heals, meaning it will react to the cold more easily in the future. So, if you’ve had frostbite of any severity, be extra prepared the next time you venture into cold temperatures. The following are also good extra steps to take:

  • Hot pads for your feet and hands are very helpful.
  • Line your bare feet with a plastic bag or GoreTex socks before putting on your socks and boots is a good idea.
  • Mittens are warmer than gloves. They work best without glove liners; that way they allow your fingers to touch for skin-on-skin body warmth. 
  • Carry a balaclava to protect your face when it gets windy.

Deep Cuts

Hunter axe injury in the backcountry
A gnarly reminder to handle your knife and axe carefully. Jim Baird

Axe injuries or the slip of a knife are the most common ways to get cut in the outdoors—but .not the only way. A deep cut from the teeth of a Northern pike can leave a nasty gash too. Here’s what to do when that kind of accident happens:

  1. Don’t panic. The sight of blood from a deep cut be shocking to everyone; not just the victim. When it’s bad, all involved need to remind themselves to stay calm and follow the steps below.
  2. Immediately apply firm pressure. This should slow the bleeding. 
  3. If you are unable to stop the bleeding by applying firm pressure, affix a tourniquet no less than two inches above the injury.
  4. Remove your hand from the wound once the bleeding has slowed. Then clean the wound with sterilized water and/or pour disinfectant on it, such as iodine, rubbing alcohol, or hydrogen peroxide.  
  5. Clean the surrounding area with alcohol wipes. 
  6. Dry the area around the wound using a sterile gauze pad. 
  7. Close the wound. Stitch the cut with sutures, or close it with Steri-Strips or butterfly sutures. In a pinch? Cut thin strips of duct tape. Make sure that the wound is closed tightly. 
  8. Cover the wound with bandages to keep it clean. 
  9. If possible, elevate the wound. If the wound is not severe, keeping it above your heart will reduce swelling and throbbing and will help slow continued bleeding. However, if the wound is severe, keeping continued pressure on the wound is more important than elevation.
  10. If the wound is severe, lay the person flat on their back and elevate both legs. This will help prevent shock.


Long treks are the main cause of blisters—and they usually form on your heels. Here’s how to prevent getting blisters on your feet:

  1. Boots that are subpar in quality, don’t fit right, or are not broken in will cause blisters quickly. Make sure you have boots that fit you properly and consider getting them heated and stretched for a more custom fit. Leather backpacking boots for long treks—including mountain hunts—will last the longest and provide you with more support over non-leather. But, they’ll take a lot longer to break in. Make sure you wear them around town or on short hikes before heading out on a long, backcountry trek.
  2. Wear two pairs of socks. This helps prevent blisters and reduces aggravation of existing blisters because the two socks will rub together, effectively reducing the friction against your skin.

If you’re taking a trip that will include extended periods of trekking or portaging, carry a blister kit separate from your main first-aid kit.

What to Keep in a Blister Kit

How to Treat a Blister in the Backcountry

  1. As soon as you feel a blister coming on, stop and deal with it. Stick moleskin or foam over the blistered area on your heel and cover it with tape. Or, line the bottom of your feet with duck tap if the blistering is happening on the bottom of your feet. 
  2. If the blistering worsens, the blister will pop from the pressure in your boots. Cut off the dead skin and disinfect the blister. Next, use Krazy Glue to attach the dead skin directly back onto the blister, and cover with moleskin, blister foam, and/or tape. 
  3. If the pain gets really bad, and the blisters area begins to swell, take ibuprofen and continue to change the bandages daily. Wash with soap and boiled water, or use another means to disinfect the blister. A thick layer of foam will provide the most relief and covering it with duct tape will reduce painful friction on your heel.

Sprained Ankle

how to treat sprained ankle in the outdoors
If you sprain your ankle in the backcountry, you might need to get creative with a splint. Jim Baird

Ankles will roll… This is one of the most common injuries in the outdoors, because of the uneven terrain in the backcountry. The chances of spraining an ankle increase with fatigue, slippery conditions, or when you’re carrying a heavy load. The typical treatment for a sprained ankle begins with the acronym R.I.C.E.S. Here’s a breakdown:

  1. Rest: To prevent further pain and injury, take some time to rest on the trail. An extra day or even a few hours to take take the stress off of the injury goes a long way.
  2. Ice: This helps reduce swelling, and reduced swelling promotes healing. Keep an instant cold pack or two in your first aid kit. Don’t have these? Place your foot in a cool stream or use snow if it’s available. Ideally, you want to be icing your ankle three to four times each day for about 20 minutes each time.
  3. Compression: Here’s where your elastic bandage comes in. The tightness helps reduce swelling and it adds additional support to the ankle. Wrap the bandage starting at the end of your foot and continue up above the ankle. Be careful to not make it too tight.
  4. Elevation: Rest your ankle above the height of your heart. This will restrict the blood flow enough to reduce swelling.
  5. Stabilization: This is particularly important for more severe sprained ankles, because it’s hard to tell the difference between a bad sprain and a break. Added pressure on a break could result in serious injury or a compound fracture in extreme situations. So, if things are bad you will have to get creative: Stabilize the injury by splinting the ankle with hiking poles, a snowshoe, or a foam ground pad. Also, take ibuprofen.

A sprained ankle can be a real challenge in the backcountry because it can destroy your means of transportation to get out. Fashioning crutches to assist with mobility may help, but if you can’t put any weight on your foot at all, you will have to consider other means of evacuation, such as an emergency air lift. Consider carrying an InReach messaging device for such situations.

Final Thoughts on Wilderness First-Aid

Because help can be days away, wilderness first-aid can be more like second-aid in many cases. Being prepared with the proper first-aid kit is one thing—but you also need to have the skills and knowledge if you or someone in your group gets injured in the backcountry. The best motto to go by is: Plan for the worst and hope for the best. Having and exit strategy, carrying wilderness comms, and taking some basic wilderness first-aid training will go along way. Now get out there an enjoy the outdoors, but don’t forget your first-aid kit.