Wilderness First Aid basics
Learn How To Treat 10 Of The Most Common Outdoor Injuries
It’s all fun and games until… [insert injury here].
That’s how it usually goes in the outdoors — you’re enjoying your day with friends until someone gets hurt, and the rest of the day doesn't go as planned. An injury can definitely put a damper on the fun, and in extreme cases can lead to survival situations.
So what do you do when someone gets hurt in the wilderness and you're hours (or days) from the nearest hospital?
We’ll cover the basics of what to do in a variety of situations — from minor injuries (blisters, cuts, dehydration) to more serious issues (shock, frostbite, concussions).
We'll also help you understand when to call for help if things get really bad.
You don't have to be a medically-trained professional to have fun in the woods, but it certainly helps to know the basics. Let’s get started!
Wilderness First Aid vs. Regular First Aid
If you already have some basic first aid training, that’s great! But when you’re deep in the woods, your first aid priorities are a little different and that can change how you care for an injured person.
- Healthcare professionals could be hours (or days) away. Basic first aid skills usually focus on keeping someone stable and out of danger as you dial 911 and wait for help to arrive. Wilderness first aid isn’t that easy. Even if you can call for help, it’ll probably be at least several hours before professionals arrive. So in the case of serious injuries, you need to keep someone stable for longer.
- Your first-aid options are limited by what you’re carrying. There’s no fully stocked medicine cabinet in the woods. The first aid you can administer is limited by what you’re carrying so you may need to get creative.
- Weather. With wilderness first aid, in addition to attending to injuries, you may also be facing extreme weather that can be dangerous even for non-injured members of your party.
- Lack of communication. Unless you have a satellite communication device, it’s likely you won’t have a way to call for help. So in some cases, you can’t just hunker down and wait for help.
But don’t let those factors discourage you from getting outside. Most people will never face serious injuries during their outdoor adventures. However, it can happen.
So in order to be prepared, let’s go over the basics of wilderness first aid starting with what to do for minor injuries.
Basic Wilderness First Aid Tips For "Minor" Outdoor Injuries
Before we get to specific injuries, let’s get a few first aid basics out of the way. CPR and the Heimlich maneuver are the backbone of basic first-aid courses and are important to know regardless of where you are.
So if you don’t currently have a basic CPR first aid certification (or just want a quick refresher), here are two quick videos to watch.
Ok, now let’s cover the outdoor first aid basics for some of the most common backcountry injuries or situations. These will probably account for like 99% of the injuries you’ll ever experience in the wild.
Cuts, Scrapes, and Other Boo-Boos
Resist the urge to “tough it out” and forgo taking care of minor flesh wounds. The last thing you need in the wilderness is an infected cut.
Clean the cut/scrape by flushing it with water and then swabbing it with an alcohol wipe from your first aid kit. Then apply a bandage to keep it covered and clean.
Cuts and Scrapes First Aid
- Don't try to tough it out. Take a minute to sterilize it and cover it.
- Use antibiotic ointment and a sterile bandage. Superglue can also help with deeper cuts.
First, cool the burn (try holding a cool water bottle against it). If it’s blistered, don’t break the blisters. A broken blister is an open wound that can easily get infected.
But if a blister does break, apply some antibiotic ointment and lightly cover the area. Take some ibuprofen or Tylenol for the pain if needed.
Minor Burns First Aid
- Cool it down, cover it up. Take tylenol for pain.
- Use antibiotic ointment and a sterile bandage for open wounds.
For tips on warning signs and treaments for more serious burns, see Wilderness First Aid - Part 2 for serious injuries
The best way to treat dehydration is by making sure you get enough fluids in the first place. Especially at higher altitudes, you need to drink extra water when you are outside.
But if you or someone in your group does end up dehydrated, take a break immediately and get as much water in them as possible. Here are some signs to look out for:
- Feeling thirsty or dry mouth
- Feeling dizzy or tired
- Dark yellow pee
Wilderness first aid for dehydration
- Start replacing fluids. If you’ve run out of water, now is the time to use one of your 10 essentials for emergency water purification.
- Eat something to replenish electrolytes. Emergen-C packets work great.
- Get out of the heat. Find some shade, sit down, take off excess clothes, and reduce your activity.
Common on your feet while hiking, blisters shouldn’t go untreated. In addition to just being plain annoying, any open wounds on your feet don’t heal very well in the wilderness and can easily get infected.
That’s why it’s important to keep a close eye on your feet and watch out for hot spots (areas of red, warm, and irritated skin that’ll eventually turn into a blister).
If you’re noticing a hot spot, one of the best things to do is just cover it with an adhesive cloth tape. Leukotape is a hiker favorite. That’ll create a protective layer that keeps the hot spot from getting irritated.
And if you end up with a big juicy blister, well then you may need to pop it. If it’s so big that you’re sure it’s gonna pop in your boot, then it’s better to pop it when you can clean and bandage it.
Wilderness first aid for blisters
- Cover up hot spots before they become blisters
- Sterilize the blister and whatever you’re going to pop it with
- Puncture the blister and let it drain
- Sterilize and bandage like you would any other open wound
If the tick is big and full of blood, don't squeeze the body of the tick, since that will squeeze all of the blood (now possibly infected with disease) back into your body, increasing your risk of infection.
Once the tick's head is out, clean the area with an antiseptic wipe and put a small band-aid over it. It’s also a good idea to try to identify what type of tick it is so you can assess your risk of getting Lyme disease or Rocky Mountain Spotted Fever.
Visual learner? Watch someone pull a tick off their arm while narrating the video (that takes skill!)
Tick Bite First Aid
- Don't squeeze the tick's body.
- Use tweezers to grab the head of the tick as close to the skin as you can, and pull it straight out.
- Clean the area with antiseptic wipes and cover with a bandaid.
- Identify the tick to assess your risk of disease.
Stings and Other Bug Bites
While most other bug bites are simply annoying and itchy, some can be extremely painful. Bees, wasps, and hornet stings can be painful for days, possibly resulting in open wounds and infections if left untreated. Same with spider bites and scorpion stings... not fun at all.
So make sure you take a minute to treat these bites properly so they don't get worse.
Stings and Other Bug Bites First Aid
- Remove the stinger (if there is one)
- Clean the area and apply after-bite wipes (in many wilderness first aid kits)
- Apply a cold compress to help relieve stinging and itching
- If it’s on your arm or leg, elevate it
- Take an antihistamine or pain reliever if needed
Twisted Ankle or Other Usable Injuries
Some of the most common soft-tissue injuries in the wild are ones that affect the lower body. Maybe you stepped wrong, slipped on a log, or just lost your footing and now you’ve got a throbbing ankle.
If nothing is obviously broken and the joint is still usable — meaning you can still carefully walk on it without too much pain — you could consider:
- Wrapping it in a bandage for extra stability
- Asking someone else to help carry your gear
- Reducing the distance you planned to cover that day
- Use a sturdy stick, trekking pole, or a friend’s shoulder to help take the weight off it as you walk
Here’s how to correctly wrap an ankle sprain.
Then, once you set up camp, take some time to RICE it:
- Rest: Stop doing stuff.
- Ice (or whatever’s the coldest thing you have…usually a dip in a cold stream): Cool down the injury.
- Compression: Make sure it’s wrapped securely, but not too securely that you cut off circulation.
- Elevation: Lie down and place your leg up on your pack to elevate it.
If you’re on a long hike, take an extra day to rest the injured joint before continuing. That’ll help it heal and reduce long-term complications from the injury.
If it’s a usable knee injury and you need to keep moving to get it to help, you’ll have to make a splint to support and immobilize the knee. Here are some ways to do that with camping gear you probably have.
DIY Knee Brace
DIY Leg Splints
Twisted Ankle & Usable Injury First Aid
- Wrap the joint to immobilize and stabilize it
- Use a splint to support usable knee injuries
- Walk with help from a pole or a friend
- As soon as possible RICE it (Rest, Ice, Compression, Elevation)
Out on a hot summer hike in the sun? Watch for heat exhaustion. Heat exhaustion is basically your body’s equivalent of an overheated engine and usually goes hand in hand with dehydration. It’ll cause your body’s systems to go haywire and if it progresses further, can lead to life-threatening heatstroke.
It’s important to watch for the early signs of heat exhaustion (hyperthermia) — cramps, fainting, excessive sweating, headache, nausea, dizziness — and treat it before it gets worse. If you start to notice those symptoms, treat them similar to how you would treat dehydration.
Heat Exhaustion First Aid
- Find shade
- Stop physical activity
- Fan the person or even douse them with some water to cool them down
- Wet a towel with cool water and place it on their head
- Hydrate (with electrolytes if possible)
First Stages of Hypothermia
Hypothermia is the opposite of hyperthermia (heat exhaustion and heat stroke). Your body goes hypothermic when it loses heat faster than it can produce heat causing your body’s temperature to reach dangerously low levels.
When it gets low enough (below 95 F or 35 C), your nervous system as well as important organs like your heart can’t function like normal. Eventually, it can lead to death.
So if you start noticing early stages of hypothermia — shivering, drowsiness, confusion, exhaustion — keep it from going any further by warming the person up. Remember, their body can’t produce enough heat so you have to do it for them while also dealing with anything that’s removing heat from their body, like wet clothes.
If more serious warming is needed, try the hypothermia burrito:
Early Hypothermia First Aid
- Find shelter or a barricade from wind and weather
- Remove any wet clothing
- Wrap in dry insulating layers and an emergency blanket to reflect body heat
- Make a fire and a warm beverage
- Don’t give someone who is in the early stages of hypothermia alcohol to “warm” them up - it actually does the opposite
- If you need more aggressive warming, make a hypothermia burrito
Hypothermia can be serious, and a person's condition can spiral if not treated early. For tips, warning signs, and treaments for more serious hypothermia, see Wilderness First Aid Part 2 for serious injuries.
Diarrhea is no fun, even when you have a comfy throne to sit on. But in the wild, it can lead to other problems (like dehydration) if not managed properly.
The best way to treat diarrhea is to avoid it altogether. Make sure you’re treating your water correctly and fully cooking your food to kill any bacteria. And of course, don’t forget to wash your hands after taking care of business.
But let’s say that despite your best efforts you’ve now got a nasty case of the runs and you’re 20 miles from any porcelain. Regardless of what caused it, here’s what to do:
- Replace lost fluids. This is the most important first aid step for treating diarrhea. Diarrhea is uncomfortable. Dehydration kills.
- Replace lost electrolytes if diarrhea continues.
- Use antidiarrheals such as Immodium... unless you’re experiencing fever, bloody stools, or severe vomiting. In that case, whatever’s in your body needs to come out and you need to get to a doctor ASAP.
Don't let this happen to you:
Diarrhea Wilderness First Aid
- Practice proper hygiene and water purification
- Stay hydrated and replace electrolytes
- Keep antidiarrheals in your first aid kit
- Get help if you’ve got a fever, bloody stools, or severe vomiting
Just like with a lot of these issues, the best thing is to avoid altitude sickness in the first place.
- If you’re traveling to higher altitudes (above 8,000 feet), give yourself time to acclimate.
- If you’re hiking above 10,000 feet, only go up an additional 1,000 feet per day and rest a day for every 3,000 feet you climb.
- Drink plenty of water and eat plenty of carbs
But if you start noticing signs of mild to moderate altitude sickness (headache, dizziness, fatigue, shortness of breath, vomiting) you can start with rest, hydration, and over-the-counter painkillers. Don’t drink alcohol and try not to exert yourself.
If your symptoms don’t get better after 2-3 days or they start to get worse, it’s time to get to a lower altitude. If you don’t, you could develop high-altitude cerebral edema which is very serious.
Altitude Sickness First Aid
- Avoid it by acclimating to high elevations gradually
- Rest, hydrate, take painkillers if needed
- Get to a lower altitude if not better in a few days
Part 2: Wilderness First Aid For Serious Injuries
Ok, by now we’ve considered some of the most common outdoor first aid situations. But what if you’re dealing with something a little more serious…a broken limb or someone who is unconscious?
Keep going with the next section for some backcountry first aid tips for dealing with more serious injuries.
Learn More About Wilderness First Aid
Learn To Treat Most Common Injuries