Backpacking First Aid Kit: What to Pack, Wilderness First Aid Basics, and Weight Budgeting

What Your Backcountry First Aid Kit Needs to Address

A backpacking first aid kit is fundamentally different from a car kit or home kit. You're treating injuries that must be managed for hours to days until evacuation is possible — not until an ambulance arrives in 8 minutes. The kit needs to address:

• Bleeding control: Deep lacerations, puncture wounds, wound closure
• Fracture/sprain management: Immobilization until evacuation
• Blister treatment: The most common backpacking ailment
• Gastrointestinal emergencies: Nausea, diarrhea, stomach cramping
• Allergic reactions: Including anaphylaxis risk management
• Environmental emergencies: Hypothermia, heat exhaustion, altitude sickness
• Pain management: For ambulation and sleep during multi-day injury management

Your kit should complement, not substitute for, wilderness first aid training. See the Safety & Navigation guide and consider carrying a satellite communicator to summon help when your kit and skills have reached their limit.

Wound Care Essentials

• Irrigation syringe (12cc with 18-gauge tip): The most effective wound cleaning tool. Pressure irrigation reduces infection risk better than antiseptic wipes alone. 1 oz.
• Closure strips (Steri-Strips, 3M): For wound closure on lacerations that need to be held together during evacuation. Pack 10–15 strips. <0.5 oz.
• Moleskin/Leukotape: The best blister treatment. Cut a "donut" hole over the hot spot. Leukotape P sticks better than moleskin in sweaty conditions. 1 oz.
• Gauze pads (4x4, sterile, 6 packs): For wound packing and dressing. 1.5 oz.
• Elastic bandage (ACE wrap, 3-inch): Sprain compression, wound dressing retention, improvised immobilization. 2.5 oz.
• Medical tape (1-inch, 1 roll): Secure dressings. 1 oz.
• Nitrile gloves (2 pairs): Always treat with gloves — protects you and patient. <1 oz.
• Antiseptic wipes (10 packs): Benzalkonium chloride preferred over alcohol for wound care. <1 oz.
• Antibiotic ointment (individual packets, 5): Bacitracin for infected or at-risk wounds. <0.5 oz.

Medications

Note: Consult a physician before adding prescription medications to your kit. The below are common OTC options.

• Ibuprofen (200mg, 12 tabs): Pain and inflammation management. Essential for sprain/fracture pain that must be walked out. 0.5 oz.
• Acetaminophen (500mg, 12 tabs): Alternative pain relief. Useful when ibuprofen is contraindicated. 0.5 oz.
• Diphenhydramine (Benadryl, 25mg, 6 tabs): Mild allergic reactions, also helps with sleep. 0.3 oz.
• Loperamide (Imodium, 2mg, 6 tabs): Diarrhea control — critical on a multi-day trip. 0.3 oz.
• Antacid (Tums, 6 tabs): GI discomfort from water treatment chemicals or unfamiliar foods. 0.2 oz.
• Oral rehydration salts (2 packets): For serious dehydration, GI illness, or heat exhaustion. 1 oz.

Emergency and Critical Items

• SAM splint (36-inch): Structural aluminum malleable splint — immobilizes any fracture from finger to leg. Folds flat, 4 oz. The most versatile emergency item in any wilderness kit.
• Tourniquet (CAT or SOFTT-W, 1): For arterial bleeding from extremity injuries. 2.7 oz. Essential for any group going into serious terrain.
• Emergency bivouac bag/emergency blanket: Hypothermia treatment and prevention. 1.5 oz (heavy-duty reflective bag preferred over foil blanket).
• Blister lancet (2): For draining large blisters that impair ambulation. <0.2 oz.
• Tweezers (pointed): Splinter and tick removal. 0.4 oz.
• Medical scissors (small, trauma shears): Cutting tape, clothing, bandages. 1.3 oz.
• Headlamp (already in pack): Essential for nighttime patient assessment.

Weight Budgeting: Build a Sub-8 oz Kit

To reduce below 8 oz: eliminate SAM splint (improvise from trekking poles), replace tourniquet with extra ACE wraps (for non-arterial bleeding only), and carry only the medications you're likely to use. Most solo weekend backpackers run a 5–8 oz kit on established trails.

Wilderness First Aid Training: Non-Negotiable for Remote Travel

A first aid kit without training is limited. A trained backpacker with a minimal kit is more capable than an untrained backpacker with a comprehensive kit.

Training Options

• Standard First Aid/CPR: 4–8 hours. Minimum baseline. Required for most guide certifications. Not wilderness-specific.
• Wilderness First Aid (WFA): 16 hours (2-day weekend). Covers backcountry emergencies including patient assessment, wound management, evacuation decisions. Recommended for all regular backcountry users.
• Wilderness First Responder (WFR): 70–80 hours (8–10 days). Professional standard. Required for outdoor guides, SAR team members, and anyone leading others in remote terrain.

NOLS, SOLO Schools, and REI Outdoor School all offer WFA and WFR courses nationwide.

Pre-Made Kit Options

Sources & Further Reading

1. National Outdoor Leadership School (NOLS). "Wilderness Medicine." nols.edu/wmed
2. Wilderness Medical Society. "Practice Guidelines for Wilderness Emergency Care." wms.org
3. SOLO Schools. "Wilderness First Aid Course Curricula." soloschools.com
4. Adventure Medical Kits. "Product Documentation." adventuremedicalkits.com
5. American College of Emergency Physicians. "Wilderness Medicine Section." acep.org