When the Worst Happens


Essential First Aid Skills for Outdoor Emergencies

By Molly Newman

You’re three miles from the trailhead on a sunny weekend backpacking trip, basking in warm rays as you begin your first steep descent of the day. Suddenly, a rock slips under your sole, your foot goes out from under you, and you crash to the ground. After the first flash of pain, a little poking and prodding from your hiking partner reveals that the ankle’s probably only sprained, not broken… but you’re still in for a long, miserable slog back that will take twice as long as you’d planned. You remind yourself at least it’s just a weekend trip spoiled; the consequences could have been much worse.

Even the most in-shape hiker or biker takes a spill at times, not to mention the many other risks a day on the trail can bring. But if you’re properly equipped with a few essential first aid skills and supplies, you can respond to the most common outdoor emergencies with what Dr. Michael Morgan, associate director of Wilderness Medicine of Utah, calls the “Three Cs”: competence, confidence, and composure.

Increase Your Competence

Though it may seem as if there are as many ways to hurt yourself in the wilderness as there are adventures to tackle, most common injuries boil down to just a few specific categories: cuts, breaks and sprains, weather-related illness, and foot injuries. Learn to tackle these problems, and you’ll be well on the way to helping yourself and others manage these on-trail problems.

Cuts may result from falls, brushing against sharp rocks or barbed wire, or mishaps with a pocket knife. For minor cuts, washing the wound with water (never hydrogen peroxide!) and bandaging it promptly should be sufficient treatment. Control bleeding from deeper or longer cuts by elevating the injured body part and applying firm pressure directly to the wound for several minutes before bandaging with gauze and adhesive tape. Or, in a pinch, Dr. Morgan suggests, wrap a clean bandana around the wound instead. Never apply a tourniquet to an injured limb unless there is danger of bleeding to death; restricting circulation can cause gangrene and loss of the injured limb.

Breaks and sprains, specifically ankle sprains, are the most common type of serious trail injury. It’s well worth your time to learn how to properly apply a spiral wrap with an elastic (“Ace”) bandage before the need arises. Gentle pressure from the bandage will reduce swelling in the area and immobilize it to prevent further injury. Broken or injured arms, wrists, and collarbones can be supported with an impromptu sling made from a scarf or T-shirt. Whichever sling material you use, angle the injured arm so that the hand is four or five inches above the elbow to help minimize swelling.

Weather-related illness strikes hardest during the summer, when high temperatures and a “power-through” mentality combine to make athletes vulnerable to dehydration, heat exhaustion, and heat stroke. “You should be drinking a minimum of three liters of water per day, and more if the weather is warm or if you’re exercising,” Dr. Morgan says. Carry more water than you think you’ll need, and schedule regular rest breaks to rehydrate and refuel. Keep an eye on kids and dogs, and make sure they get plenty of water too. Know the symptoms of heat exhaustion: profuse sweating; dizziness or confusion; and cool, moist skin with goose bumps. If unchecked, heat exhaustion can rapidly lead to heatstroke and permanent injury or death may follow. Treat early symptoms by moving to a shady spot, loosening clothing, and applying cool, wet cloths to overheated skin. Minimize your risk of heat illness with common-sense measures such as wearing a wide-brimmed hat and loose-fitting, light-colored clothing, staying out of the sun during the hottest hours of the day, and stopping frequently to rest in the shade.

Foot injuries may not be life-threatening in most cases, but they can turn a long-planned weekend into a hellish experience. Before beginning a hike, make sure your toenails are clipped short; this simple step stops many hotspots and blisters before they start. Wear only properly fitting shoes or boots and lace them tightly to minimize friction against your feet. If you feel discomfort at any point, stop immediately to address the problem: applying a gauze bandage, moleskin patch, or even a square of duct tape can help keep a hotspot from developing into a full-fledged blister. Besides making every step torturous, open blisters make you vulnerable to infection…not a souvenir anyone wants to bring home from a hike.

Build Your Confidence

Prefer to have some essential first-aid skills under your belt before trying them out on the trail? You’re not alone. Utah is home to many providers of wilderness medicine classes, ranging from weekend courses aimed at athletes to intensive seminars for healthcare professionals. Wilderness Medicine of Utah (wmutah.org) offers regular instruction throughout the year starting at $200 for a weekend course.

Adventure First Aid 1.0

Whether or not you’ve received formal training, a well-designed first-aid kit is a vital addition to your standard gear. Adventure Medical Kits (adventuremedicalkits.com) offers a variety of ready-to-use packages from the ultra-light 0.5, perfect for a day trip for one or two people, to the time-tested Comprehensive, trusted by pro guides for more than 20 years. The Adventure First Aid 1.0, shown here, includes supplies to treat cuts, sprains, blisters, and other common trail injuries, plus instruction cards to help you use the supplies effectively.

Keep Your Composure

Even minor “emergencies” such as heel blisters or sprained fingers can lead to frustration, chaos, and an ultimately unsatisfying backcountry trip. Arming yourself with the most basic first aid skills can help you stay calm and rational when confronted with these unexpected situations.

“Anyone can manage a wound, and anyone can make a splint,” Dr. Morgan says. “It’s being able to stay cool in a possible situation of life and death that makes all the difference.” By preparing yourself with information, skills, and essential supplies ahead of time, you can head out on your next adventure feeling calm and confident… no matter what the trail may throw your way.

Molly Newman

Molly Newman lives in Portland, Oregon, where she hikes, walks, and runs whenever it isn’t raining­—and often when it is. A contributor to Outdoor Sports Guide since 2009, she also hosts regular trivia nights and homeschools her two sons.


About Author

Molly writes about fitness and nutrition from her home in Portland, Oregon. When she’s not at her desk, you can find her teaching history, hiking the Gorge, or hitting the archery range.

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