Wilderness first aid: One skill you don’t skip

Ian Carroll

Wilderness first aid can sometimes mean the difference between life and death when in the backcountry. Would you rather sprain your ankle thirty miles from help, or break your leg right outside of the hospital? When was the last time that you were wounded in the wilderness? What did you do?

If you plan to spend your long weekends in the woods this summer, don’t go unprepared. A complete first aid kit and the skills to use it are the necessary elements for staying safe. Today we’ve put together a list of the most important things that everyone should know about wilderness first aid.

Anyone that spends a significant amount of time in the wilderness knows that first aid isn’t a class you skip. Accidents tend to happen when you least expect them, and more often than not, far from help.

Warning: This article contains mildly graphic images of blood and injuries. But don’t worry, I stayed away from the gory stuff. We’ll leave that to Game Of Thrones.

Common accidents

Fortunately, most injuries you will have to treat in the wilderness are minor and easy to deal with. Twisted ankles, scrapes, and blisters all have reasonably simple solutions. However, just because they may seem like minor inconveniences doesn’t mean they can’t cause serious problems.

  • Ankles

Ankle injuries are by far the most common accidents that cause big problems in the back country. One wrong step or loose rock can lead to a painful twist or worse. If you’re ten minutes from the car, no problem. However, eight miles up a mountain pass, retreat might become a much more serious and dangerous undertaking.

ankle x-ray first aid
X-ray of a broken ankle

The best way to protect your ankles is to stretch, strengthen, and train them to be strong before an accident happens. Practicing trail running, jumping, and anything that increases the accuracy of your steps can also help to reduce the risks.

However, if you do injure your ankle, applying an ice pack and elevating the affected leg as quickly as possible is the best way to reduce swelling and speed recovery. Depending on the severity of the injury, it may mean setting up camp and resting for a couple of days. If you don’t have the food or gear to do that, then a speedy, but careful retreat might be in order.

  • Skin care

Friction Blisters on Human foot due to running barefoot. – Author: AndryFrench – CC BY 3.0
Friction Blisters on Human foot due to running barefoot. – Author: AndryFrench – CC BY 3.0

Blisters are common on long hikes, especially with new gear or inexperienced hikers. They may start as a minor inconvenience, but if you have days of hiking ahead of you, they can become a serious problem for the entire party. If left untreated, blisters can become infected, bleed, and stop the strongest of hikers dead in their tracks.

The best treatment for blisters is properly applied moleskin and rest. Often times, the reason for the blisters in the first place is wet feet or poor footwear. After treating blisters, put on dry, comfortable socks and lace shoes up as tightly and snugly as possible. That way your feet won’t slide around as much and friction will be kept to a minimum.

  • Joints, sprains, and dislocations

knee x-ray first aid
X-ray of knee joints. Our ankles aren’t the only joints prone to painful injury

Our ankles aren’t the only joints prone to painful injury. Knees, hips, shoulders, and elbows are all prone to getting hurt. Sprains and dislocations are not only extremely painful but also severely limit your ability to get to safety in the case of an emergency.

If a joint is dislocated, I hate to say it, but you have to pop it back in. There’s no easy way to do it, and it always depends on the situation. If it’s possible to wait for professional help, maybe that’s what you’ll want to do. However, the majority of dislocations are best treated immediately by the person experiencing it.

  • Scrapes, cuts, abrasions

first aid cut
Cut on the hand

Fortunately, blood is often the least serious problem you’ll encounter on the trail. Small cuts and scrapes happen frequently in the backcountry and usually pose little risk.

However, the further you are from civilization, the more seriously you need to consider the chance of infection. If you have days of hiking left ahead of you, a small scrape can become a very serious problem if it gets infected.

No one likes to do it, but it’s important to scrub and disinfect scrapes and cuts you get in the woods. Make sure you get all the dirt and grit out of the wound before you cover it. A little bit of antibiotic ointment can be a big help as well.

Emergency situations

Ambulance first aid
Emergency van

Unfortunately, not all accidents are easy to deal with. While most problems you’ll encounter in the woods amount to only minor inconveniences, there are those that pose a serious threat to the lives of the party members. There’s no way to prepare for everything that could happen, and certainly, no way to teach you what to do via a short article on the web.

Head trauma

In case of a head injury, the most important thing to remember is not to panic. The scalp bleeds a lot, even if the injury is not serious. Remain calm, whether the blood is coming out of your head, or your friend’s, it’s critical that everyone remains collected and accurately assesses the extent of the injury.

Don’t get up. The injured person should stay where they are while someone carefully assesses their injuries. It is important to talk. Ask them questions that require them to think of the answers. Do they know what day it is and where they are? Can they tell you a story about something they did yesterday?

Head injuries are unpredictable, symptoms may develop quickly, or slowly due to unseen causes. What looks serious might only be a surface wound and what looks mild might actually be internal damage and a developing emergency.

Remember, head injuries can kill, and they can do it without warning. Take them seriously and hopefully, you can avoid ever being in this situation in the first place.

Spine injuries

X ray of an injured spine
X ray of an injured spine

Much like head trauma, injuries to the back and spine can be hard to assess. The bundles of nerves that make up the spine are immensely complex and essential to our brains function, not just our body’s movement.

If someone in your party hurts their back or spine, or if you even suspect that they may have, it’s very important that they move as little as possible. If they have fallen, leave them there, even if they say they can move. Start slowly, have them wiggle their toes and fingers. Move ankles and wrists. Take your time.

Muscles often seize up during an injury and it can be hard to assess what is muscular and what is neurological in nature right away.

If you discover that you can’t move, then you will have to decide what the best way to get help is. Two person parties may have to carefully plan how to split up so one can go get help as quickly as possible. Parties of three or more can have one person stay with the injured person while another or a small group go for help. Assess your own situation carefully and try to make the best decision.

Broken bones

Breaking a bone can be incredibly scary and painful. However, a broken bone can be much more straightforward to deal with than other emergencies. It all depends on where you are. If you’re miles away from the car, you may be in for an epic, but a bit of improvised splinting and a lot of pain tolerance can often get you to safety.

Just like all the other injuries that can happen in the wilderness, a broken bone is hugely situational. You may have just a minor fracture that you can easily splint until you get to a hospital. However, you could have a major break that requires setting and causes excruciating pain. A broken arm is much easier to evacuate than a broken leg or ankle.

first aid evacuation
Emergency help

If you or someone in your party does break a bone, your goal is to protect the limb and to immobilize it past a joint on either side. So if you were to break a bone in your forearm, for example, you would immobilize the arm past the wrist and past the elbow. Movement in a joint on either end of a broken bone will cause pain and could injure the limb more.

Learn wilderness first aid, but hopefully, never use it

Take care when planning trips into the back country
Take care when planning trips into the back country

You can practice all the wilderness first aid in the world. But even if you are a certified EMT and ready for any emergency, undoubtedly the best way to deal with an accident is to avoid it altogether. Take care when planning trips into the back country. Take a first aid kit and have a plan in case of an emergency. Being prepared is critical when disaster strikes.

If you have any comments then please drop us a message on our Outdoor Revival Facebook page

If you have a good story to tell or blog let us know about it on our FB page, we’re also happy for article or review submissions, we’d love to hear from you.

We live in a beautiful world, get out there and enjoy it. Outdoor Revival – Reconnecting us all with the Outdoor


ian-carroll is one of the authors writing for Outdoor Revival