Backcountry Accidents receives numerous enquiries about exactly what should be in a wilderness first aid kit. Approaches range from minimalist (half a roll of sleek tape) right through to the MASH units complete with anti-psychotic drugs for those driven over the edge by Fiordland sandflies and rain.

In the past, this column has published specific lists but this article takes a different approach by looking at the principles of what is needed rather than the specifics. The trick is to have a first aid kit sufficiently small that you will actually carry it (it should fit in your coat pocket) – not one that you groan at the sight of.

It’s amazing what emergency improvisations you can make in the outdoors. With appropriate wilderness first aid knowledge and a good first aid kit, many parties have managed a self-rescue instead of having to engage emergency services.

Blistered feet. Prevention, perhaps using strapping tape, is better than cure. Photo: Shaun Barnett/Black Robin

First Aid Knowledge

Get on a first aid course (preferably an outdoor one) and read this column. Prevention is better than all treatments! Know your group and ask about their medical conditions. If someone in the group has a medical condition (e.g. asthma or diabetes), talk to them about the specifics of their condition and medication. Have someone else in the group carry some spare medication in case they leave theirs behind (for example, carry a spare asthma inhaler). Most parties know when to activate the PLB in a trauma situation, but may not recognise the seriousness of a medical situation such as a heart attack or aneurysm.

Stopping Pain

This includes analgesic and anti-inflammatory drugs such as paracetamol, codeine, ibuprofen and diclofenac. Combination drug therapy (the use of several drugs at a time) can be very effective as the total synergistic effect is greater than the sum of the individual component drugs. However, make sure to carefully follow the directions and do not exceed maximum doses. Many off-the-shelf generic products contain paracetamol, so you should always check the active ingredients. All the drugs have various side effects, and you may have to manage these. Aspirin can be used as a painkiller and also for suspected heart attacks to help reduce clotting. 

Do not forget other effective pain management strategies such as splinting, distraction, reassurance and PRICE (Prevention, Rest, Ice, Compression and Elevation). Liniments such as Tiger Balm and diclofenac creams can also reduce pain.

Stop Infection

Carry disposable gloves, antiseptic solution (iodine) and a CPR face shield.

Stop Bleeding, Keep Infection Out

Carry assorted sterile dressings (big ones are best as they can always be cut down), steri-strips, and band-aid strip. Small sterile saline ampoules are very useful for irrigating wounds and flushing eyes.

Stop Blisters

Blisters have compromised many trips, so prevention is by far the best policy. Strapping tape on hot spots can prevent blisters, as can two pairs of socks separated by a plastic bread bag that allows slippage rather than rubbing on the skin. Blister doughnuts can be fashioned from closed cell foam or off-the-shelf products (moleskin) secured with sports strapping tape. Foster a zero tolerance blister policy where people can stop and check hot spots (rubbing) before proper blistering occurs.

Carry strapping tape, crepe roller bandages, safety pins, steri-strips. You can improvise splints using closed cell foam, blow-up sleeping mats, sticks, or clothing. Include in your kit:  good scissors, tweezers and a needle (for splinters and possible sutures).


People can have severe reactions to sandflies, wasps, spiders, stinging nettle and various foods. Take non-drowsy, antihistamine tablets. If your tramp takes you through beech forest where wasps pose a risk, consider taking an anaphylaxis adrenaline ‘Ana-Kit’ (prescribed).


Items such as a waterproof notepad and pencil, barrier cream (for chaffing) and – for above bushline – lip balm, spare sunblock and sunglasses. Dental floss has all sorts of uses. A survival bag can keep a patient warm and be used as a reflector to attract attention.

Odds and Ends

The first aid kit is a good place to keep other useful things such as waterproof matches, a candle stub and a length of twine. Keep your kit dry and protected using dry bags, waterproof containers and zip lock bags.


This article was re-published from the August 2011 issue of FMC’s Backcountry magazine. To subscribe to the print version, please visit