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  • Writer's pictureWinston Endall

How to Build a First Aid Kit for Backpacking

Emily, the Backcountry Nurse, shares what's in her first aid kit in Ep. 19 - How to Build a First Aid Kit for Backpacking

Of all the things you need for backpacking your first aid kit might be the least sexy but if you need it, then it’s the most important.

When we head out into the wild, no one wants to think about getting hurt but it can and often does happen. Being prepared with the correct gear can keep an injury or illness from becoming life-threatening.

A first aid kit is part of the 10 Outdoor Essentials. Even when on a day hike you should have one with you. When doing overnight trips it is even more important as you are further away from help if something goes wrong.

Part of outdoor adventure is being as self-sufficient as possible so never head into the backcountry without an adequate first aid kit.

Knowledge is power

Before we get onto what to carry in your kit we need to talk about first aid training. The best kit means nothing if you don’t know what to do with it.

At the very least take a first aid/CPR course and take a refresher course every 5 years. Groups like the St. John’s Ambulance or Red Cross offer basic first aid training courses. Check with your local community college or recreation department for dates and prices.

If you want to take your training to the next level then consider taking a Wilderness First Aid course. More in-depth than the basic first aid courses, wilderness first aid training recognizes the fact that help won’t be coming quickly.

You can find wilderness first aid courses at local colleges, Red Cross and NOLS to name just a few of the sources. If you do more remote trips or look to work in the outdoors this is a great qualification to get.

Common Outdoor Injuries and Maladies

Your first aid kit should be able to address the most common issues you can expect to run into in the outdoors.

Below is a list of some of the most common things you should be prepared for.


We are hiking with a pack so our feet take a pounding. Baby powder in your socks will help keep feet dry and reduce friction. A bit of petroleum jelly can reduce friction enough to stop a blister from forming. If you start to feel a hot spot putting a piece of duct tape or Leuko tape over the spot will keep the blister from forming. If you get a blister it’s good to drain it and put a sterile dressing over it. Do this in the evening and cover it with duct tape or moleskin for the next day's hike.

Pain and Inflammation

Ibuprofen and Acetaminophen are both painkillers you should have on hand. In addition, Ibuprofen is a non-steroidal anti-inflammatory that will help reduce inflammation. With enough scientific research studies, data may point to using CBD oil as it is both a pain killer and anti-inflammatory that doesn't appear to have the negative side effects of either ibuprofen or acetaminophen.

Sprains and Strains

Twisted ankles are the most common. If you are prone to this then carrying a Tensor bandage or other form of brace can help you walk out from the back country on your own. You can also support an ankle by taping over the sock but you should be careful it isn't so tight that it cuts off circulation.

Prevention is a big key here so look to supportive boots and hike with poles.

Between outdoor adventures, your fitness training should include strength training for your feet and ankles to reduce the chance of injury. Good cardiovascular fitness is also important as you are more likely to get hurt when you are tired.

Insect Bites

The first line of defense is prevention so if it is buggy out then wear long clothing and use insect repellent. Consider pre-treating your clothing with permethrin as it helps keeps insects off of you including ticks. You spray down your clothing and let it dry. This is best done outdoors. The treatment lasts six weeks or six washings.

If you do get bit then having Afterbite can help with the itch. Carry a tick key and tweezers if you have to remove ticks or stingers. If you are allergic then Benedryl can help but if it is severe then you should carry an epi-pen and let the people with you know how to use it.

Cuts, Burns and Abrasions

Any time the skin is broken you have to worry about bleeding and infection. You should have antibiotic cream, antiseptic wipes, bandages, and sterile dressings. Additionally, clotting agents and butterfly sutures will be useful for more severe cuts.

Diarrhea and Stomach Issues

Stomach issues can be pretty common in the outdoors. Gastrointestinal problems can arise from poor hygiene or contaminated water. Make sure you use hand sanitizer after using the bathroom or when you are about to eat. Make sure all of your water is filtered or treated to avoid ingesting pathogens that can make you sick.

If you do run into these issues having an antacid, anti-diarrhea medication, and an anti-nauseant can help make these issues more tolerable until you can get to medical attention.

Dehydration and Heat Stroke

On hot days or when you are exerting yourself for long periods, dehydration can be a serious threat. I always have water purification tablets and electrolyte tablets in my first aid kit to aid in treating dehydration. A bandana can be soaked in water and used to help lower the temperature of someone with heatstroke by placing it on the neck or head.


On the other end of the spectrum, hypothermia is a major danger in cold or wet conditions. In these conditions having an emergency space blanket and the ability to make fire are the major treatments. I carry a mini fire kit in my first aid kit including a mini Bic lighter, Light My Fire Ferro rod, and a tinder source like cotton with vaseline and Wetfire cubes.


The thing that happens to many but rarely gets talked about. When you are walking many miles and sweating a lot the possibility of chafing is very real. This abrasion of the skin can be very painful and has a risk of infection. Vaseline can be put on the skin to help reduce friction. If you do get some bad chafing then clean the area with disinfecting wipes and treat with antibiotic cream.

Make it Personal

In addition to general items, you will need to personalize your first aid kit with items suited to your particular health issues.

Do you need specific medications? Make sure to pack them in your first aid kit.

If you are super prone to blisters or burn easily in the sun then packing extra items to deal with this ahead of time will help you.

How Much Do You Need?

The size of your first aid kit will depend on how many people are in your group and how long you will be out. If you are on a long hike in rough terrain then you will probably need a lot more ibuprofen for sore knees than just a weekend overnighter.

When All Else Fails, Improvise

In addition to what you have in your first aid kit, you can address many medical issues by repurposing items that you have in your pack. I have made shoulder slings out of bandanas, tied on dressings with tent guylines, and made finger splints carved from wood.

Don't just limit yourself to thinking the only things you have are in your first aid kit.

What To Do When it is Beyond Your First Aid Training

Sometimes things happen that a bandaid won't fix. What to do in these situations should be part of your first aid planning.

If you are in cell phone range then you can call 911.

Since many backpacking areas are beyond cell coverage you should carry a satellite communicator such as the Garmin Inreach or Spot devices. These allow you to communicate with civilization via satellite and have an SOS emergency locator function. Just like a cell phone, you have to pay for service but you only have to pay for the months you need.

Pre-Packaged VS DIY First Aid Kit

While you can build a first aid kit from scratch, buying a ready-made one can be the easiest way to start. Adventure Medical Kits makes some of the best with different sizes from solo to large group sizes.

When you buy a pre-packaged first aid kit you will have to add medications and creams as they don't tend to come with them. But they have all the tools plus a first aid booklet to refresh your memory about what to do.

If you choose to build your own first aid kit find a small waterproof bag to store it in. There are specifically marked first aid kit bags but if you are the only one to use it the identification isn't important.

Basic First Aid Kit


  • Variety of Elastoplast or other sticky bandages.

  • Sterile gauze pads

  • Butterfly sutures

  • Medical tape

  • Duct tape or Leuko Tape for blisters

  • Tube of antibiotic cream

  • Antiseptic wipes

  • A tube of vaseline

  • Alcohol-based hand sanitizer (can be used for both hygiene and starting a fire)


  • Scissors and Tweezers

  • OR

  • Multitool such as Swiss Army knife with knife, scissors, and tweezers.

  • Tick removal tool

  • Magnifying glass (To see slivers or ticks. Can be the one on your compass.)

  • Mirror (To see if you have something in your eye or check yourself for ticks. Can be part of your compass.)

  • Lighter


  • Ibuprofen (Pain and anti-inflammation)

  • Acetaminophen (Pain and fever)

  • Imodium (Anti-diarrhea)

  • Gravol

  • Benadryl

Group First Aid Kit

Unless you are a guide or group leader I suggest everyone carry their own first aid kit. If you are out with family then take what you would run for yourself and double the amount for every four people.

Here are a few items you will need your kit if you are out with a group.

  • CPR Mask

  • Pads with clotting agent to slow severe bleeding

  • Aspirin in case of heart attack

  • Sharpie to note the time of medication or treatment

  • Latex or Nitrile Gloves

  • An extra freezer ziplock bag for medical waste

  • Solo Ultralight First Aid Kit

To save weight for you need all of the same items but you can strip down how much you carry. Here are a few tips to lighten your first aid kit.

  • Don't carry full bottles of pills or ointments

  • Don't bring full rolls of tape

  • Choose travel-sized options when available


When you head out on a backpacking trip you will need to be prepared to be self-sufficient and that includes medical issues. While none of us want to have an injury it can happen so make sure you are educated and equipped to deal with anything you may come across in the wild.

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Cover Photo Credit: Catharine Gerhard

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