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First Aid Hacks on the Trail

First Aid Hacks on the Trail

While First Aid is a skill we never WANT to actually use, accidents can (and DO!) happen when we are playing outside.  Part of being a responsible parent on the trail means being prepared for anything, including injuries.  While nothing beats being prepared, we’ve put together some first aid hacks to help when trouble strikes.

In a wilderness setting, we often need to improvise, since help is not readily available.  I have been a Wilderness First Responder (a guide-level first aid certification) for almost 20 years and I have seen my share of incidents. 

I’ve found that it’s important to have a well-stocked first aid kit, but it’s also important to know how to improvise because you often won’t have exactly what you need in the field (SAM splint – I’m looking at you).  This is where knowing a few tips first aid hacks comes in handy!

See a list of what we stock in our first aid kits.

Note: We are not doctors and obviously in a true life-threatening emergency you should call 911, use a satellite beacon, or send someone in your party for help.  This article addresses simple fixes for common injuries, following wilderness medical standards.  In the event of a serious injury you should always see your doctor for follow-up evaluation after you get out of the wilderness.

first aid hacks tips and tricks
Practicing Wilderness Medical skills at the Flagstaff Field Institute in Arizona with NOLS.

What can go wrong?

Most common outdoor injuries are from slips, trips, and falls.  This means sprained ankles, twisted and scraped knees, wrist/elbow injuries and bruises are the most likely to occur on an outdoor adventure.  After that, blisters are probably the second most common issue, especially on hikes.  And of course, don’t forget about the usual cuts and splinters.

Blister Hacks

Prevention

The first tenant of blister treatment is to prevent them from happening in the first place!  Make sure your shoes fit well and keep your feet dry. Wear one pair of thick wool socks.

If you start to feel a “hot spot” forming, STOP and fix it immediately.  Don’t wait until you’ve walked another mile or two and it’s turned into a full-on blister. 

When hiking with kids (or honestly, with other adults), stop and fake your own hot spot after the first mile or two.  Take off your pack and boot, and encourage others to do the same if they feel like their boots are rubbing.  The biggest barrier to treating hot spots is simply that most people don’t want to take the time to stop and pull their boots off. 

First Aid Hacks Blisters
Stop and fix those hot spots before they become blisters.

Hot Spot Treatment

If you’ve ever put a band-aid on a forming blister and kept on hiking, you probably had it rub off after about two minutes.  The adhesive simply can’t hold up to the sweat of your foot and the friction inside your boot.

If your skin is just red, you can try cutting a section of KT Tape (be sure to round the corners so it doesn’t peel off) and placing that overtop to help prevent so much friction.  KT Tape is a special athletic tape and is super stretchy and super sticky.  Duct tape can work as well, but is far less comfortable.

My favorite choice is to use a Band-Aid or Second Skin Blister Pad.  These have a spongy cushion that absorbs moisture.  Tincture of Benzoin is my absolute favorite first aid hack to keep blister pads from slipping off!  You can pick up Tincture of Benzoin from Amazon or NOLS in neat little single-use ampules that are perfect for your first aid kit.

Tincture of Benzoin is very sticky like a mild superglue.  Just crack the vial if it’s a single-use container, and apply it directly to your skin, around the blister where the edges of the blister pad will cover.  Stick your blister pad on and, voila!  It will actually stay on your heel!

Full Blisters

I know there are whole websites dedicated to popping blisters, but do NOT pop your blisters if you can avoid it.  Even if it’s puffy, keeping your skin in tact will help prevent infection and the puss provides some level of padding to the irritated spot. 

If you have a blister that has puffed up, moleskin is the best way to deal with it.  Cut a hole in the middle to match the size of your blister, and round the outside edges to keep it from peeling up.  This will provide padding around the blister to prevent it from rubbing any further inside your shoe. 

Adding some Tincture of Benzoin will, again, help keep it from coming off.    

If the skin has ripped off your blister, 2nd Skin burn pads can be cut to size and, like a blister pad, can be used to cover the open blister.  This will keep it both moist and padded, allowing it to heal more effectively.  Cover with a moleskin donut like above, using Tincture of Benzoin to keep it on.

A *really* bad blister. Don’t let them get to this point! Prevention is key.

Hacks for Cuts and Scrapes

Clean It Well

The most important treatment for cuts and scrapes on the trail is to clean them VERY well.  That will help prevent infection.  That means rinse very well with drinkable water and scrub/debride when needed.

Truly the best way to clean effectively is with an irrigation syringe.  I always pack one in my first aid kit, but if you don’t have one, fill a clean Ziploc with water and poke a tiny hole in it.  Then just squeeze the bag to create a pressurized stream of water. 

For scrapes that get a lot of dirt in them, you will need to scrub the scrape to get all the dirt and debris out.  This is no fun for anyone, but use a clean piece of gauze and a mild hand soap to clean the injury as well as possible.  Use tweezers to pull any larger pieces of debris out of the wound. 

Cleaning an abrasion
This abrasion is just stage makeup used to train at a WFR class, but it’s a great way to practice!

I once treated a camper who accidentally impaled his hand on a chopstick, so you never know when a weird injury will happen. For puncture injuries, do NOT use an irrigation syringe.  That will simply push the dirt further in the hole.  Instead, allow the injury to bleed for a bit before bandaging, as that will help remove dirt.

Bandaging Cuts and Scrapes

Obviously, it’s hard to substitute a bandaid or a sterile gauze dressing, so always make sure you have both in your first aid kit.

In a pinch, you can use a tampon (again, they are sterile) and secure it to the injury site with a bandana or other cloth or tape.  If you don’t have anything sterile to use, you can boil a bandana or piece of cloth and then allow it to cool off before using that as a bandage.

Sprained Ankle Hacks

Prevention

Rolling an ankle in the backcountry is pretty common, but again, prevention is the best hack there is!  Hiking in flip flops is the best way to get a sprained ankle on the trail.  Make sure you wear shoes or boots on the trail with good ankle support and traction that will keep you from slipping.  You can also use trekking poles to help your balance and stability.

If someone does take a tumble, evaluate the ankle within your personal scope of knowledge, for useability.  If it is weight-bearing, you can decide to continue on your hike within the injured person’s comfort limits, or evacuate to the nearest trailhead based on their comfort limits.  If it is not weight-bearing, you’ll want to splint it (see below) and call for help.

Taping an Ankle Injury

It takes almost a full roll of athletic tape to tape an ankle, so always keep a roll or two in your first aid kit.  Taping an ankle is honestly a bit of an art form, but here’s a great video from NOLS on how to do it right.

Make sure the tape is snug for support, but not so tight it cuts off circulation (be sure to check the toes for capillary refill after taping).  The tape will loosen over time, so if the injured person complains that it’s too tight, have them walk on it for a bit.  If it’s still uncomfortable after an hour, you’ll have to cut it off and start over. 

If you find yourself without tape (hey, it happens!) you can try to wrap it with an ace bandage for support. 

Don’t have one of those either?  You can improvise one by cutting a single strip in a spiral out of a t-shirt. Start from the bottom hem and work your way up, remembering to keep the strips wide.

Tapled Ankle First Aid Hack
A taped ankle uses a LOT of tape.

Splinting Hacks

If you have an injury bad enough (athletic injury or a broken bone), you’ll want to create a good splint to keep the injury stable.

There are two kinds of splints.  A splint for a long bone injury (for example, a broken arm) will require you to stabilize the joint above and below the injury.  A splint for a joint injury requires you to stabilize the bone above and below the injury and prevent joint movement.

Making a good splint requires both rigid items to create support, and padding to create both compression and comfort.  There is no wrong way to make a splint.  Just use what you have on hand the best you can.  I’ll go through two of the most common examples of splints below.

Lower Leg Splint
Creative splinting a lower leg injury with a sleeping pad for rigidity, lots of padding, and compression.

Splinting a Knee Injury

Most ACL/MCL injuries are painful, but the injured party is usually able to walk with some stability and support.  You can generally create a walking splint that will create both stability and the freedom of motion to walk.

If you have a crazy creek or a sleeping pad on hand, these make excellent rigid frames for your splint.  A sleeping pad can be placed perpendicular to the leg, then rolled up on the outside of each knee to create rigidity.  Leave the front of the knee open so it can bend slightly.

Trekking poles can also be used on the outside of the splint to create extra rigidity.

Use plenty of rolled-up padding, like t-shirts, fleece layers, and even bandanas and pad the entire length of your splint.  Don’t forget to put a little padding behind the knee as well, to keep it in a more natural position of comfort. 

In a perfect world, wrap the whole thing up tightly in an ace bandage.  If you don’t have athletic wrap, you can use t-shirts, bandanas, pack straps, or anything else available to tie it tightly.  Don’t forget to check the circulation in the toes after you finish your splint!

Walking Knee Splint
Unwrapping a walking knee splint. Rolled up padding on each side of the knee and behind the knee, and a compression wrap to create some rigidity. A rolled up sleeping pad works well for this as well. The kneecap is left open to allow the knee to bend.

Splinting an Arm Injury

When most people trip and fall, they tend to land on their hands or shoulders, leading to wrist sprains or even bone breaks.

With any arm injury, you’ll want to splint the affected area and then create a sling and swath to prevent movement of the joints and to help keep the injury elevated if it’s in the hand or lower arm. 

If you’ve got a SAM splint, those are awesome for splinting arms.  But since 99% of us don’t carry those in our first aid kids, you’ll usually have to improvise.  Using the same rigidity and padding principles as above, use a daypack, crazy creek or even a collapsible trekking pole to create rigidity on the outside of the splint and plenty of rolled up soft layers on the inside of the splint. 

Arm Splint
Splint for the lower arm made from a Crazy Creek camp chair and clothing, wrapped tightly in a compression wrap.

To isolate the joints, you want to put the injured party’s injured hand across their chest (like they are doing the pledge of allegiance and create a sling and swath.  The sling supports the weight of the arm at the elbow and the swath keeps the arm compressed to the body. 

You can create a great version of a sling and swath by simply tucking their elbow into the arm of a jacket and then zipping it up.  If they don’t have a jacket, you can also take the hem of their t-shirt and pull it up and around the injury, attaching it to the shoulder with a safety pin. 

As always, be sure to check circulation in the fingers when you are done with your splint.

A textbook sling and swath to keep the shoulder and elbow immobilized.
Jacket Sling and Swath
A jacket or a vest make an excellent improvised sling and swath.

Splinting a Toe or Finger Injury

Most toe injuries are super easy to splint with buddy taping.  Put a little padding between the two toes (a folded up bandaid can work nicely) and then just tape the toes together.  Your other toe creates rigidity, while a little padding helps it to not “stick” to the other toe. 

Fingers are a little more challenging, but you can also buddy tape them to the next finger over.  If you can’t comfortably do that, you can try taping a popsicle stick under the finger.  Don’t forget to make it comfortable for the wearer and check finger circulation.    

Finger Splint
Buddy taping an actual broken pinky finger.

Athletic Injury Hacks

Icing an Injury

Rolling an ankle, or bruising a shin are common enough injuries on the trail.  If you are out for an extended period of time, sometimes ice can help reduce swelling and manage pain.

The obvious problem is that it’s awfully hard to pack ice around in the wilderness.  You can carry commercial ice packs (“shaker bags”) but honestly they don’t work that great.

Your best option is to find a cold lake or stream to submerge the injury in.  Now clearly the risk here for kids is drowning, so make sure the spot you pick is safe.  Watch out for fast currents or deep holes.

Heating an Injury

The opposite treatment, heating, can also be beneficial if the injury is an overuse athletic injury, a sore muscle, or even period cramps.  Alternating heat and ice can also help reduce chronic inflammation.

To create a hot pad, boil a microfiber towel on your camp stove, and then wrap this in a second microfiber towel (do NOT put boiling water directly on your skin please).  Alternatively, pour boiling water into a Nalgene and then put the Nalgene in a sock. Always test to make sure it’s not too hot before putting on someone’s skin.

Fishing Hook Injury Hack

How to Remove a Fishing Hook

If you fish (especially if you fly fish), it’s likely that a fishing hook “incident” could happen to you.  There’s a lot of bad ways to remove a fishing hook (cut it out or push it back through, for example).  There’s ONE good way to remove one!

Push the eye of the hook down to your body and hold with your thumb.  Loop some loose fishing line between the widest part of the hook and your body.  Then just tug firmly (ok, yank) perpendicular to the fishing hook on the fishing line.

It will pop that hook right now, with no extra drama required.  Be sure to clean and bandage the injury site appropriately.

Fishing Hook Removal
Removing a fishing hook from a poor banana. Hold the base of the hook against the body with your thumb, and pull the hook out with a perpendicular tug.

First Aid Kit Must-Haves

There are a few things that are really hard to improvise in the wilderness, if an accident should occur.  These are things I recommend you keep in every first aid kit, so you always have on hand.

  • Gloves – Protect yourself and others. In a pinch, cover your hands with Ziploc baggies.
  • Irrigation Syringe – As mentioned, you can poke a hole in a Ziploc bag, but it won’t have same force or do nearly as good a job cleaning out wounds.
  • Gauze – You can always use a t-shirt, sock, etc, but gauze is sterile and it prevents you from ruining your favorite trail shirt!
  • Band-aids – As we mentioned, in an emergency you can tie or tape on a tampon or sterilized shirt, but scrapes and blisters are so common, it’s worth it to carry some along!
  • Elastic/compression wrap – As we mentioned, you can spiral-cut a t-shirt, but it won’t provide as much compression.  A good compression wrap is worth it’s weight in gold during a real medical emergency!
  • Tweezers
  • Safety Pins – These can be used for anything from digging out splinters to fastening swaths, to fixing a broken button on a pair of pants. 
  • Lighter or matches – Useful for sterilizing tweezers and safety pins.
  • Tape (duct tape and athletic tape)
  • P-cord or extra shoelaces – These are very handy for fixing a broken shoe, but also tying up a splint, fixing broken gear, and more.
First Aid Kit
A sampling of my first aid kit must-haves.

First Aid Hacks

A Wilderness First Aid or First Responder class can give you indispensable knowledge about dealing with an emergency in the backcountry, but also really helps you learn how to improvise.  We always endorse taking a course from a reputable school like NOLS, SOLO, or AERIE.  It can be a fun weekend adventure, learning how to manage backcountry emergencies. 

Learning Wildernes First Aid at the Flagstaff Field Institute in Arizona.

Most of the photos in this article are from a Wilderness First Responder course, and show a few of the skills you will learn in a class.

Prevention and prior preparation will save you a lot of grief on the trail, but of course, accidents can still happen!  These first aid hacks should give you a great starter bag of resources to help manage common incidents when you are on the trail and away from definitive medical care. 

Happy and safe hiking out there!

First Aid Hacks

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