Hiking First Aid: What to Bring, Do, and Know to Stay Safe on the Trail

June 1, 2022

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Man and woman hiking applying first aid to ankle. There are different degrees of hiking. There’s the kind of “hiking” you do through Golden Gate Park in San Francisco, Central Park in NYC, or Runyon Canyon in Hollywood. You’re outdoors and amidst the trees and foliage and physically active, but it’s not quite roughin’ in. You still have cell coverage and you can procure an iced coffee within twenty minutes if you have to. For those hikes, you don’t need first aid. You don’t need any special skills other than the ability to ambulate across the landscape.

But there’s real hiking. Hiking more than five miles. Multi-day hiking. Overnight hiking. Backpacking. Hiking in a place where the trail might not be so well-maintained, where you might run into an aggressive animal, where you have to keep your wits about you. For this type of hiking, which is what most people imagine when they think of “hiking,” it’s a good idea to come prepared with first aid: with physical medical supplies and skills and knowledge that will help you enjoy the great outdoors without staying helpless. Because the true allure of hiking is getting out into the wilderness where the niceties and comforts of the modern world no longer apply. We all want a bit of adventure, but we also want to make it back in one piece.

So let’s dig into hiking first aid. I won’t tell you to “bring water” or “snacks” because, well, you’re an intelligent adult who doesn’t need to be told the absolute basics.

Hiking First Aid

Tweezers

Tweezers are a godsend, but you need both needle tip and broad tip. Needle tip tweezers are excellent for removing ticks—just get as close to the skin as possible and pull straight out—while broad tips are good for removing splinters and thorns.

These fit the description.

Adhesive bandages of all sizes

Adhesive bandages (or bandaids) of varying sizes are essential for covering up cuts and wounds. Butterfly bandages are also nice for binding wounds that would otherwise need stitches.

Betadine

Betadine is an iodine-based antiseptic that cleans wounds and kills germs. A little bottle is great to have on hand so you can spray your cuts and wounds.

Antiseptic wipes

Clean wounds, sterilize skin and hands and tools. These are just handy to have around.

Medical scissors

In case you need to cut a bandage or some fabric/clothing, these are indispensable.

This is a good pair.

Surgical tape

You never know what you’ll need to tape to your skin.

This is a good one.

Gauze

Used to stop bleeding, protect wounds, improve healing, and all that good stuff that helps you overcome bad luck on the trail.

Multitool

Gives you just about everything you might need to handle the occurrences that you can’t quite anticipate.

Here’s one.

Good knife

A good sturdy knife is always a wise choice on the trail, even if you only use it to whittle a stick to pass the time. You’ll never regret having a knife. This one has a firestarter attached.

Voodoo floss bands

Voodoo floss bands can be used to compress injured limbs, like ankles, wrists, or knees. They provide stability and keep down swelling. Normally used in training, they can be quite handy on the trail as well.

Link to buy them.

Magnesium oil

In my experience, topical magnesium chloride oil is great for reducing joint pain and inhibiting inflammation. Very helpful in a pinch. Great for cramps.

Make your own by filling a spray bottle with magnesium chloride flakes and adding water, or buy it.

Electrolytes

Staying hydrated requires more than just water. You also need electrolytes, especially if you’re hiking. LMNT is a great powdered electrolyte supplement to keep on hand. Just add to water, shake, and drink to stay hydrated. Snake Juice is another option.

Mustard packets

Cramps are debilitating on hikes. They can even be deadly. One of the best cures for cramps is pickle juice, which works but not because of electrolyte repletion.¹ It actually has no real impact on hydration or electrolyte status, and drinking it resolves muscle cramps faster than the gut can absorb it. TRP ion channels in the oropharyngeal region (tongue/mouth/throat) react to something in the pickle juice—probably the vinegar—and short-circuit the excitation of the muscle, blocking the cramp immediately.

Other TRP ion channel activators are found in cayenne pepper, ginger, and cinnamon, and researchers have created a blend of extracts from all three plants that shows efficacy against muscle cramps.² It’s called Hot Shot.

Basic yellow mustard also works. To really kick it up a notch you can add cayenne pepper and ginger to the mustard. The combo of mustard and spicy/gingery can be an instant fix for muscle cramps.

Skills and Best Practices

Have a map.

Most places I find aren’t giving out paper maps anymore of the hiking area. If they’re not, you can buy maps of the area or take a picture of the map at the trailhead with your phone before starting so you always have something to refer to.

Take a compass (or have a compass on your phone) and know how to read a map.

A compass and a map go very well together. If you need it, this is a comprehensive explanation of how to use the two together to orient yourself.

Charge your phone.

Go into the hike with a fully-charged phone. Keep it charged by keeping the phone on airplane mode.

Walking downhill correctly.

Don’t walk downhill with your pelvis tucked and all the weight on the balls of your feet, knees and quads. Instead, keep the weight on your entire foot/heel. Break at the hips slightly to accept the bulk of the load on your glutes, hamstrings, and hips.

Walking uphill correctly.

Take shorter strides and, again, accept the load onto your glutes and hamstrings. The posterior chain is far stronger than the quads and lasts longer without cramping.

Most hikers don’t need to carry a big first aid kit with them all the time. Going for a few miles? You don’t need much of anything. Going for a few hours? Take some bandaids and betadine. Doing a half day hike? Throw in some tweezers and mustard packets. Going overnight? Add some more from the list. This isn’t a definitive list of things you must have on your person at all times once you leave city limits. It represents as complete a list as I could muster for serious hiking.

And remember: this is all “just in case” stuff. For most of your hikes, even the long, intense ones, you won’t dip into the kit at all. It’s just good to be prepared.