We all know someone who throws a couple of bandaids, a half-used sheet of moleskin, and some expired Tylenol into a baggy, stuffs it into their pack, and calls it good for their first aid ensemble. That person could be you.

It’s not a matter of if but when things go bad, are you prepared?

Let me paint you a picture…

You’ve just successfully gave a dirt nap to an animal you’ve been so stoked to punch your tag on. You are 6 miles from the trailhead where you parked. You and your buddy are just wrapping up with taking photos to relive the moments this hunt has brought you two. You break out that knife to start breaking it down. Your foot slips down from the steep mountainside. You catch yourself. You begin to feel the sensation of warmth and wet roll down your arm. It’s odd to you because it doesn’t feel like sweat, surprising because you’re already in a dehydrated state as it is. You look down… red. 

I can picture it now. It’s as if I have been there before. 

But, you are prepared. You tell your buddy to “open the front of your pack, grab the red pouch,” while you hold pressure to your embarrassing knife wound. In this red pouch are the items that you intentionally packed after you read this. 

As a firefighter/paramedic, my first aid kit is probably the bulkiest out of the bunch of hunting misfits. My intent isn’t to use it on myself, but for my band of eclectics that all call ourselves friends. Because, it’s not a matter if but when someone could get hurt, furthest away from any hospital or ambulance service. But my kit has been refined, reviewed, and has changed a lot over the years. And as one of my favorite veteran owned businesses coined the phrases, “No one is coming. It’s up to us,” and “Expect To Self-Rescue” - 30 Seconds Out

This FIELD NOTES is not to take place, or substitute any formal education setting. I will always advocate for taking classes and learning as there are many great resources out there. Stop The Bleed. Wilderness First Responder. And many others. I’d rather be a warrior in a library than a librarian in the war. Or something like that. Having the equipment is great, if we know how to actually use it.

So, here is a list of what lives in my backcountry first aid kit.

1. Tourniquet

Not all tourniquets are created equal. The important part is they provide compression around arteries and veins to the point of obliteration of any pulse. It’s meant to cause a roadblock, where blood can no longer pass through, finding its way to the outside world. I am a big believer in the C-A-T Gen7 TQ. It’s trusted by the military and backed by the Tactical Combat Casualty Care (TCCC) Committee. Are there other products out there that do the same thing? Certainly. The important lesson is to know how your equipment works. 
In my opinion, there are a few TQs that I would not pack into my bag of first-aid goodies for prolonged application. The SWAT-T and the RATS. However, I do carry a SWAT-T and I’ll talk about my application strategy for it further on.

2. Pressure Dressing

Does every bleed need a tourniquet? Here’s where a pressure dressing comes into play. I carry a vacuum sealed Israeli Emergency Bandage. It’s lightweight and provides unmatched control of bleeding by combining absorbent materials with a sustained, focused pressure directly over a wound, helping compress damaged vasculature and promote clotting. I can utilize both, a TQ and a pressure dressing at the same time, with the importance of PRESSURE. Now, this an application that the multi-use SWAT-T is a benefit. The elastic strength of the SWAT-T can be applied as a pressure dressing WITH bandages, such as a 5x9 or a couple 4x4’s.

This doesn’t fix the problem, but it helps buy you or someone else time to move or call for help.

3. Compressed Gauze

Some wounds can’t take a tourniquet. Areas of the groin, shoulder, armpit, junctional areas (without getting MacGyver-like with a Nalgene and TQ). Wound packing combined with direct pressure is often the choice in these cases. I carry hemostatic gauze, such as QuikClot for these cases. Tourniquets stop limb bleeding. Gauze stops the rest.

By now, you’ve probably figured that the first 3 in my kit are for hemorrhage control. If we can’t keep the blood from escaping, everything else is for nothing. They are extremely important and carrying these items can change our decision making. Knowing we can manage major bleeding lets us hunt, travel, and work with confidence due to preparedness. It’s the same mindset that governs any good backcountry kit; hope you never use it, but when things go bad, you don’t want to wish you’d packed it.

4. Fracture and Sprain Management

Lower extremity injuries are the most common reason backcountry trips turn into really bad times. Immobilization reduces pain, prevents further damage, and allows for self-extrication. This is why I carry an ACE-wrap and Leukotape. And you might have guessed it, another application to use the SWAT-T. I also use trekking poles. I can utilize a trekking pole by taking it apart and using a length or two to create a splint. We’re not fixing the injury, we are making the hike out possible.

5. Blister, Foot, Soft Tissue Care

Blisters don’t sound serious until they stop movement. Foot failure leads to poor decisions, slow movement, and cascading risk. As said before, I carry Leukotape wrapped around an old cut-in-half credit card. I also carry some pre-fab blister pads tucked away for those smaller areas. Most issues started with something small. Take care of your feet. Air them out when you can, let the dogs breath.

6. Environmental Injuries

Hypothermia and heat illness can sneak up fast when we’re wet, tired, or under-fueled. Exposure kills more reliably than trauma in many environments. That’s why I carry an emergency blanket in my kill kit. In the kill kit? Well, for me it’s multi-use. I carry it mainly to keep meat clean once it’s off the animal and I need a place to put it before I can get it into a bag. Lightweight and costs hardly anything. I also carry water purification tablets as a backup to my filter in my first-aid kit. Redundant, sure. Just remember, the environment is always part of the injury.

I carry a few other things, such as prepackaged doses of Ibuprofen, Acetaminophen, and Diphenhydramine. Pain, inflammation, and allergic reactions can end trips early.
 
A set of small tweezers, splinters and ticks. Lesson learned the hard way.

In the backcountry, small wounds get dirty fast. So I have antiseptic wipes, antibiotic ointment, and a variety of small adhesive bandages. Infection doesn’t matter on day one, it matters on day four when you’re miles out. Clean early or pay later.

The best kit in the world is useless if you don’t know how to use it under stress, cold, and fatigue. So train and prepare.