How to Make Your Hiking First Aid Kit Light and Powerful

So we've all probably had that moment when it's like, "Damn. I really need a better hiking first aid kit."

Mine came when a friend fell off his mountain bike and skidded across 15 feet of dirt. "I'm OK!" he said, leaping up. And then his shin melted like the Nazi's face in the final scene of Raiders of the Lost Ark. And this was upsetting, considering he had no hiking first aid kit, and I had two Band-Aids and some Advil.

After that wake-up call, I spent the next few years engineering the perfect hiking first aid kit that balances portability with preparedness. In this post, we'll look at nine simple kit hacks that will help you adventure with confidence and won't weigh you down.

Mandatory disclaimer: I am SO not a medical professional. The following are guidelines only. They're not a substitute for medical advice and training.

1. Always DIY

There are a couple big advantages to building your own hiking first aid kit rather than relying on a preassembled commercial model.

First, you can customize it any way you want. For example, I almost never hit the trail these days without an extra large flexible splint. (More on those in a minute.) And it's pretty tough to find a commercial hiking first aid kit that a) includes a splint, and b) is smaller and lighter than a car battery.

Second, building your own kit forces you to know what's in it and where it is. When I first started guiding, I'd waste a lot of time digging in our giant commercial kit for common things like Band-Aids and moleskin. These days I actually separate my homemade kit into systems (ortho, blister, wound care, etc.), each in its own plastic bag.Finally, you can often massively improve the awesomeness-to-size ratio by building your own kit.

Here's a handy checklist that will help you build a pretty bomber hiking first aid kit that fits in a gallon-size freezer bag.

2. Carry protection

Keep two pairs of surgical gloves in your kit in case you have to deal with a friend's (or stranger's) bloody mess.

Why two pairs, you ask? Because when you're all amped up in an emergency, it's easy to pull too hard and rip a glove in half.

Another good thing to remember: just like condoms in wallets, surgical gloves become brittle with age. So keep them sealed in a Ziploc bag and replace them every year.

3. Discover benzoin

Are you sick of patching blisters — only to have the bandage slip off your sweaty foot in minutes? Let me introduce you to your new best friend: tincture of benzoin.

TOB is this stinky brown stuff that makes bandages and tape stick like magic to skin. If you swab some around a blister, let it dry a little, and then apply moleskin — well, be ready, because that moleskin is probably going to be there a week from now.

TOB also works great with wound closures and Band-Aids. If you like to tape your feet before a trip to prevent blisters, try putting a little TOB on the area first to help the tape stick and reduce skin irritation.

An important caveat: don't rub TOB directly in the wound, and be sure to read the directions for your particular product.

If there's a downside to TOB, it's messiness. The bottle tends to leak, so place it in a separate baggie before adding it to your hiking first aid kit. (Another option: buy your TOB in single-use ampules.) In the event of a spill, an alcohol swab should remove TOB from skin and most surfaces.

4. Prep for common injuries

Smart as you are, you can't anticipate every potential problem. So to keep your hiking first aid kit light yet powerful, focus on those injuries you're most likely to encounter.

Colorado Mountain Club recently conducted a 10-year review to determine the most common medical emergencies encountered by its trip leaders. The winner by far: muscle, bone, and joint injuries to the knee and lower leg. So for most of us, that's probably a great place to focus.

One of the best things you can carry for foot and ankle injuries is a flexible aluminum splint that can be formed around the injury and tied in place. (I recommended the extra-large Sawyer SAM Splint or C Splint.) Proper splinting can stabilize injuries and reduce pain. You can even splint around a shoe or boot to help the person walk out.

Splints can be secured with t-shirts, utility cord, and even duct tape. But for convenience and comfort, grab an old sheet and some scissors and make yourself a pair of triangular bandages. Just cut a square with 37-inch sides, cut a diagonal, and voila. Pro Tip: they also make great arms slings.

5. Get self-adhering tape

This springy, spongy bandage conforms to your skin, so it won't pinch or pop off every time you reach for a hold. It's excellent for patching up fingers, arms, elbows and knees. Just clean the wound, place some gauze dressing, and wrap away.

Another tip: it's reusable, at least once or twice. So don't discard it after a dressing change.

Coban is a popular brand for humans, but word has it you can save some bank by buying a veterinary version. (Check the first aid section next time you're in Petco.) The 2-inch size offers the best balance of utility and portability. Just split the strips in half for use on fingers and toes.

6. Bring drug information

Carrying your medicines in blister packs saves space. But it's an awful feeling to be sitting there with your guts in agony, going, "Now is it one Immodium — or two?"Here's an easy way around this. When you add a new medication to your hiking first aid kit, cut the drug information panel out of the box and stick it in the baggie. On the back, note the expiration date (if it's not printed on the blister pack).This is also a great place to add any personal notes on dosage. For example, I've realized through trial and error that I can't take more than half a Benadryl without falling asleep on my feet.

7. Identify yourself

If strangers find you incoherent in a boulder field — or a bar — they won't know your pertinent medical history or how to contact your loved ones. So unless you've always loved the name Jane Doe, it's a good idea to carry this information in your first aid kit.

Here's a handy emergency contact form you can fill out and print.

What if I don't have my gallon-size hiking first aid kit in the bar, you ask? A wearable identification tag is a great way to ensure would-be rescuers will always have access to your vital info. I'm personally partial to the elegant, affordable designs of Road ID.

8. Refresh yearly

Drugs, surgical gloves, hand sanitizer, water purification tablets, sunscreen, and chemical warmers are just a few of the first aid supplies that degrade rapidly — especially in harsh backcountry conditions. So at least once a year, go through your entire kit to restock and replace.

9. Take a course

The best hiking first aid kit in the world won't help anyone if you don't know how to use it. So if you spend a lot of the backcountry, developing world, or anywhere medical care could be delayed, invest in learning some advanced first-aid skills. A great place to start is a Wilderness First Aid course, which is offered by a variety of organizations and takes 16–20 hours to complete.

If you want to be a total rock star (or if you wrestle grizzlies for a living), check out Wilderness First Responder, an advanced course that takes about 80 hours to complete.

So back to my friend who was bleeding all over the trail ...

Well, there's a happy ending. Just as I was about to rip off my sweaty shirt and use it as a dressing, the mountain bike patrol came by. And they did an awesome patch job that allowed us to get back to the trailhead.

But seriously, that was fate tapping us on the shoulder. I'm going to assume I'll never get that lucky again and carry a hiking first aid kit on all backcountry trips.

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There you have ‘em. My best hiking first aid kit tips.

Got tips to add? Comment and share.

Last updated May 8, 2017.