Create a custom first aid kit for hiking that includes the medical and survival items you might need in an emergency. Credit: Aislinn Sarnacki / BDN

Accidents happen. No matter how well prepared you are for a hike, you could become sick or injured due to many circumstances. And in the wilderness, even the smallest hurt — such as a blister — can really put a damper on your experience.

While it takes special training and experience to treat many medical issues, anyone can learn a few first aid skills to take care of minor, common issues that occur during hikes. Here are five items to pack in your personal first aid kit for hiking, along with the skills required to use them.

Blister treatment

One of the most common hiking injuries, a blister is a small bubble of skin filled with fluid that’s caused by friction or burning. For hikers, blisters often form on their heels or toes, and sometimes on their hands from holding trekking poles. If they pop, they can be extremely painful and even slow down your pace.

There are a few different materials you can use to treat blisters. Greg Sarnacki, a registered Maine guide who teaches first aid classes, often uses Moleskin, which is a thick cotton fabric designed specifically for treating blisters. Some Moleskin patches have holes cut into them, or you can cut your own. The hole should go over the blister.

“The idea is to raise [whatever’s rubbing on the skin] up off that blister so there’s no more friction,” Sarnacki said. “The biggest problem with the blister is if it bursts in your boots. Then it’s a raw, open wound.”

To prevent this, Sarnacki usually cuts a small hole in the blister using disinfected scissors and drains the fluid from it. Then the outer layer of skin, though dead, will dry up and remain over the raw skin, protecting it.

Of course it’s preferable to avoid developing blisters in the first place, and Sarnacki has a few tips for that.

“Make sure you’re not going out on a hike in brand new boots,” Sarnacki said. “Be aware of hotspots. Listen to your feet. If they start to get sweaty and wet, make sure you stop and air your feet out and put on some dry socks.”

Bandages and abrasions

While scrambling up rocks and over fallen trees during a hike, it’s easy to cut or scrape your legs, hands and arms. It’s important that you have some materials in your first aid kit to clean and cover those small injuries.

Alcohol wipes and antibiotic sprays and ointments can be used to sterilize wounds, preventing bacteria from causing an infection, Sarnacki said. It’s also good to carry an assortment of bandages.

“I tend to go with bigger dressings rather than lots of dinky dressings,” said Jon Tierney, a lead instructor for Wilderness Medical Associates. “Then I can cut them into smaller dressings, but you can’t make small dressings into a bigger one. Also, carry a few Band-Aids of different sizes and shapes because if you skin your knuckles, some don’t fit very well.”

Tierney also suggests adding Vet Wrap or a similar type of self-adherent wrapping material to your first aid kit to secure gauze or bandages in place.

Carefully labeled pills

If you have any daily medicine that you rely on to maintain your health, it’s important to carry a supply of that with you when you’re hiking, just in case you get stuck in the wilderness for a night or two. It may also be useful to carry pain relievers such as Tylenol or Ibuprofen, Tierney said. These could help you if you twisted an ankle, or if your knees or back became sore.

Fast-acting oral antihistamines such as Benadryl can also come in handy when hiking due to the many different things in nature that can cause allergic reactions, such as bee stings, poison ivy, pollen and insect bites.

An old first aid kit. Credit: Courtesy of Julia Bayly

Emergency nourishment

When hiking, drinking enough water and eating enough food is especially important for keeping your body working properly. Often, hikers become dehydrated or deficient in important nutrients.

Carry plenty of water, and — as an added precaution — you can pack emergency water purification tablets or drops in your first aid kit, just in case you run out of water and need to purify some from a stream or spring. Another useful item to throw in your kit is electrolyte packets, which can be stirred into your water for an added boost of electrolytes.

“Your body needs electrolytes to function correctly,” Sarnacki said. “If you flush a lot of electrolytes out of your system — say by drinking a lot of water and sweating, which you do while hiking — you can start feeling sluggish, irritable and nauseous. It feels a lot like dehydration, but you don’t know why because you’re drinking plenty of water.”

This could develop into hyponatremia, which is when sodium (a type of electrolyte) in your blood is so low that your body’s cells begin to swell. The condition can be life threatening if untreated.

Splint for a twisted ankle

One of the most common hiking injuries is a twisted or sprained ankle. This is because hikers are constantly navigating over tree roots, jagged rocks and otherwise uneven terrain. The best way to avoid a twisted ankle is by carefully selecting your footwear so it offers your ankles optimal support (high top hiking boots are a great option). Also, maintain a hiking pace that you’re comfortable, and try to always pay attention to where you’re stepping.

Still, a twisted ankle will likely happen at some point — whether it’s your own ankle or the ankle of a person you’re hiking with. For major sprains, you may need to call for the help of a medical professional, depending on how far up a mountain you are. But there are a few tools you could use to treat a minor sprain so you can make it back to the trailhead.

Using an ACE elastic bandage, Coban self-adherent wrap or athletic tape, you could wrap a twisted ankle, offering it more support. However, effectively wrapping an ankle takes some skill and experience, Tierney said.

Another option would be to apply a lightweight, packable splint, such as a SAM splint, Sarnacki said. Learning how to use a SAM splint to support an ankle is easy, he said. Simple directions are displayed on the splint itself, and the company offers an online training video.

Customize your first aid kit

This is far from a comprehensive list of items you should carry in a first aid kit or hiking. There are many more helpful medical supplies you can carry, such as poison ivy wash (if you’re very reactive to poison ivy), an EpiPen (if you’re severely allergic to something like bee stings) and butterfly closure bandages for large cuts. If you purchase a pre-made first aid kit, be sure to look through it before you go on a hike. Remove and add items, based on your needs. And always service your first aid kit after your hike, Sarnacki said, replacing items you’ve used up and checking for any damage.

A multi-tool that includes sharp scissors, a knife and tweezers is a great addition to any hiking pack. It can be used for medical emergencies and survival situations. Scissors are useful for cutting up bandages and cutting too-long toenails that are causing your feet discomfort, Tierney said. Tweezers can be used to remove splinters and ticks.

First aid kits also often contain survival tools such as waterproof matches. Hikers should always carry with them the ability to start a fire, Sarnacki said. It could save your life. An emergency bivvy is another survival item that would help you stay warm in a pinch.

Carrying a first aid kit that you’ve carefully pieced together can make a big difference if you ever find yourself in an emergency situation. The kit could be as big as a lunchbox or small enough to fit in your pocket, depending on the length, difficulty and remoteness of your adventure. Only carry what you need (for example, a few pills, not the whole bottle). This extra step of preparation can give you peace of mind and confidence while out on the trails.

Aislinn Sarnacki

Aislinn Sarnacki is a Maine outdoors writer and the author of three Maine hiking guidebooks including “Family Friendly Hikes in Maine.” Find her on Twitter and Facebook @1minhikegirl. You can also...