Basic First Aid on the Trail

By Stephanie Nusbaum, Girls Who Hike North Carolina Ambassador

It happens to all of us. You’re having a great time, hiking with your friends and family, loving the sun and mountains when disaster strikes! Someone in your group trips and sprains an ankle, or cuts themselves on a sharp branch.

We’ve all scrapped ourselves before, so what’s the big deal? Just throw a bandage on it and go, right? Or does that need stitches? Do the ankles need to be raised, or is it better to lower it so blood can travel? 

Well here are some tips to help you when that moment strikes! 

First! Stay safe. You can’t help anyone if you’re also in trouble so please take a breath and then you can help the person. Staying calm in this situation will help calm the injured hiker, who might be freaking out. It also helps to carry a first aid kit, even a small one can come in handy.
Second! I am not a doctor nor medical personnel. Please always contact someone with experience after an injury.

Ok, let’s get into the fun part!


We all experience these, even in our everyday lives! 
(If you have a weakish stomach I do not suggest looking for images of blisters.)

A blister is simply a pocket of fluid that forms below the skin. It can come in many shapes and sizes but usually, hikers will develop them on their feet. The biggest culprit is friction due to poorly fitting shoes, socks, or even sweaty feet. The best way to prevent a blister is to buy shoes that not only fit properly but also wear them in properly before endeavoring into the wild for days. Also carrying extra socks to keep your feet dry will help, especially in our warm summer months. 

You will need to pop and drain the blister as soon as you can. Now, please don’t grab the nearest sharp object and go at it. The best thing for this will be a sanitized needle. You can keep a sewing kit, (Dollar Tree sells small kits) and sanitized the needle with an alcohol wipe from your first aid kit. After the blister has been drained you’ll want to apply antibacterial ointment and a bandage. 
My favorite thing in my first aid kit is Moleskin. It’s a heavier bandage and comes in all shapes and sizes. Saved many a foot in my family during dance and speed skating seasons.


Let’s now get into sprains. Another common injury for hikers. The Mayo Clinic defines a sprain as the stretching or tearing of ligaments — the tough bands of fibrous tissue that connect two bones together in your joints. It can happen from a fall or even just stepping wrong. 

Symptoms can include pain, not being able to put weight on your ankle, bruising, swelling, an odd shape. Basically, it hurts and doesn’t look correct. 

The simplest way to remember how to treat a sprain is RICE

Photo Courtesy of Cheezeburger

Photo Courtesy of Cheezeburger

You’ll want to get off that ankle and sit down. Find an ice pack or cold running water, if neither are available then a water bladder or cold water bottle will help. To prevent frostbite please wrap the ice in a t-shirt. After 15- 20 minutes you’ll need to wrap the foot, which will keep the ankle supported and straight. Elevate the ankle while icing and with the bandage on. Use trekking poles or a walking stick to keep weight off the injury.

Always seek medical attention or consult a doctor. Sprains have three levels of severity and will need further consultation.


This can be a tough one. A small scrape can appear normal enough but imagine all the bugs and bacteria out there in the woods, a small cut can get infected easily.
Keep an eye out where your feet land and use trekking poles, especially on uneven ground. 

To treat the wound first apply pressure to try and stop the bleeding. If pressure doesn't work then elevate above heart level for 10 minutes. 

Clean the cut with an antibiotic, such as Neosporin, and apply a bandage. Once you’re back in civilization seek medical advice if the wound seems deep and might need stitches or maybe a tetanus shot (I recently learned that even if you are up to date on your tetanus shot you may need a booster if you receive a dirty or deep wound). 

Please do not try and clean an open wound in a river. If you need to wash it with water use filtered drinking water.


This is an easier thing to prevent, just make sure you drink enough water! 
FUN FACT: It is a myth that if you’re thirsty then you’re already dehydrated. It just means you’re thirsty and should drink water. 
Also a myth: Everyone has to drink eight glasses of water a day. There are a lot of variables- genders, height, weight, active status. A good rule of thumb is that when you’re thirsty...drink!!

This is not a complete list of injuries but a few common ones you might experience on the trail. We could continue on for an another few pages. Let’s go over one more important thing.

What should be in a first aid kit?

You can purchase a complete first aid kit at any store or build another one at home. I have a small one from REI and added what I needed. 

Here’s a quick list:
Bandages- I also like Moleskin
Tweezers (fine-point)- Helps with ticks as well
Safety Pins and needles
Neosporin or antibiotic ointment
Alcohol wipes
ACE Bandage
Emergency electrolytes
Aloe- for sunburns
Gauze pads
Butterfly bandages
Medical tape
Manual or info cards
Poison Ivy and Oak wipes
Bug Sting Wipes

Emergency Equipment for you pack:
Duct tape
Small mirror
Ziploc Bags
Cotton Swabs
Magnifying Glass
Small Notepad
Emergency Blanket
Whistle or Personal Alarm

You can now feel prepared for small first aid emergencies on the trail! Now, what are you doing still reading? Go out, have fun, and see you in the woods!

Stephanie is the Ambassador for our North Carolina chapter. You can join her local meet ups and discussions through Girls Who Hike North Carolina by clicking here.