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Backpacking First Aid Kit: Roll Your Own

I carry a lightweight (6 oz) home-grown first aid kit when I go day hiking and backpacking. It contains more bandages and medications than I might need on a trip so I only have to replenish it periodically. It’s closely “aligned” to the locale where I do most of my trips, in the Eastern United States where emergency healthcare is usually accessible in a worst-case 24-hour time window, even in rural areas. Different locales will have different first-aid requirements.

I also carry several multi-use items that can augment my first aid kit, which I explain below. My trail clothing system also lets me avoid many issues and ailments associated with ticks, insects, and sun exposure.

Easy-to-Identify Stuff Sack

My first-aid kit is packed in a white stuff sack which makes it easy to find in a backpack and to check whether I’ve packed it.

First Aid Kit Ingredients

Here are the contents of my first-aid kit. I buy everything in quantity and refill things periodically when they run low. You’ll find this approach much less expensive than buying a pre-packaged first aid kit and resupplying it with items sold by the kit’s manufacturer.

All of these items are easy to find over the counter. I rarely use any of it, to be honest and actually give most of these items away to people I hike with or come across in distress.

  • Blister prevention: 12 pre-cut Leukotape strips, stuck to release paper
  • Blister treatment: 6 Band-aid hydro-skin band-aids of various sizes
  • Wound cleaning: 6 alcohol prep wipes
  • Small cut care: 6 very sticky Elastoplast bandaids
  • Small meds bottle: Personal medical prescriptions, as needed
  • Pain and inflammation relief: 10 ibuprofen tablets, 10 Acetaminophen tablets
  • Pain and blood thinner in case of heart attack: 12 children’s chewable aspirin pills
  • Allergic reaction: 20 Benedryl tablets
  • Diarrhea relief: 10 Imodium tablets
  • Electrolyte replenishment: 1-2 Tailwind electrolyte drink packets
  • Body fluid isolation: Nitrile gloves in case I have to administer first aid to someone else

Multi-Use ingredients, which can be used for first aid if needed

  • Wound cleaning, irrigation: Chlorine dioxide water purification drops or tablets
  • Scissors: Victorinox Swiss Army Knife Classic
  • Chaffing relief: a small container of Zinc Oxide packed in my toilet paper bag
  • Chaffing relief: a small container of Vaseline packed in my fire starting kit

Explanation of Ingredients

Leukotape is a very sticky tape that hikers and runners put on their feet to prevent hot spots from forming. The only time I get blisters is when I’m breaking in a new pair of shoes or insoles or I have to do a long road walk. Leukotape comes in a roll which is inconvenient to pack. So I pre-cut it into 3-4″ strips that I stick to mailing label paper (“called release paper”) and carry those instead. This works great, but you have to change the strips once or twice per year because they lose their stickiness over time. Leukotape will typically stay stuck to your feet for two to three days.

Cut the strips into 3-4 inch strips, that you could use to cover your heels
Cut the strips into 3-4 inch strips, that you could use to cover your heels

Band-aid Hydro Seal Bandages (comparable to Compeed in the UK) are gel-like bandages that help heal blisters and provide cushioning for pain relief. They’re also very sticky and waterproof, so you can shower, keep hiking, etc., while wearing them. They’ll typically stay on for two to four days. They’re the best bandages for blisters I’ve found.

Alcohol Prep Wipes are good to sterilize scrapes, shallow wounds, and blades or scissors before use. The “outdoors” is a pretty dirty place and these wipes are one tool to help prevent infections. They’re often sold in large quantities, like 100 wipe packages.

Elastoplast Plasters are very sticky bandaids that are much stickier than the conventional Band-aids you typically get in the United States. I first discovered them in Scotland, but you can also buy them on Amazon US. They’ll typically stay on for two to three days. They are quite inexpensive, actually.

Elastoplast band-aids are very sticky and stay on for days.

A 2 oz polyethylene bottle (sold by REI) with a screw-on cap is a good way to package prescription drugs because it prevents the pills from being crushed and is much more space-efficient than carrying a daily pill dispenser. If you lose the cap you can replace it with a plastic soda bottle cap. If you’re paranoid about losing your prescriptions, carry a second bottle with them in some other part of your pack or personal effects. This can be helpful when traveling overseas where getting a refill is problematic.

Ibuprofen tablets are quite helpful for pain relief, fever reduction and to reduce inflammation when it is needed. I repackage mine in EZ Dose Ziploc pill bags to keep them dry.

Children’s chewable aspirin is good as a blood thinner to prevent clotting if someone is experiencing heart attack symptoms. Chewable tablets can be consumed by anyone. It’s important to check that a patient is not allergic before administering.

Benedryl tablets are good for treating all manner of allergic reactions ranging from bee stings to hayfever. Benedryl is also a good sleep aid that will make you drowsy if you’re having trouble falling asleep. I also repackage mine in pill-sized Ziploc bags to keep them dry.

Acetaminophen tablets (Tylenol). For pain relief, especially for those who cannot take Aspirin & Ibuprofen.

Imodium tablets, also called Loperamide, help reduce the symptoms of diarrhea if you consume bad food or water by slowing down your bowel contractions and the movement of food or fluids through your digestive tract. In other words, it plugs you up so nothing comes out. I also repackage mine in pill-sized Ziploc bags to keep them dry.

I repackage over-the-counter meds in little plastic bags: Ibuprofen, Imodium, Benedryl.

Tailwind Electrolyte Replacement Packets: Tailwind is an electrolyte replacement mix that contains a mixture of electrolytes including sodium and potassium, and simple sugars so it can be consumed by people who are allergic to the artificial sweeteners found in many other electrolyte mixes. These mixes are surprisingly prevalent in drinks and mixes and they can make people very sick. I mainly carry this drink mix for other people to consume when they bonk or feel nauseous because they haven’t been hydrating properly, particularly on hot and humid days.

Nitrile Gloves: One of the most important lessons you learn in Wilderness First Aid is body fluid isolation. You want to avoid coming in contact with an injured person’s blood, sweat, piss, or shit. I help people who I come across from time to time who are in some sort of distress, and wearing Nitrile gloves is a simple way to keep yourself safe if I have to touch them.

I carry zinc oxide and vaseline in small hinged cosmetic tubs which makes them easy to resupply from a larger jar. Hint: wear a nitrile glove when transferring from a large jar to these small tubs.

Multi-use Ingredients

Aquamira Chlorine Dioxide Water Purification: I carry chlorine dioxide as a backup (to my filter) and as a batch water purification technique on all of my hikes and backpacking trips. Water purified with chlorine dioxide is sterile and can be used to irrigate deep wounds. While it’s painful, scrubbing debris out of wounds helps prevent infection. While you can carry an irrigation syringe for this, a plastic bag, bladder, or hydration hose can also be used to create a  stream of water.

Swiss Army Knife Classic: This tiny knife has a small pair of very sharp scissors which are handy for shaping Leukotape or bandages.

Zinc Oxide: Zinc oxide is a soothing cream for treating minor skin irritation including chafing. I carry a small hinged cosmetic jar of it in a plastic bag with my toilet paper. It works wonderfully well to relieve discomfort and prevent further irritation. I go through enough zinc oxide that it pays to buy a big jar and refill my small tub as needed. The refill process is best performed using a nitrile glove to keep the zinc oxide off your hands.

Vaseline: I carry a small tub of vaseline which I smear onto cotton balls as a fire starter. It can be used the same way as zinc oxide although it’s a little greasier. I occasionally use it on my toes under my socks if I feel friction, to prevent blisters.

The Problem with Commercial First Aid Kits

I’ve never been a fan of small commercial first aid kits because they don’t contain the products that I prefer or in enough quantity, necessitating frequent and costly resupply if buy their replenishment kits. I’d rather carry 20 Ibuprofen or Benedryl tablets than the 1 or 2 tablets included in commercial first aid kits because I use them far more often than a commercial kit assumes. When I’ve guided people, I’d carry a heavier commercial first aid kit, but it contained far more items than you’re likely to ever need on a hike or backpacking trip. Guides carry them to avoid lawsuits as much as to help their clients.

Take a look inside a consumer Adventure Medical Kit sometime. Paying $32.95 for this Ultralight/Watertight .7 Medical Kit is a total rip-off. You can stock a roll-your-own first aid kit that costs less and is just as effective and complete with items in your home medicine cabinet.

Health Maintenance System vs First Aid Kit

The problem with most commercial first aid kits is that they try to package “first aid” as a separate entity so they can sell it and not as an element in a larger gear system. Sure, boo-boos happen, and it’s nice to have enough ingredients to stabilize a patient until you can receive proper medical attention.

But if you’re a serious day hiker or backpacker, I’d encourage you to think about the medical supplies and gear you carry as a larger “health maintenance system” made up of interlocking and multi-use parts. For example, a foam sleeping pad and removable backpack straps can be used to fashion a splint for a broken leg, chlorine dioxide water purification tablets can be used to purify the water used to irrigate wounds, and the hose from a hydration reservoir can be used like an irrigation syringe to wash out wounds. This is why I view them as part of a larger health maintenance system along with the other gear and supplies that I carry on trips.

Food for thought.

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48 comments

  1. This is a great list I see a lot of experience in this. I have all of this in mine, I also add strips of old fashion cloth Elastoplast first aid tape. (Along with a couple others) I use the 3 in. wide 14 in. long strips attached to release paper. This works great to support ankle sprains (among other things) for self-rescue. I am an old paramedic and SER-Tec from Rocky Mountain Search Rescue, and if we can walk someone out vs. carrying them, makes for a safer day for all. I recommend your site to every new hiker I meet.

  2. In many states it can create legal problems if a person carries prescription drugs in any container other than the original one they were dispensed in. It’s probably not an issue for most hikers unless you get searched for some other reason, but it’s important to know nonetheless. I have tried to make myself feel better about this by carrying the prescription order or the original bottle’s label with me when I use a smaller container for pills, but I don’t know if that would hold up if it came down to a problem.

    • Me, I just don’t give a F about BS laws like that so I will just do me.

    • I carefully peeled the labels from some of my prescription bottles, folded them in half, sticky side to sticky side, and put them in the EZ Dose Ziploc pill bags with the meds. I think that’s the same system you use.

      • If you ask your pharmacist, they will print off labels for your meds. you can then place the labels on zip lock bags or any other container.

    • When I travel by airlines, especially out of country, I purchase the individually packaged OTC meds in his list. Not only does it eliminate the problem of little bags filled with pills raising suspicion, they are sealed against moisture. Also, if I provide them to someone the directions, etc are printed on the packet. Unfortunately the extra packaging does increase my pack weight 0.1 oz. Purchase them online from: https://www.minimus.biz/
      I also purchase a few other individual packet items from them like honey, ketchup, etc.
      Thanks Philip for a very helpful article.

  3. Why not leave the Leuko tape on the backing that it comes on?

  4. Great list! As a takeaway from wilderness first aid I split mine into big problem and little problem bags. Couple of pills, band aid, piece of moleskin, etc. go in a small zip lock in a outside pocket. Everything else goes inside the backpack.

  5. I am allergic to anything with a sticky backing – band-aids, tapes, Hydro-Seals, etc. I carry lots of gauze, which can be wrapped around almost anything and then taped. It doesn’t prevent or help moisture issues, though. I am always open to suggestions for an easier way to treat boo-boos, if anyone (EMT? medic?) has any ideas.

    Separating pills and tablets from their original packaging can be life-saving. I am (also) allergic to bees and wasps, and one time I was unable to get into my Benedryl, a first step before grabbing the Epi-pen. Fortunately, I had someone with me who cut into the blister pack with a knife. The first thing I did when I got home was take out all the pills and put them in a waterproof container.

    • Bunch of guaze then vet wrap. Vet wrap is stretchy and sticks to itself. They sell it at Target under a different name.

    • Pills in a container are less likely to get crushed. Before the pandemic I worked out at the Y. Inevitably I’d forget to pack something. There’s nothing like putting on sweaty underwear after you’ve showered to get your creative juices flowing. So I wrote a list of items to take with me and taped it to my door at eye level. This prevented me from forgetting to pack clean underwear which was now on my list. You could put a knife or scissors on your list so you’d have it for next time. Just remember to read the list each time because I’ve even forgotten to do that.

      • If I understand this correctly, you now have to list your list on a list so that you don’t miss anything on your list.

        I’ve been considered in the past to be rather listless…

      • I appreciate your suggestion. I actually did have a SAK with me. When someone expects a life-threatening anaphylactic reaction, the logical part of their brain kind of stops working. The body is beginning to itch, turn red, swell, etc. There’s almost a doom & gloom feeling. I focused on getting the Benedryl packet open, but obviously not on the best way to do so! I remembered my knife only after the fact. My first solution was to leave the knife with the Epi-pen and Benedryl in my outer pack pocket, but then I realized it would be better to have them loose in an easy-open container instead. I’m not sure I could have opened the knife without cutting myself.

        • I don’t know if I’d be brave enough to continue to hike if I knew I could go into shock. I’m glad you had someone with you.

  6. When I took a WAFA course, the instructor said most problems you’ll face with a diabetic on the trail are related to low blood sugar. He said, “Give sugar!” I also keep a few sugary candies in my kit.

  7. I go back and forth about the SAK Classic versus purpose-made items like Uncle Bill’s Sliver Gripper (tweezers), Gerber LST Ultralight lock-back knife, and those folding scissors (Coghlan?) you can get on Amazon. The SAK has a useful set of tools, but I always wonder whether the small size means they aren’t as useful or convenient as purpose-built items. Any thoughts on whether the SAK really works, or is just small and light? I really prefer the SAK Classic to the individual items, but this little voice in my head keeps saying “penny wise and pound foolish.”

    Victorinox also makes a nifty little “SAK” Nail Clipper, that’s lighter than the drugstore ones and works well. I always carry nail clippers because my biggest issue is normally a torn or broken fingernail that snags on clothing, or member(s) of a group that forgot to trim his or her toenails before the trip. (Victorinox also makes a combo Classic/Nail Clipper, but you give up the screwdriver and the serrated scissors don’t cut as cleanly as the Classic scissors.)

    One other thing I carry, since I normally hike and camp alone, is one of those acrylic mirrors (again, Coghlan’s.) I found out, the hard way, that if you’re alone without a mirror, it’s really hard to put a bandaid on the cut on your forehead. When I told my kids, they all said “just turn the screen around on your iPhone.” That’s fine, unless the screen shattered when you fell.

  8. Great article. For a stream of water sometimes you already carry a tool to back flush a water filter.

  9. Thanks for the great tips. A small make up bag or old personal first aid kit is usually brightly colored and makes a great carry case for a roll your own kit. I really like the easy selection of items in your article and I agree, most commercial first aid kits are legal cover.
    Depending on my hiking crew and length of hike, I have a small pocket bag or a small cargo pocket bag I can outfit. At 55 I am one of the youngest in my Backcountry group and it isn’t possible to know what ailments will happen. I recommend having the difficult conversation with a crew about medical issues before packing for the hike. Ask the questions now because it isn’t possible when someone is unconscious.

    • I’ll be the voice of (minor) dissent here: I took the path of least resistance way back when and bought the Adventure Medical .5 kit. Is it overpriced? Yes. I knew I was paying for convenience: I didn’t have to go to two or three drugstores to get the stuff I needed (this was in the day of the small-twon local drugstore.) Was the commercial kit complete? No – I ended up adding scissors and nail file (SAK Classic), burn cream, and rehydration tablets (refill items from REI), and nail clippers (currently the SAK Nail Clipper.)

      With the advent of chain store pharmacies, I no longer get refill items from REI – but I’m still using the same nylon pouch with Ziploc bags. I may replace it with a new kit one of these days, just because it’s ratty; I’ll comparison shop the cost of the kit against a small ditty bag or stuff sack, if I can find one in a different color from my usual stuff sacks.

      Not a good reason to buy a commercial kit, but at least it was a reason.

      • My first kit is an REI multi-day I paid $10 for years ago. It has the main waterproof kit for multiday, and a smaller wallet size to use for a single day. Both are red, easy to see, and hardly ever used except for others. Now I use those bags and add my own medical kit because most of the stuff they had is overkill. I don’t agree with carrying a first aid kit in the backpack because I consider it part of the 10 essentials, which I carry on my person because the pack can become separated from me. My 10 essentials other than my knife fit nicely into the waterproof first aid kit, which fits in my hiking cargo pocket.

  10. With you on all the selections. I toss a half roll of either athletic tape or electricians tape into mine. seems to get used regularly.

  11. This is a great list and a topic that is always worth revisiting. Myself and my wife also have a similar strategy when it comes to first aid kits. We have built our own, but I see nothing wrong with purchasing one either. I think the big thing is to take it with you and know how to use the stuff in it. I agree with the above comments regarding vet wrap. The stuff is amazing as it sticks to itself and allows basically anything to be used as gauze or padding under it. In addition to the items mentioned by most I also carry wound closure strips, a tourniquet, and maxi-pads and tampons. The pads and tampons are great for controlling bleeding (esp when use with the vet wrap). I know many would say the tourniquet is overkill, but ask yourself if you could stop arterial bleeding in under 2mins, with items you have, under stress. We have also given maxi pads to a desperate woman far in the backcountry…..she was extremely appreciative. I also don’t worry too much about infections as if you hurt yourself that bad the Dr. Is going to give you antibiotics anyway and clean out your wounds again.

    • I think its more likely that a small cut can result in infection because you are less likely to take it seriously, clean it well, and take measures to keep it clean.

  12. Great list with lots of useful information. Thanks!
    I buy my EZ Lok pill ziplocks at my local Walgreens.

  13. Note that Leukotape K, prepackaged with packing, is a stretch “kinesiology” tape. Leukotape P, which I use for blister prevention, is not.

  14. I keep thinking Phil, that you’re going to block me from commenting. Here goes. I don’t like drugs. Benedryl is bad. Please don’t take it to fall asleep. All drugs have side effects. I just read another article today https://www.aarp.org/health/conditions-treatments/info-2023/drugs-that-can-harm-kidneys.html?cmp=EMC-DSM-NLC-OTH-WBLTR-1532702-1840406-7359074-NA-06172023-Webletter-MS1-NA-NA-ARM60-Health&encparam=blqwypOiCXFgwbJ6wjh9%2f6KDLlOO1bknurKpClUflfc%3d
    What if I fall and break a bone? I won’t be taking any pain killers. Hey, I gave birth with only zylocain for the episiotomy and felt one of the stitches anyway. At another medical visit, I’ve been told I have a high pain tolerance. I do take Vitamin D but that’s because I’ve already had skin Cancer and I’m very fair complected. I like to say that I could give Lilith a run for her money. Also, D helps your immune system and I haven’t had COVID yet. At least not to my knowledge. I do have a First Aid kit which I keep in my car and I did take a First Aid class in college. At the beginning of the pandemic an article was published on what you need for an emergency. It’s still taped to my wall by my computer. Everything that’s on the list is in the trunk of my car. I replenish the food periodically. Having said all that, what, if any, would be emergency treatment for a dog bite? On the B&O trail, in the past 3 months I’ve seen 6 dogs off leash. I’ve been lunged at several times. It’s not like me, but I’ve lost my temper twice at dog owners who don’t control their dog. My patience is wearing thin. I’m looking for another trail nearby where there are less indifferent dog owners. Dog bite medical care?

  15. Vincent Palmieri

    Great article. I didn’t know about the pill ziploc bags. Definitely ordering some. I use Leuko-P with gauze to make band aids rather than buying them. Leuko-P will stick for days whereas regular bandaids will stick for a two minutes.

  16. Those pill-sized zip bags are great for all kinds of stuff. I put firestarter in one. I cover the bowl of my spoon with another to keep it cleaner. Earplugs go in another. Endless uses. “Snack” sized bags are great for things like my toothbrush.

  17. My hack for medicines is to take a 1-week pill container and fill each day’s compartment with a different type of pill (ibuprofen, Benadryl, anti-diarrheal, etc.). That way everything is in one container. I write a key to remind me what pills are in which sections, and usually fold it into one of the sections.

  18. Great list—thanks! I only ever take a smidge of unguents (hydrocortisone, A&D ointment, antibiotic), so I bought screw-on contact lens cases. I cut them in half, so they would pack more easily, and smoothed the sharp edges with a file. I also bring a piece of emory board, 4 pepto-bismol, and 4 butterfly bandages. I put the expiration date on everything I re-package.

  19. Slings to me would seem to be a pretty good idea… thoughts? As always, thanks for the great article Phil!

  20. Thankfully i I’ve never had to administer any first aid on the trail other than people I come upon with foot blisters which has happened a few times, it is still time to up my first-aid game. Thanks for article !!

  21. Probably one of the most practical lists I’ve seen.

  22. Great list backed by my own experiences with similar. I’ll mention two additional items that should be in every backpacker’s first aid kit, 1) tourniquet like the CAT v7 which the Army uses for destroyed limbs, and 2) blood-clotting bandages often called “Israeli” bandages.

    Both suggestions are lightweight although somewhat bulky. I’ve ready plenty of stories where hikers bled out in car accidents enroute to the trailhead, accidental stabs with knives, axes, tent stake impalings, falls on broken poles or fences, animal attacks etc. If a person can eff up, it’s been done, and having proved and not improvised means of stopping blood flow is worth the carry in my book.

    Additional suggestions based on my experiences include anti-histamine for insect bites, tick removers, tweezers for splinters, stingers and brambles, burn cream, and a quality razor blade kept sharp for shallow cutting away of destroyed tissue. A pain reliever might make sense and vial of medical iodine solution, too.

    Thanks for doing what you do, Philip.

  23. Great list. I will check my kit to see what I’m missing. Thank you!

  24. As an experienced paramedic and backpacker, I’m inclined to also carry a few 4x4s and a small (4″) Israeli-style pressure dressing.

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