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On this episode, we are continuing our series on getting ready for a shakedown hike and talking about some general first aid stuff,
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maybe to help you when you're dialing in that kit that you need to put together. Let's get into it.
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This is the 2nd Act Backpacking Podcast.
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Whether you're starting later, getting back into it, or just looking to spend some more time outside,
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we share real experiences, lessons learned, and everything that comes with it to help you hit the trail with confidence.
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Welcome back to the 2nd Act Backpacking Podcast,
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the podcast for backpackers who are getting started or back into it a little later in life,
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or those who are just a little later in life and enjoy being outdoors.
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We started the series on doing an annual shakedown trip to dial in all of your gear and your setups.
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And we were talking about the four W's in the last episode, with the second one being wellness.
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And wellness includes first aid.
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And that got me thinking, how many people probably overpack their first aid equipment
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because of some kind of background that they have, be it medical background,
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maybe they were first responders, maybe they were just in Boy Scouts as a kid.
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And they kind of got this idea that you got to carry everything in order to be safe in the backcountry.
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Well, I will say that you have to carry first aid supplies with you into the backcountry in order to be safe.
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However, I will also say that you probably don't need to carry as much as you think.
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And it's important because one of the areas that you can get into some pretty concerning weight territory is first aid
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because of the fact that the consensus a lot of time is to do this thing called packing your fears.
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The idea behind packing your fears is that you start out with packing for this,
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and then you think, well, what if this happens? I need to pack for that.
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Well, what if this happens? I need to pack for that.
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Well, I should probably pack for this too.
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Well, while I'm doing it, I better pack for that.
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And pretty soon you've got this behemoth setup where it's just weighing you down
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and it makes it uncomfortable and it can really make your trip miserable.
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And if your trip's miserable, you're not going to stay out.
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And you might decide, man, backpacking is terrible. I hate this.
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So the first thing we have to do is we have to talk about those fears.
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And we have to talk about the reality of those fears.
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Now, I'm going to go ahead and get into the reality of what I said in the previous episode
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about the general idea behind statistics and how little comfort people take in statistics.
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I get that when I say that you have a one in five million chance of this happening,
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so it's not worth doing this, that one in five million doesn't do anything to dissuade those fears.
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So I'll just go on record as saying that.
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I am not a licensed health care professional, a doctor, anything like that.
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What I've got over the years is just experience through different aspects of first aid
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and rescue training from previous jobs that I've done.
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And I was a Boy Scout and first responders.
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You should probably talk to your doctor and get an idea of the things that might be important for you.
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To get started off with this, we probably need to have the conversation about what are the most common things
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that you're going to come into contact with and the problems that you're going to have when you're in the backcountry.
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And they really are pretty minor.
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And I will give you the basics of what you would need in order to be able to treat some of those minor things.
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And I'll direct you to our website, backpackingover40.com.
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That's backpackingover40.com.
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We've got in our tips and tricks section of the blog,
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we will have a breakdown of first aid kit things that you should pack and what their purposes are.
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The most common trail injuries that you're going to experience are these.
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One is blisters because you're going to be walking a lot.
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Second is minor cuts and scrapes.
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And third is going to be burns, minor burns, little owies, probably because you tried to grab your clip pot or something.
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Those are the three most common injuries that you're going to have.
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So you're going to need to make sure that you pack stuff to take care of those issues.
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You can get into big lacerations.
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You can get into traumatic injuries.
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And you can get into broken, sprained, that sort of thing.
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And I want to make something very clear to you.
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If you're in the backcountry, let's say.
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Let's say you're five miles from the trailhead.
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And you fall and break your leg.
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There's really not anything that you are going to be able to do.
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It's going to be up to your people that you're backpacking with.
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They're going to have to be the ones to get you out of there.
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If it's a sprain, the same thing is true.
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And a lot of times, if you have something complicated like that, you're going to require external rescue.
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It's just a fact of life.
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Somebody else is going to have to come get you.
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And if that's the case, you don't need to have all the equipment for advanced traction of a compound fracture.
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There are some good pieces of information about how to deal with a compound fracture or how to deal with a broken femur.
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But those are well beyond the scope of any kind of podcast.
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That's advanced backcountry first aid.
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And in situations like that, it's important for you to make sure that you have proper training before you even think about that kind of stuff.
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So when we're talking about first aid, we're talking about the idea that an ounce of prevention is worth a pound of cure.
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So we're going to talk about blisters first because they're the most common issue.
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Blisters occur due to friction.
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Friction is caused by your feet rubbing against a bad spot in your shoe.
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Maybe a piece of gravel gets in there.
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A piece of sand gets in there.
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And it starts to rub in a specific spot.
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And it causes a blister that way.
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The way that you prevent blisters is to make sure that your footwear fits you, how you walk, and the load that you're carrying.
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And then the next thing is just to try to keep any foreign debris out of your shoes.
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However, it's pretty much inevitable that you're going to get something in there.
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So the way that you treat the blister is through prevention.
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And that is at the moment that you feel that hot spot start to pop up, you need to do something about it.
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And the way that you do it is to support it by using something like Leukotape and just covering the hot spot with it so it doesn't get any worse.
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If you do get a blister, the treatment for that is going to be to cover it and make sure that you have a way to keep it from getting worse.
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And there's a couple ways that you can do that.
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Again, Leukotape is what I use.
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I don't carry moleskin anymore.
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Leukotape makes things a lot better.
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It sticks a lot better.
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And you can do the same thing with a couple layers of Leukotape as you can with a piece of moleskin in terms of cutting the bandage around it and that sort of thing.
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So if the blister is there and it pops and it's bad, then you're going to have to probably treat it.
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And if it hasn't popped, you shouldn't pop it.
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That's the general rule.
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I will say that I have popped many a blister because it's just not possible to get your foot and get back on the trail and that sort of stuff.
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So I have had to do that.
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Another way that I've done that in the past is I have utilized the blade of my multi-tool and cleaned that and sterilized it as best I could, give it in a quick lance, drained all the fluid out, cleaned it, and applied Leukotape over top of it to keep anything from getting into it, and just continued on about my hike.
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So that's treatment for blisters.
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The most important thing, again, is to try to prevent them.
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It's that simple.
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If you can prevent them, you're going to be a lot closer to being comfortable than if you are trying to treat them after.
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So the next thing that you're going to come into contact with is the minor cuts and scrapes.
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Minor cuts and scrapes, because you're going to be on the trail, you're going to get smacked with brush, you're going to maybe take a misstep and get a little scrape because you went down a rock gut.
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Those pretty standard first day, just like you would at the house.
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You want to clean the area of any big chunks of foreign debris.
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You want to use some type of a disinfectant on the wound if it's bleeding and the skin's broken.
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You want to apply a triple antibiotic ointment.
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And then you want to cover it.
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Again, I don't use Band-Aids.
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I use Leukotape for just about everything.
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And I carry a couple of 4x4 gauze pads and I will cut down the gauze pads as I need to kind of make my own Band-Aid.
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And it just kind of stays there and I'll deal with it.
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The third thing is burns. Burns are a little bit more difficult.
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I've singed my fingers a few times on the backside of my cook pot and stuff like that.
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That's not fun.
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It sucks.
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I hate it.
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But it is just a fact of life that you kind of do it.
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So in that situation, I try to make a cold compress.
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Usually all you have is room temperature water, but anything works.
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I'll wet a rag out, one of my cleaning rags out, and I'll just keep that on there.
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If it's a bad burn, it's probably going to blister.
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So you have to use caution there.
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Now we're talking about serious burns.
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Let's say you decided that you're going to try to hold your meal with your legs and then you dump boiling water on the inside of your thigh.
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Your trip is probably over.
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The best thing I can give you is just go ahead, get your stuff packed up, get to the trailhead, and call it a day.
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Because, I mean, if there's really good cold water out there, maybe, but for the most part, you're going to be in that situation where you're just going to have to address it.
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And you may need medical treatment if it's a decent size burn.
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Boiling water can give you some pretty significant second degree and even some third degree burns, depending upon how bad it is.
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Again, all of these things, the same thing holds true.
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An ounce of prevention is worth a pound of cure.
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So those are the three most common injuries that you're going to have on the trail in the backcountry.
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Those are things that you need to keep in mind while you're going through your day to day.
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And those are the things you need to pack for.
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So first aid should be single use antiseptic wipes, be they iodine or alcohol wipes.
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I prefer iodine. It doesn't burn quite as much.
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Some single use triple antibiotic ointments.
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And for me, it's a couple pieces of four by four gauze, some Leucotate.
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Now, the other issues you're going to come into contact with that you're going to need stuff to treat are things like being sore at the end of a long day.
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So in this case, vitamin I is your best friend.
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Two ibuprofen at the end of the day will help you out a lot.
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I always carry a couple of Tylenol as well.
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If I've got a really bad headache, it helps me to maybe just take the Tylenol.
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In general, inflammation from work, hiking all day gives me that ability.
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If you have a fever or something like that, I prefer to go offsetting my Tylenol consumption.
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So two Tylenol every three hours and then two ibuprofen every four hours or every five hours to kind of keep it down.
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But again, a fever is something that you're going to probably come off trail with anyway, because you need to figure out what's going on there.
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Another thing is Benadryl, because you might have an issue where you get poison ivy.
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You could get stung or bitten by a bug.
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Sometimes it gives you a bit of an allergic reaction. That helps.
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And the last two things are for your stomach. One is Imodium.
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Just in case you do contract something like norovirus, it will help you get to the next place by keeping you from having to drop trow every five minutes.
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And for me, a handful of Tums is plenty.
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I carry about ten ibuprofen, about six acetaminophen, Tylenol.
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I carry two Imodium caplets, four Benadryl caplets, and four to six Tums.
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It all goes in a 35 millimeter film canister that shows you how old I am.
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And it just sits in my first aid kit. No issues there whatsoever.
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So those are the fundamental things that you need for your use case.
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And people always ask, well, what if I have a severe laceration?
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It's probably going to be an external rescue.
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However, for a medium-sized laceration, I do carry some Steri-Strips with me to just kind of hold things in place until I can get back to better aid.
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I'm not carrying a full-size thing of Hibiclens or hydrogen peroxide to clear out a deep laceration.
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I'll probably just try to hold it closed until I can get to help.
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That's kind of the goal.
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Because once you become walking wounded, you are pretty much at a point where you're going to have to get yourself some external treatment.
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And whether that treatment is you go to urgent care or the ER, or you just get off trail and go to the CVS and get everything that you need to treat yourself, your trip at that point is done.
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The goal should not be to carry enough stuff that if you cut the back of your leg three inches deep that you could stitch yourself back up and get back on trail.
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That's not the goal.
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The last thing I'm going to talk about is some things that are unique to me, and I'm going to explain why I carry them.
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But I will go ahead and say that I don't recommend you carry them unless you have the proper training on how to use them.
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In my years as a first responder, I was trained in the use of these items, and I carry them with me because they're specific to my use case.
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And I'll give you the use case to start with.
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I typically backpack solo.
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So, I am my own rescue up until a point. That's why I carry an inReach so I have an SOS button. That's why I make sure that I'm telling people where I'm going, what I'm doing, how long I'm going to be there, that sort of thing.
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And then, of course, I'm also carrying enough stuff to make sure that I can stabilize myself to the greatest extent possible while help is on the way after I push my SOS button.
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So, if I have a compound fracture or break my ankle, sprain my ankle, I can't move, I'm by myself, I can do what I need to do to make myself as comfortable as possible, push the button, and wait for help to arrive.
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And there's some things that are just within the risk profile of being a solo backpacker that can be kind of concerning.
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If I fall and hit my head and I'm knocked unconscious, no one's there to help me.
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So, there's no reason for me to carry anything crazy for head injuries, but there are a few areas where you might encounter problems that as a solo backpacker, you could find yourself needing these things and it could be life-threatening before help could get to you.
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For me, that factor is massive blood loss injuries.
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When we were first responders, we were trained primarily in gunshots, but also severe car crashes and things like that about the dangers of massive blood loss.
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If a major vein or artery or something is nicked on an extremity, you could die within minutes or an hour.
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And if I'm in the back country and it's two to three hours for rescue, I need to be able to do something about that.
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So, I carry a combat application tourniquet with me in my pack everywhere I go.
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So, that is something that I receive very specific training on how to use, when to use, what to do, what not to do, so I know how to use it.
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It's important that you get training because tourniquets are a touchy subject and without advanced specific training, I don't recommend you carrying one, but you are your own risk analyst in this situation.
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The next thing that I carry is a compression bandage that some people call an Israeli bandage.
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And it is a multi-use piece of kit because it works as a compression bandage, where it will help apply pressure to a wound that is bleeding.
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If you need your hands free to do other stuff, you can utilize it and it's a great tool.
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But in lighter compression, it can also be used to stop bleeding on a head wound by just applying light pressure.
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It can also be used to brace an extremity if you need to brace an extremity.
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So, it's a pretty multi-use tool.
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And the third thing that I carry is Chitosan powder or gauze, which is blood stopper or quick clot.
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It's another trauma item that we were trained to use to help stop wounds and I learned how to utilize it and specifically that and rolled gauze to pack wounds and apply pressure.
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So, those are the traumatic blood loss tools that I carry with me.
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Again, do not carry those things unless you understand how to use them and are trained and use them at your own risk.
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But for me, if I am injured with a significant blood loss injury and I can stop the bleeding, I can get help en route, stop the bleeding and stand by until somebody gets there to help me.
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With all that said, we've been talking about first aid and common injuries and what to put in your first aid kit.
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But a big thing about first aid comes down to decision making.
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First aid while backpacking is not about having an extensive kit to be able to address a myriad of different injuries and ailments.
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It's about stabilizing those things and either preventing them from getting worse or helping you get to a higher level of care somewhere off the trail.
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And that's where the decision making point kind of ties into first aid kits and the injuries and things like that that you're going to see.
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So, I came up with this concept of zones to kind of help people understand what I'm talking about.
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And the zones break down like this. There's green, yellow, orange and red.
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And in the green zone, everything is fine. Everything is great.
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In the yellow zone, something has popped up and it's kind of something that you need to be cautious about, need to watch, need to monitor, need to do something about then.
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The orange zone is something has happened and it's up to you to kind of make a decision about what you're going to do with a given set of circumstances that you find yourself in.
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And then the last one is the red zone. And the red zone is your trip is over.
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The questions of the red zone are about what you do now that your trip is over.
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So, those are the zones. And it kind of goes into practice like this.
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In the green zone, we're talking about what we've been saying this entire episode.
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An ounce of prevention is worth a pound of cure.
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So, in the green zone, you're doing things to help prevent things from showing up.
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Making sure that you're wearing good fitting shoes that have the right width, toe boxes, whatever you need to work for you.
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Making sure that you're wearing quality socks that are good and designed for the purpose.
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Sock liners, gaiters, whatever that may be for you.
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You're trying to prevent ankle and knee injuries, so you're using trekking poles.
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You make sure you got your backpack fitted and your weight is right, so that everything is balanced and it's going to make you more functional on trail.
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That's the green zone. So, when you're hiking along on the green zone, everything is right.
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The yellow zone is that first indication that something might be becoming a problem.
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That is when you are backpacking along, you're on the trail and you notice something doesn't feel right in your foot.
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And you're saying, oh, that doesn't feel right.
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You're trying to maintain and prevent things from getting into the orange zone, which your goal is obviously to get back into the green zone.
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An easy example of that is you've been putting in some miles that day and you're getting close to the camp.
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You're still a couple miles away, but your back is starting to give you a little bit of hollering.
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You take a break, stretch out, you do that kind of stuff to prevent those things from getting worse.
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So, you take a couple ibuprofen before you knock out or you take a couple ibuprofen in the morning to get rolling, that kind of stuff.
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So, that's kind of what you're doing in the yellow zone.
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You're trying to keep things from escalating and if all goes well, getting them back down into the green zone.
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Now, the orange zone is where we already have something.
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Easiest example for that is your hotspot has turned into a blister and now you're at a decision point.
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You're going to have to address that, treat that, and watch it.
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Because if it gets worse, you could bump into the red zone and it's time to get off the trail.
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And if it gets better, well, you can keep going. Great.
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But that's kind of where those decisions have to be made at.
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And finally, in the red zone, your trip is over, it's done, there's no more doing anything.
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The question is not if you're getting off trail, it's how you're getting off trail.
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And that's going to come down to a pretty simple thing.
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You're going to get yourself off the trail or you're going to have to get rescued from the trail.
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But that's the red zone.
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So, those are the zones.
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When we're looking at the zones, you can see that the purpose of your first aid kit
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isn't about doing anything other than helping you avoid getting into orange
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and then potentially giving you the capabilities to self-evacuate if you find yourself in the red.
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I'll use the example of norovirus because that does impact a lot of through hikers
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and busy trails and shelters and stuff like that.
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Appalachian Trail is notorious for norovirus.
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It's a stomach virus and some people recover from it naturally,
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but a lot of people have to take some zero days.
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They have to get to a higher level of care, be that the urgent care or just to a CVS
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or maybe they stay in a hotel for a few days until they're feeling better and they're squared away.
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But if it happens 12 hours away from the closest town and you are in misery
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because of your gastrointestinal issues, be that diarrhea, vomiting, what have you,
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the addition to your first aid kit of some Imodium and some Tums can help you
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evacuate yourself to the closest trail town.
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So that's its purpose.
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If you have a really bad blister and you just can't go any further,
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but you're still kind of walking wounded, then you can use what's in your first aid kit
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to square yourself away enough to where you can get off trail.
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Now, in the case of a severe sprain or a break,
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maybe you can use a compression bandage to get your ankle situated
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and then use your trekking poles to hobble yourself off trail,
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or maybe you have to push the button.
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And then in the case of something like a break or a head injury,
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really all you're doing is trying to just maintain consciousness and comfort until rescue arrives
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and that's when you've got to push that button and make that call.
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So the purpose of your first aid kit is to help you stay in the green and at worst yellow.
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And if you do get into the orange and you have the right equipment and the right training,
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then you can actually do quite well to stay out on trail.
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There's a lot of people that stay out on trail for weeks or months at a time with blisters.
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It's just about being able to treat them.
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Even the folks who are through hikers know that they really only need to carry
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enough first aid supplies to get them from trail town to trail town.
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If anything gets sideways on them, it's not going to be something where they're going to need
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advanced traction equipment or that type of thing.
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So just keeping those ideas of the zones in mind with the goal of staying in the green
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and focusing on the yellow rather than letting things get all the way into orange
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before you decide to take action.
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If you do it that way, you're going to be in a much better position
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than if you had no plan and no system.
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Because that's where a lot of people make mistakes,
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is that they unknowingly put themselves in the orange.
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And then that's when they start focusing on, well, I need to do something,
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instead of two layers before that.
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There's no shame in getting out on the trail for your first day
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and realizing that the shoes might not fit or the socks might not be right and then backing up.
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And if anything, it ties very neatly into our series on the importance of doing shakedown trips,
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is that it helps you notice that there's going to be something wrong.
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If you're changing types of shoes or types of backpack or whatever, it helps you in that way.
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So those are kind of the 30,000 foot view of first aid.
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As we close out the episode, I'm sure there's some people saying,
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hey, we talked a lot about first aid supplies and kits and zones and decisions,
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but we definitely talked about the actual thing of doing the first aid.
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And there's a good reason for that.
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And it's that I don't feel like I am qualified to teach first aid to anyone.
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These are things that I've learned over a lifetime, starting with my childhood in scouts
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and then progressing into law enforcement and then first responder training
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and then trauma wound care and all those things that I've learned over the years.
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And I've learned how to do them, but teaching someone is well beyond the scope of my capability.
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That said, I do feel like it's important that anyone who's traveling on the trail,
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you need to get some training, some formalized training about first aid and CPR,
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not just for you and your hiking buddies, but just for the entire backcountry community.
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It's really crucial that as many of us know how to deal with these issues in the backcountry as possible.
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The stuff that I carry in my kit is lightweight, takes up almost no room.
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It's a last resort type option.
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However, it works just as well on someone I come across on the trail as it works on me if I need it.
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So that's kind of where the thought behind getting training comes from.
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I'm a big fan of the American Red Cross and their basic first aid training and their basic CPR training.
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They have online options.
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The American Heart Association does a good CPR class that you can also take online.
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There's nothing quite like taking it in person and being able to see and touch and work with the items that you're going to be learning about.
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But just getting some training on what to do helps.
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Training also increases your confidence.
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And I don't want to recommend that you go out and just watch any old YouTube video on how to do this or how to do that.
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Some people get it wildly wrong.
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So I recommend that you go to a reputable source and get some training.
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And if you can find a dedicated training entity that is reputable that does backcountry first aid, then that's also a great option.
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On our website, we have our companion episode blog for this episode of the podcast.
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We've also put together a first aid checklist that gives you an interesting breakdown of the tools that I personally carry with me.
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And we link to the Red Cross first aid classes there.
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At the end of the day, I hope what you get from this episode is a quick understanding of some of the things that you might come across and some of the decisions that you might have to make.
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And then conversely, the equipment that you might need to carry so that you're prepared for those things.
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As always, no podcast or blog or anything is 100% complete.
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Information changes all the time.
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I cannot stress enough how important it is for you to get out there, get some formal training, and understand the things that you might come across and how to address them.
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One of the easiest ways to improve your confidence in the backcountry is through knowledge.
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And I hope that you'll go out and obtain as much knowledge about this subject as you can so that you feel more comfortable.
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So that does it for this episode, folks.
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We will see you on the next one as we continue our series on shakedown trips.
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Until next time, enjoy yourself in the backcountry and stay safe on the trail.
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Thanks for listening to the 2nd Act Backpacking Podcast.
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If you want more, be sure to subscribe.
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And you can always find us over at backpackingover40.com.
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That's backpackingover40.com.
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Until next time, we'll see you on the trail.
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Backpacking is a fun way to improve your confidence in the backcountry.
