First Aid

Treating injuries and medical emergencies in the wilderness when help isn't coming quickly.

1. Bleeding Control

Minor bleeding (scrapes, small cuts):

• Clean with water. Apply pressure with a clean cloth. Cover.
• In the field, keep wounds clean and dry. Infection is the main risk with minor wounds.

Serious bleeding:

1. Apply direct pressure. Use the cleanest cloth available — a shirt, bandage, sock. Press firmly and do not release to check. Continuous pressure for at least 10 minutes.
2. Elevate the wound above the heart if possible.
3. If blood soaks through, add more material on top. Never remove the first layer — it's forming the clot.
4. Pressure bandage: Wrap tightly enough to maintain pressure but not so tight that circulation stops below the wound (fingers/toes should stay pink and warm).

Tourniquet (life-threatening limb bleeding only):

• Use only when direct pressure fails and the person will die without it.
• Apply 5–7 cm (2–3 inches) above the wound, between the wound and the heart. Never on a joint.
• Use a belt, strip of clothing, or rope — at least 4 cm wide (narrow cord cuts into tissue).
• Tighten until bleeding stops. It will be painful.
• Note the time applied. A tourniquet can stay on for up to 2 hours without tissue damage. After that, the risk of losing the limb increases.
• Do not loosen periodically — this old advice is wrong and increases blood loss.

2. Fractures & Sprains

Signs of a fracture:

• Deformity (limb looks wrong, bent at an unusual angle)
• Swelling and bruising at the injury site
• Inability to use or bear weight on the limb
• Grating sensation (crepitus) when moved
• Intense pain at one point

What to do:

1. Immobilize. Splint the fracture in the position you find it. Don't try to straighten it.
2. Splint materials: Straight sticks, trekking poles, tent poles, rolled newspaper, a sleeping pad. Pad the splint for comfort. Secure with strips of cloth, tape, or cord.
3. Splint rule: Immobilize the joint above and below the fracture.
4. Check circulation below the splint: Can they feel their fingers/toes? Are they pink and warm? If not, the splint is too tight.

Sprains (ankle, wrist, knee):

• RICE: Rest, Ice (cold water, snow in a cloth), Compression (wrap firmly, not tightly), Elevation.
• A sprained ankle can often still bear weight with a tight boot and a walking stick. Lace the boot tight — it acts as a brace.
• If you can't tell whether it's a sprain or a fracture, treat it as a fracture.

Spine injuries:

• If the person fell from height or has neck/back pain, numbness, or can't move limbs: assume a spine injury.
• Do not move them unless they are in immediate danger (fire, rising water).
• Keep them still and warm. Wait for rescue.

3. Hypothermia

See the detailed section in the Shelter guide. Quick summary:

• Remove wet clothing. Replace with dry.
• Get into shelter, out of wind.
• Warm the core: armpits, groin, neck. Not extremities.
• Warm drinks if possible. No alcohol.
• Skin-to-skin contact in a sleeping bag is highly effective.
• Handle severe hypothermia patients very gently — rough handling can trigger cardiac arrest.

4. Heat Exhaustion & Heat Stroke

Heat exhaustion (serious but treatable):

Symptoms: heavy sweating, weakness, cold/pale/clammy skin, nausea, headache, dizziness, muscle cramps.

• Move to shade immediately.
• Lie down with feet slightly elevated.
• Sip water slowly. Add a pinch of salt if available.
• Cool the skin: wet cloth on neck, wrists, forehead.
• Rest. Do not resume activity until fully recovered (hours to a full day).

Heat stroke (life-threatening emergency):

Symptoms: body temperature above 40°C/104°F, hot/red/dry skin (sweating may have stopped), confusion, slurred speech, rapid pulse, seizures, unconsciousness.

• Cool the person aggressively and immediately.
• Immerse in cold water if available (stream, lake).
• If no water: wet all clothing, fan constantly, apply cold packs (wet cloth) to neck, armpits, and groin.
• Do not give fluids if unconscious or confused (choking hazard).
• This is a true emergency — death or brain damage can occur without rapid cooling.

5. Wound Care

Cleaning:

• Irrigate with the cleanest water available. Pressure irrigation is best: poke a small hole in a water bottle cap and squeeze forcefully to flush debris from the wound.
• Remove visible dirt and debris. Use tweezers or clean fingers.
• Do not use alcohol, iodine, or hydrogen peroxide directly on deep wounds — they damage tissue.

Closing:

• Small, clean cuts can be closed with butterfly bandages, medical tape, or even superglue (cyanoacrylate — the standard kind, applied to the surface only, not inside the wound).
• Do not close dirty or bite wounds. These need to drain. Pack lightly with clean cloth and cover.

Infection signs (watch for over 24–48 hours):

• Increasing redness spreading outward from the wound
• Swelling and warmth around the area
• Pus or foul-smelling drainage
• Red streaks running from the wound (lymphangitis — serious)
• Fever

If infection develops: keep the wound clean, apply warm wet compresses several times a day to draw out pus, and prioritize getting to professional medical care.

6. Blisters

Blisters can immobilize you. In a survival situation, prevention is critical.

Prevention:

• Tape hot spots (areas of friction) before they blister: moleskin, medical tape, duct tape
• Keep feet dry — change socks, wring out wet socks
• Tighten boots to prevent heel slip

Treatment:

• Small, unbroken blisters: Don't pop. Cover with tape or moleskin with a hole cut out around the blister (donut method) to relieve pressure.
• Large, painful blisters: Sterilize a needle (flame, alcohol wipe). Puncture at the lowest edge. Drain gently. Do not remove the skin — it's a natural bandage. Cover with clean dressing.
• Already torn blisters: Clean gently. Apply antibiotic ointment if available. Cover and protect.

7. Burns

Minor burns (red, painful, no blistering):

• Cool with clean, cool water for 10–20 minutes.
• Cover loosely. Don't apply butter, oil, or toothpaste (old myths — they trap heat).

Moderate burns (blistering):

• Cool with water. Don't break blisters.
• Cover with the cleanest dressing available. Loosely wrap.
• Ibuprofen or other pain relief if available.

Severe burns (charred, white/waxy skin, deep):

• Do not remove burned clothing stuck to the skin.
• Cover with clean, dry cloth. Do not apply water to large burns (hypothermia risk).
• Monitor for shock. Keep person warm.
• This requires professional treatment — focus on evacuation.

8. Bites & Stings

Snake bites:

• Move away from the snake. Do not try to catch or kill it — note its appearance if possible.
• Do NOT: cut the wound, suck out venom, apply a tourniquet, or ice the bite. All of these old remedies cause more harm.
• Do: Keep the bitten limb below heart level. Immobilize it (splint). Remove rings, watches, tight clothing before swelling starts.
• Stay calm and still. Movement circulates venom faster.
• Mark the edge of swelling with a pen and note the time — this helps medics gauge progression.
• Most snake bites are survivable with professional treatment. Focus on getting to help.

Insect stings (bee, wasp, hornet):

• Remove the stinger by scraping sideways with a flat edge (credit card, knife blade). Don't squeeze — this pushes more venom in.
• Apply cold if available. Clean the area.
• Watch for anaphylaxis (see below).

Anaphylaxis (severe allergic reaction):

Symptoms: swelling of face/throat, difficulty breathing, widespread hives, rapid pulse, dizziness.

• Use an EpiPen if available (inject into outer thigh through clothing).
• Lay the person down with legs elevated. If having trouble breathing, let them sit up.
• This is immediately life-threatening without epinephrine. Focus on evacuation.

Tick bites:

• Grasp the tick as close to the skin as possible with tweezers or fine-tipped tool. Pull straight out with steady pressure. Don't twist or jerk.
• Don't use heat, petroleum jelly, or nail polish — these cause the tick to regurgitate into the wound, increasing infection risk.
• Clean the bite area. Watch for a bullseye rash or flu-like symptoms over the next 2–4 weeks (signs of Lyme disease or other tick-borne illness).

9. Shock

Shock occurs when the body isn't getting enough blood flow. Causes include severe blood loss, dehydration, infection, heart problems, or allergic reaction.

Signs:

• Pale, cool, clammy skin
• Rapid, weak pulse
• Rapid, shallow breathing
• Confusion, anxiety, or unresponsiveness
• Nausea or vomiting

Treatment:

1. Treat the cause if possible (stop bleeding, splint fracture).
2. Lay the person flat. Elevate legs 20–30 cm unless head, neck, or spine injury is suspected.
3. Keep warm. Cover with whatever you have — blankets, clothing, leaves, your own body heat.
4. Do not give fluids if unconscious.
5. Reassure them. Talk calmly. Shock patients who stay alert have much better outcomes.

10. Choking & CPR Basics

Choking (conscious person):

1. Ask "Are you choking?" If they can't speak, cough, or breathe:
2. Stand behind them. Wrap your arms around their waist.
3. Make a fist with one hand. Place it just above the navel, well below the breastbone.
4. Grasp the fist with your other hand. Pull sharply inward and upward (J-shaped thrust).
5. Repeat until the object is expelled or the person becomes unconscious.

CPR (person not breathing, no pulse):

1. Call for help first if anyone else is present.
2. Place the person flat on their back on a firm surface.
3. Place the heel of one hand on the center of the chest (lower half of the breastbone). Stack your other hand on top.
4. Push hard and fast: compress the chest at least 5 cm (2 inches) deep, at a rate of 100–120 compressions per minute (the beat of the song "Stayin' Alive").
5. If trained: give 2 rescue breaths after every 30 compressions. Tilt the head back, lift the chin, seal your mouth over theirs, and blow until the chest rises.
6. If not trained: chest compressions alone are still highly effective. Don't stop.
7. Continue until the person revives, help arrives, or you are physically unable to continue.