Tag: adventure tourism

The six most common wilderness injuries that you should know how to treat

Any hobby that has a degree of excitement comes with risk, and traveling in the wilderness is no exception. As a smart hiker, you’re probably already taking steps to mitigate some of the risks, like bringing warm clothes to protect yourself from the cold, or flashlights to protect from the risks associated with darkness.Any time you’re more than a few hours from advanced medical aid, you should also be thinking about the risk from simple, common backcountry injuries that have the potential to ruin a trip, or worse.If a medical emergency happens in the backcountry, anyone who is on-scene immediately becomes a “first responder,” whether the injured person is in your group, or just someone you encountered along the trail. In order to be a safe, responsible hiker, you should know what to do if someone needs basic medical assistance.I’ve compiled a list of the skills and treatments that I’d consider “essential” for anyone who goes deep in the backcountry, based on my own experience in the outdoors.The specific instructions are pulled from widely-regarded sources including:

This article is obviously not a substitute for proper medical training, and you shouldn’t be used in place of good judgment. If you’re interested in leaning more I’d highly suggest taking a full Wilderness First Aid (WFA) or Wilderness First Responder (WFR) class.

Here is a quick look at the six injuries that are most common in the backcountry:

  1. Wounds & Infections
  2. Burns
  3. Knee & Ankle Injuries
  4. Blisters
  5. Dehydration
  6. Shock

Wounds & Infections

With lots of sharp tools, jagged edges and rough surfaces, there are all sorts of hazards that can lead to cuts, scrapes and puncture wounds in the backcountry. Knowing how to treat a serious wound and prevent it from getting infected is an extremely useful first aid skill.

Anytime you have substantial blood loss there’s an immediate risk of “bleeding out.” The average adult human has 5-6 liters of blood in their body – picture 5 nalgenes. When you donate blood, they take half a liter (500ml) which the body can easily handle. If you lose one to two liters of blood, you’re going to go into shock (more below). Anything more than two liters of blood loss and you’re in dire straits.

Controlling Bleeding

Most forms of bleeding can be stopped with a combination of direct pressure onto the wound and elevation of the wound above the heart. Always make sure you put on gloves before touching someone else’s blood, I carry a few pairs of these in my first aid kit.

Hand the patient a piece of clean gauze and tell them to put pressure on their own wound as you put your gloves on. If the gauze is getting saturated, add more gauze on top but do not remove any existing gauze that’s already in the wound.

If the situation requires your hands to be free, or you’re having trouble keeping pressure on the wound, you can make a pressure bandage. Place gauze over the wound and wrap it tightly with something like an ace wrap or bandanna. Your goal is not to make a tourniquet, you should be able to slide two fingers under the wrap and the patient should have no tingles or loss of feeling in the extremities.

Preventing Infection

Once the bleeding has been successfully controlled, the next steps to think about are preventing infection and promoting healing, especially if your plans call for you to still be out in the backcountry for several more days.

The first step is to wash, or “irrigate” the wound with at least half a liter of clean water. The goal is to flush out any dirt and germs that have already made their way into the wound and under the skin. Ideally you use something with high pressure like a syringe or the backwash pump that comes with the Sawyer Mini Filters. If there are any large pieces of dirt that you can see in the wound, be sure to pull those out carefully with tweezers.

Most first aid kits have alcohol wipes, which should be used to wipe the skin around the wound, but should not be used to clean inside the wound, since they can damage good tissue. Now that the wound is relatively clean, you can cover it with antibiotic ointment and then clean gauze and a wrap to hold it all securely in place. Note that antibiotic ointment is not a substitute for good wound cleaning, so make sure you get things nice and clean before applying it.

You’ll want to check on the wound once or twice a day to reapply the ointment and monitor it for signs of infection. A little bit of swelling, warmth, redness and puss is normal to see as the body fights off bacteria. But if the symptoms get more extreme – hot to the touch, bright red, hardening skin, painful and itchy – then that’s a sign that the body is losing its battle against an infection and you need to step in.

You’ll need to open the wound back up and re-clean it very thoroughly with at least a full liter of water. It also helps to soak the wound in the warmest water that the patient can tolerate (without causing burns). If you have pain killers or antibiotics, ask the patient about them and consider using those as directed.

If a wound is going to get infected, it will usually show up in the first 24-48 hours. You should stop the trip and evacuate any patient where you can’t control the bleeding or there are persistent signs of a bad infection.

Burns

On camping trips, you’re likely to be handling fire, boiling water and hot pots with primitive tools. Burns are another common risk that you should be aware of in the backcountry. This also includes sunburns, since those are also burns, albeit much more minor.

The very first step for treating any burn is to stop the burning process. Remove whatever the source of heat is and immediately cool the affected area with cold, clean water. Depending on the thickness of the burn, it may take several minutes of soaking in cold water before the burning process has stopped.

Once the burned area has cooled off, you may want to scrub the area with clean water and a bit of mild antibacterial soap, if it’s available. The goal is to prevent infection if the burn goes deep into the skin.

Next you should cover the burned area with antibiotic ointment and clean gauze or clothing. This will help protect the burn site, and also help reduce the patient’s pain. Feel free to offer the patient ibuprofen as well, as there will usually be substantial pain.

For burns in extremities, keep the burned area elevated to reduce swelling. For more long-term care, it’s important to keep the patient warm and well-hydrated since the major risks to life are fluid loss (see dehydration and shock, below).

Evacuate any burn patient if the burn:

  • exposes deep layers of skin or bone
  • is circumferential, going completely around a limb
  • is on sensitive areas like the face, groin, armpit, hands or feet
  • covers a significant part of a patient’s arm, leg or torso

Knee & Ankle Injuries

According to a Reddit AMA with search and rescue volunteers, soft tissue injuries are the most common things that people need to be rescued for. And while an injured wrist, elbow or shoulder might be inconvenient, lower body joints like knees and ankles can have a serious impact on your ability to hike out on your own.

Whether they’re chronic injuries that flare up from over-use or sudden injuries from a bad step on steep or uneven terrain, it’s important to stop and address soft tissue injuries. Trying to “tough it out” can lead to permanent, lifelong injuries that require ongoing physical therapy.

I can speak from personal experience on that, I took a bad step on a mountaineering expedition years ago and kept hiking down the mountain on it – it still bothers me to this day, whenever I do too much hiking on it. 😢

As a lay-responder, your job isn’t to diagnose whether it’s a strain, sprain, tear, fracture or other specific injury. Your goal should simply be to diagnose whether the injured joint is usable or unusable.

“Usable” Injuries

Wrapping a usable ankle injuryIf the patient still has most of the mobility in their joint and can comfortably put weight on it, then you can support the injury by wrapping it with athletic tape or an ace bandage.

There are also special-made wraps you can buy for various joints at stores like Walgreens or CVS. If you have a chronic injury in a knee or ankle, it’s a good idea to strap one of these on before you head out into the woods at all.

If you’re able to keep hiking on it, albeit gingerly, make sure you take sufficient time to address it when you get to camp.

The common RICE acronym is your guide:

  • Rest – especially if each use causes pain, which is a sign of tendinitis
  • Ice – alternate 20-30 minutes of cooling with 15 to naturally rewarm
  • Compression – wrap securely with an ace wrap, making sure circulation is preserved
  • Elevation – have the patient lie down on a sleeping pad and elevate their feet on a backpack or two

If your schedule allows you to take a day to rest the injured joint, this can go a long way to preventing complications and letting it heal. If you can keep the injury cold, compressed and elevated, this will help reduce swelling and make it more likely you’ll be able to continue hiking on it again shortly.

“Unusable” Injuries

If the patient can’t easily move the joint through its full range of motion or feels pain when putting their weight on it, then the joint should be considered “unusable” and treated as such. Note that an injury that starts out as usable may become unusable if the patient continues to hike on it, or swelling starts to set in.

For treating unusable joints, you want to splint the joint in a comfortable position:

  • For ankle injuries, keep the foot at 90 degrees to the lower leg
  • for knee injuries, bend the knee about 5 degrees from straight

You want to pad the injured joint with whatever is available – jackets, sleeping pads, clothing, etc. You also want to add something stiff like a hiking pole or canoe paddle to keep the joint from moving at all. Finally, wrap everything with something wide like a belt or webbing, and cinch it all tight. Remember this equation:

padding + compression = rigidity

Keeping it tied tightly will help hold everything together firmly as you begin your long, slow hike out. You will likely need to stop and readjust things often, whenever the patient is sufficiently uncomfortable.

Remember that you never want to tie anything so tight that the patient loses feeling in their extremities. Check periodically to make sure you can slide two fingers into the splint and that the patient can still wiggle their toes and has feeling in their toes when you touch them.

If the injury is so bad that there’s no way the patient will be able to hike out on it – like if bone is protruding through the skin – you’ll need to send someone to fetch professional help.

Getting carried out on a litter

Note that even the fastest search and rescue teams will take a few hours to reach you, and that being packed and carried out in a litter is generally a pretty terrible experience for everyone involved. Don’t expect most local SAR agencies to send a helicopter, you should encourage the patient to hike out in a splint if you don’t think it will complicate the injury.

Blisters

While not technically a medical emergency, blisters are one of the most familiar backcountry injuries to many people, and can certainly go a long way to ruining your trip if they’re not handled well. Blisters are also one of the most misunderstood backcountry injuries, and there are a lot of conflicting tips on what to do – the NOLS mythcrushers even tackled the issue:

A blister is formed when thick skin – like on your palms or feet – is rubbed, and it begins to separate from the softer, more sensitive skin beneath. Blisters are especially likely to form when the skin that’s being rubbed is warm or sweaty, which is exactly the conditions you’ll find inside most hiker’s boots.

With blisters that don’t occur on the foot, your best bet is just to leave them be. But if you have a firm, fluid-filled blister is on your foot you don’t really want to “tough it out” and risk having the blister pop inside your dirty, sweaty sock – leading to an infection (and a gross sock). It may also be too painful to continue hiking at all if the blister has grown too large.

To treat blisters, the best option is to carefully and slowly drain it, and then treat it like a minor wound. This will relieve the pressure and allow you to continue on your way.

Begin by washing the area around the blister thoroughly with water and then an alcohol pad. Sterilize a sharp point with either alcohol or by holding it over a flame.

To reduce the risk of cutting a jumpy, antsy patient, hold the sharp point so that it’s nearly parallel with the skin of their foot, and slide it up into the bottom of the blister’s roof. The skin of the blister should be dead, so the patient should only feel the tug of your point lancing the outside of the blister, not any sharp pain.

Once you’ve lanced a hole in the blister, leave the rest of the roof intact to protect the inner layers of skin. Give the blister at least a few minutes to drain, applying light pressure to help squeeze out the fluid. Then cover the area with antibiotic ointment to prevent your lanced hole from getting infected.

Some people use a donut of moleskin around the blister to hold the ointment in place, and then another piece of moleskin or tape over top to keep it all together. There are also products like 2nd Skin Blister Pads that you can slap over a lanced blister to help protect it.

Some people really don’t like the idea of another person sticking a knife into their foot, but the relief that comes after the blister has been drained is usually well worth the anxiety involved in lancing it. There’s no need to evacuate a patient with a friction blister, unless you’re starting to see signs of infection.

Dehydration

Like blisters, dehydration isn’t often a major, life-threatening situation, but it can certainly create issues if people aren’t watching out for it. Being well hydrated helps keep joints lubricated, muscles healing and your digestive system chugging along. Water also supports crucial brain function. Letting yourself or those in your group get dehydrated can make all sorts of other issues more likely.

Mild dehydration is something that we’re all familiar with – dry lips and a mild thirst. More severe dehydration can lead to fatigue and joint soreness, and eventually to irritability, frustration and poor decision making as the brain begins to shut down. This is especially likely if you’re also suffering from heat-stroke, but even in cold environments, dehydration can sneak up, so it’s important to know the signs.

I always think of dehydration like those Snickers commercials – you’re not you when you’re dehydrated.

To ensure everyone in your group stays hydrated, remind them of these simple rules:

  • If you’re not peeing every 4-5 hours on the trail, you’re probably dehydrated
  • If your urine isn’t clear, copious and bubble-free, you’re probably dehydrated

It’s also important to remember that dehydration also comes from a loss of key electrolytes like sodium and chloride. Ideally, someone in your group brought powdered sports drink mix to share, and everyone is consuming salty snacks like peanuts.

Shock

Shock is the body’s response to a sudden drop in blood pressure, in order to prioritize blood flow to the brain and other vital organs. Shock is a common response to major trauma or bleeding, or it could also be an issue with the heart not pumping enough, or blood vessels dilating and not maintaining high enough pressure.

Imagine that you’re trying to take a shower in a cabin on top of a mountain, and the shower is fed with lake water from the base of the mountain. If you turn on the shower head and nothing comes out, there could be three potential issues:

  1. The pump at the bottom of the hill (ie, your heart) isn’t putting out enough force to move the water adequately
  2. The water itself (ie, your blood) is leaking out of the pipe, or there just isn’t enough of it
  3. The pipes between the pump and the cabin (ie, your blood vessels) are too wide to maintain good pressure

In this analogy, you can think of the flow of water from the shower head as the flow of blood to your body’s various tissues. While a non-functioning shower is a big annoyance, if your tissues aren’t getting the blood flow they’ll need, that can cause life-threatening issues.

The various causes of shock are outside the scope of an article like this, but as a responder, you should look for signs of shock whenever there’s major injury or someone is feeling really off. Symptoms include:

  • anxiety or confusion
  • rapid pulse and rapid, shallow breathing
  • cool, pale clammy skin
  • weakness, dizziness, lightheadedness
  • nausea and vomiting

If you are able, you want to focus on treating whatever is causing the person to be in shock. But also keep these treatments in mind for any patient that’s exhibiting signs of shock:

  • keeping the person calm and reassured – by staying calm yourself – helps lower their heart rate
  • try to reduce their pain and discomfort by having them lie down on a sleeping pad in a comfortable position
  • elevate their feet on a backpack (unless you suspect a back injury) to keep blood in their core
  • even if it’s not freezing cold, wrap them in a sleeping bag and try to keep the patient warm and dry
  • if the patient is able to drink on their own, make sure to keep them hydrated – but never force them to drink if they might choke

Any patient who is exhibiting signs of shock will likely need to be evacuated with professional help. As you’re waiting for help to arrive, it’s a good idea to keep a log of the patient’s heart rate and mental status every 10 to 15 minutes. You will be able to hand this information off to rescuers to help their evaluation when they arrive.

Learn More

Well that’s 3500 words to get you started with the basics of wilderness medicine. Want to learn what I always carry in my first aid kit?

Check out this blog on Essential items to carry in your backcountry first aid kit.

If you love learning about this stuff, I’d highly recommend checking out a local Wilderness First Aid class. Some reputable companies that teach wilderness medicine include:

  • NOLS’ Wilderness Medical Institute
  • SOLO
  • Wilderness Medical Associates

The wilderness medicine community is full of some of the smartest, most interesting people I’ve ever met, and taking a class is also a great way to meet up with like-minded adventurers in your area.

If you can’t find a class near you, or if you want a handy reference or some not-so-light bedtime reading, I’d definitely recommend picking up a copy of Wilderness First Responder: How To Recognize, Treat, And Prevent Emergencies In The Backcountry.

Make sure you share this information with other people you often head out into the wilderness with. You never know when it could save their life – or yours.

Article by:  Hartley Brody

Be sure to check out this awesome adventure blog for more great content:

https://adventures.hartleybrody.com/

 

 

What do you need in your First Aid Kit?

But if you think that tossing a store-bought kit straight into your pack will get you out of any emergency situation, you’re in for a pretty terrible surprise if something actually goes wrong.
First Aid Kit Cartoon Diagram
Backcountry first aid kits are pretty different from urban emergency kits.
Anyone who is venturing more than a few hours away from civilization needs to be fully prepared for handling the most common emergencies and injuries on their own.Even if you find yourself in a truly dire situation, search and rescues teams often take several hours to reach your location by foot. You should have the gear and knowledge to prevent bad situations from getting worse, and to get yourself out safely.I’ve broken this comprehensive guide to first aid kits into a few sections, for review:

  1. Medical Situations an Outdoor First Aid Kit Helps With
  2. Specific Considerations for Your Trip
  3. Building Your Own Customized First Aid Kit
  4. Checklist of Items in a Backcountry First Aid Kit
  5. Recommended Popular Commercial Kits to Start With
  6. Other Resources For Building Your Own First Aid Kit

Medical Situations an Outdoor First Aid Kit Helps With

Before we even dive into the nuts and bolts of building out a great kit, it’s important to know the most common backcountry injuries and medical emergencies that you can handle on your own. I’ve written more extensively about those before but here’s a brief overview of what a first aid kit can help you prepare for.

Cleaning Wounds and Protecting Skin

In the wilderness, you’re likely to be working with fire and using sharp, primitive tools that you might not be totally familiar with. Cuts, scrapes, and burns are all relatively common injuries that can usually be treated without much fuss.

The majority of cuts you’ve gotten in your life likely stopped bleeding on their own, or with a bit of direct pressure and elevation. A good wilderness first aid kit will have items to help you control someone else’s bleeding (gloves and gauze) as well as tools for cleaning deeper cuts and keeping them from getting infected.

Supporting Injured Joints and Fractures

Especially when carrying a heavy backpack over rugged terrain, one bad step or a poorly timed fall can lead to fairly debilitating musculoskeletal injuries. These are the kinds of injuries that can not only ruin a trip, but make it difficult to get back to civilization on your own.

Having a few key items on hand can make a big difference in dealing with injured joints or broken bones, and can prevent smaller injuries from getting worse over time.

Maintaining Normal Body Functions

While issues like diarrhea, mild fever, seasonal allergies and low blood sugar are annoying but easily treatable in the front country, anything that gets you laid up and prevents you from hiking out can become a serious issue in the backcountry.

If you find yourself struggling with these issues on a backpacking trip, some simple over-the-counter medications can make a huge difference in your ability to get back to the trailhead safely.

Relief for Pain, Soreness and Discomfort

While not the most heroic form of first aid, sometimes offering a few advils or a tums can go a long way to improving someone’s experience while they’re out on a trip.

Being able to treat blisters can make you seem like a super hero to someone who has been struggling with one all day.

Specific Considerations for Your Trip

When preparing your gear list for a trip, you should already be thinking about key packing considerations like group size and expected weather conditions.

It’s important to also think about the hazards that each trip presents, in terms of first aid situations you’re likely to encounter. Here are a few questions you should ask yourself before each trip.

  • Are there members of your group that are older, out of shape, or otherwise at risk for a heart attack?
  • Is there anyone on the trip with known, severe allergies that would be at risk of anaphylaxis?
  • Are there venomous creatures like snakes or spiders in the area you’ll be hiking through?
  • Are you at risk of puncture or gunshot wounds on a hunting trip, or a hike during hunting season?
  • Could the weather conditions lead to heat or cold related injuries?
  • Will there be ticks, leeches, mosquitoes or other small biting pests you’ll have to contend with?

The answers to these questions will often vary from trip to trip, but it’s important to consider each of them to ensure you’re prepared for the situations you’re likely to face.

Building Your Own Customized First Aid Kit

We’ll talk more about pre-made, commercially available kits later in this article, but I’d really recommend building your own (or heavily customizing a purchased one) for a few key reasons.

Cheaper in the Long Run

There’s often a huge markup on store-bought, pre-packaged kits. You’re paying for the brand name and the heavy bag that it comes in. Each of the materials can often be purchased for much cheaper online or at your local pharmacy.

This is especially important if you think your first aid kit will be getting some decent use over the years. It’s much easier to buy most items in bulk, store them in your medicine cabinets and then restock your kit whenever you need to.

Easier to Customize

While most kits make a decent attempt at preparing for the generic problems a hiker is likely to face on the trail, often they don’t really hit the mark. I’ve usually found that most kits include way too much gauze and not nearly enough ibuprofen, for example.

Building your own kit also forces you to think about your own personal needs and those of your group. You might be more likely than the average hiker to be dealing with allergies, chronic joint pain or blood sugar issues.

You Know What’s In It

I can’t tell you the number of times I’ve seen someone hike for miles with blisters or a headache or some other easy-to-treat issue, without realizing they’ve been carrying the solution to their ailment on their back the entire time.

Build your own kit forces you to consider each of the elements that you’re carrying, and makes you much more likely to recall and use them in the appropriate situations.

Keeping everything in a sturdy, clear ziplock freezer bag is fine. Just make sure it’s well labeled so that someone else can find it in your pack in an emergency.

Checklist of Items in a Backcountry First Aid Kit

I tried to err on the side of including more stuff rather than leaving something out that might be important for your trip. You likely won’t need all of these items for every trip, but I’ve put asterisks next to essential items – the ones that I always carry.

Medications

Common medications in a first aid kit

Pills weigh almost nothing and are easy to keep in a small baggie. I toss a few grains of rice into my pill bag to help soak up any moisture that might make its way in. Make sure to take stock of your pill bag before each trip so don’t run out of anything at a bad time.

  • Ibuprofen (Advil)* – Common for headache and pain relief as well as for reducing fever and inflammation. Affectionately known as “Vitamin A”. 💊
  • Diphenhydramine (Benadryl)* – Antihistamine for allergy relief and early anaphylaxis. Can also be taken as a sleeping pill.
  • Loperamide (Immodium)* – Anti-diarrhea pill that can be essential for getting yourself out of the woods if you catch a bug due to bad food or poor hygiene.
  • Epinephrine (Epi-pen) – My WFR instructor described an epi-pen as pound for pound, the most lifesaving piece of gear you can carry if someone in your group has severe allergies.
  • Aspirin – Good to have on hand if someone in your group is likely to suffer a heart attack as it can decrease the associated risk of death.

Wound Care

Wound care items for a first aid kit

 

This is the stuff that usually takes about about 90% of a hiking first aid kit. The goal of these items is to help you stop the bleeding, control infections and promote healing.

In a pristine hospital setting, anything that goes on or into an open wound must be sterile. In the backcountry, you’re unlikely to have that luxury, so “clean” will usually suffice. Make sure you follow up with any sketchy wounds when you get home or if they start showing signs of infection.

  • 3” Fabric Band Aids* – Your normal, everyday bandaid for protecting most minor cuts and scrapes. The fabric ones breath well and stretch with your skin as you move, so they’re more likely to stay on and not get gross.
  • Triple Antibiotic Ointment (Polysporin)* – Once a wound is no longer bleeding and has been flushed with water, add some of this ointment to help prevent infections and promote healing.
  • 2” Roll of Gauze* – A lot of off-the-shelf kits contain individually-packaged squares of gauze in various sizes, which creates a lot of waste and extra weight. A 2” roll of gauze packs down small and lets you use the right amount for any given wound.
  • Alcohol Pads – Use these for cleaning the skin around a wound before dressing it.
  • Quickclot Dressings – A vacuum-sealed packages of gauze impregnated with a hemostatic agent, they’re designed to be used on cuts or punctures with extra-strength bleeding to bring it under control quickly.
  • Nexcare Steri-Strip – These are long, thin pieces of tape designed to be laid across a wide cut to pull the skin together on both sides. They basically function like stitches that you can apply yourself to keep a wound closed.
  • Spenco 2nd Skin Blister Pads – A small pad that sticks well and protects blisters and small burns, allowing them to heal faster and with less discomfort.
  • Irrigation Syringe – You can get a small 5ml syringe for free from your local CSV pharmacy if you ask nicely. These are useful for pushing clean water into deep lacerations to help flush out the nasties.

Two other pieces of wound care gear that are commonly mentioned that I would not recommend:

  • Sheet of Moleskin – It’s really only useful for one, non-essential job – padding around blisters, and it takes too much fiddling to cut out a piece that is the correct size and get it to actually sticks to your skin. Learning how to safely drain a blister will relieve the pressure with a lot less fuss.
  • Israeli Bandage or Tourniquet – I really struggle to come up with a situation outside of a battlefield where this would be useful. You’d have to have a high chance of losing a lot of blood from an extremity for it to justify its own weight in your pack. That said, it might be good for hunting trips.

Other Essentials

Other essential first aid itemsAs a general packing philosophy, I tend to prefer simpler items than can perform multiple jobs rather that specific pieces of gear that can only do one thing. With that in mind, here are a few extra pieces of gear in my kit.

  • Leukotape* – The best thing I’ve found for sticking to skin while not being painful when you eventually want to remove it. It breathes better than duct tape and sticks better than medical or athletic tape. It’ll last you the entire trip back to the trailhead and then some.
  • Nitrile Gloves* – These should be standard in any kit but unfortunately aren’t. Nitrile protects you from coming in direct contact with another person’s blood and fluids while you’re working on them. Ask for a few pairs the next time you’re visiting the doctor.
  • 2” Elastic Bandage* – Can be easily fashioned to support an ankle or knee injury, if the joint is still usable. If it’s not usable and you need to make a splint, this is also very handy. I prefer the ones with velcro closures over those bendy metal pieces that don’t last.
  • Tweezers – Can be used for any task where you need fine motor control and precision, like removing a splinter or pulling off a tick.
  • SAM Splint – A stiff but packable splinting material commonly carried by many search and rescue teams. Useful for stabilizing and supporting injuries.
  • Snub-nose Scissors – If your pocket knife doesn’t already have a pair, a small set of scissors is useful for trimming gauze, opening packaging and removing clothing in a pinch.
  • Safety Pins – I carry a few in case of gear repair issues anyways, but they’re also great for draining blisters safely.
  • Q-Tips – Useful for applying ointment deep inside a cut without sticking your fingers into it. Also useful for cleaning ears and noses as well as gauging a person’s skin’s touch sensitivity.
  • Triangular Cravat – Basically like a giant bandana that you can use to help fashion a splint or pack into a wound. This is easily improvised with the bandanas and clothing that you’re likely already carrying.

Recommended Popular Commercial Kits to Start With

While there are many benefits to building your own kit from scratch, it can be intimidating if you’re not sure where to begin. Instead, it might be better to start with a pre-built commercial kit and customize that to your needs – tucking the excess supplies it comes with into your medicine cabinet and bolstering the kit where it’s lacking.

Adventure Medical Kits Mountain Series Hiker Medical Kit

Adventure Medical Kits Mountain Series Hiker Medical Kit

Weight: 7oz
Price: Click for Price & Availability

The Adventure Medical Kits Mountain series is a great light-and-fast set of first aid kits that don’t skimp on essentials. Their Hiker Medical Kit has 3 pairs of nitrile gloves, a stretchy elastic wrap bandage as well as roll gauze, which are all excellent essentials.

The bag itself is lightweight and no-frills, and it also comes with a handy pocket guide to wilderness medicine which can definitely be useful in an emergency situation.

I’d ditch the trauma shears, moleskin cutouts and giant gauze pads for most trips. I’d probably also swap out the fabric tape with some Leukotape and add way more ibuprofen (they only include 4 pills).

This is a great all-around starter kit that’s light and flexible and comes with a bunch of useful items that you can choose to leave at home on specific trips if you’d prefer.

Adventure Medical Kits Ultralight & Watertight .7

Adventure Medical Kits Ultralight and Watertight Medical Kit .7

Weight: 8oz
Price: Click for Price & Availability

Another great starter kit from Adventure Medical Kits is their Ultralight & Watertight 0.7. This kit is even more compact that the Mountain Series Hiker, ditching the shears and bulky gauze pads, but still includes 1 pair of nitrile gloves, a stretchy elastic wrap bandage and a roll of 2” gauze.

The bag itself is allegedly waterproof, making it a pretty durable package for your kit. However, the slim profile also makes it a challenge to add bulkier items like an epi-pen or scissors, if you needed to toss those in on an occasional trip. It also seems to weigh a bit more that the Mountain Series Hiker kit, despite the “ultralight” name.

I’d remove the moleskin sheet and swap the fabric tape for something that sticks better. The kit also includes some duct tape and safety pins if you need to MacGyver a wound together, but you might already be carrying these staples elsewhere in your backpack already.

This is a good no-frills kit for the minimalist who doesn’t plan on adding much extra gear of their own.

REI Co-op Backpacker Weekend First-Aid Kit

REI Co-op Backpacker Weekend First-Aid Kit

Weight: 9.5oz
Price: Click for Price & Availability

REI has a whole series of their own first aid kits but the Backpacker Weekend First-Aid Kit seems to strike the right balance of gear. It has important essentials like a roll of gauze, elastic wrap bandage, and a wilderness first aid manual. It doesn’t have gloves but it does have an assortment of small creams for burns and stings.

REI seems to tout all of the many labeled pockets in their kits as a way to keep everything organized. However, they add a lot of bulk to the packaging and make it much more difficult for you to reorganize it with your own gear mixed in.

This is a good starter kit for anyone who appreciates the organization and doesn’t plan on customizing their kit very much.

Other Resources For Building Your Own First Aid Kit

All of the advice I’ve given so far is based on my own experiences treating and managing real backcountry medical emergencies, as well as my Wilderness First Responder training.

But don’t just take my word for it.

Whenever you’re putting together something as important as your first aid kit, it’s important to consider multiple sources. Here are a few other great resources to help you think more carefully about what you should bring for you next trip.

“Backpacking First Aid Kit for soloists & groups” by Andrew Skurka 
Andrew Skurka is a well-known adventure racer and ultralight backpacker. In this post, he lays out the core first aid essentials he brings as well as group considerations that might add a few more items to his kit.

“Building a Wilderness First Aid Kit” by Wilderness Medical Associates 
Wilderness Medical Associates is one of the leading backcountry medicine training providers in the US. In this article, one of their staff members lays out her ideal first aid kit for remote trips.

“First-Aid Checklist” by REI 
In this article on the REI blog, they list every possible item you might ever want to include in your kit, including many I intentionally skipped over, like a magnifying glass, mirror, CPR mask and oral thermometer.

“What Items Belong in My Backpacking First-Aid Kit?” by Outside Magazine 
A very minimalist perspective from another Wilderness First Responder. He lists the core essentials he takes on every trip.

“Can we talk about First Aid?” on Reddit 
If discussions are more of your thing, here’s a great thread on the Wilderness Backpacking subreddit where a bunch of people share what’s in their kits and debate what they feel is necessary.


Ultimately, a first aid kit is just a collection of a bunch of small but essential pieces of gear. It’s a backpacking myth that a survival kit alone will get you out of any situation you get yourself into.

In reality, it takes training and thoughtful decision making to handle backcountry medical emergencies.

If you’re interested in learning more, check out my article on essential Wilderness First Aid skills. I’d also highly recommend taking a weekend-long Wilderness First Aid class in your area.

 

Article by:  Hartley Brody

See more awesome wilderness content here:

https://adventures.hartleybrody.com/

 

 

10 Most Legendary (And Infamous) Travelers In History

10 Most Legendary (And Infamous) Travelers In History

By: Matthew Kepnes
History is filled with amazing adventures who paved the way for future explorers and inspired generations of wanderlust. Here are some of the best.

Fridtjof Nansen

Fridtjof Nansen was the first man to cross Greenland’s ice cap. He also sailed farther north in the Arctic Ocean than any man before him. That’s pretty awesome. He and a colleague even endured nine winter months in a hut made of stones and walrus hides, surviving solely off polar bears and walruses. Nansen explored the great white north and had an asteroid named after him.

Christopher Colombus

Here’s a guy who had no idea where he was when he landed so assumed he was in India, enslaved a population (for which he admitted to feelings of remorse later in life), and brought a host of terrible diseases to an entire hemisphere (he got syphilis from the native people, in return). Colombus showed Europeans there was a new world out there and ushered in a new age of European exploration.

Ibn Battuta

Ibn Battuta was a great Muslim explorer who traveled more than 120,000 kilometers through regions that, today, comprise 44 countries — from Italy to Indonesia, Timbuktu to Shanghai. He was mugged, attacked by pirates, held hostage, and once hid in a swamp. His travel writings provide a rare perspective on the 14th-century medieval empire of Mali (from which not many records survive).

Xuanzang

Xuanzang was a Chinese Buddhist monk, intrepid traveler, and translator who documented the interaction between China and India in the early Tang Dynasty. He became famous for his 17-year overland journey to India, on which he was often ambushed by bandits, nearly died of thirst, and survived an avalanche.

Lewis and Clark

These two guys lead an expedition of 50 men to chart the northwestern region of the United States after the Louisiana Purchase and establish trade with the local populations. They set out in 1804 and didn’t return until 1806. They rode off into the unknown, were helped by the famous Sacagawea, and were the first Americans to set eyes on the Columbia River. They faced disease, hostile natives, and extreme weather conditions. They were true adventurers and scientists.

Ernest Hemingway

The manliest of manly travelers, Hemingway traveled extensively. His journeys inspired many of his greatest stories. He was a fisherman, hunter, soldier, and ardent drinker who lived in Paris, Cuba, and Spain. He was the most interesting man in the world before it was cool to be the most interesting man in the world.

Marco Polo

This legendary Venetian set out with his father and uncle to explore Asia when he was just 17 years old. They came back 24 years later after traveling over 15,000 miles. He’s inspired generations of travelers with tales that provide fascinating insight into Kublei Khan’s empire, the Far East, the silk road, and China.

Ernest Shackleton

Antarctica’s most famous explorer (though Roald Amundsen was the first to reach it in 1911), Ernest Shackleton is synonymous with Antarctic exploration. He traversed the continent many times and is most famous for the 1914 voyage that trapped his ship Endurance in ice for 10 months. Eventually, she was crushed and destroyed, and the crew was forced to abandon ship. After camping on the ice for five months, Shackleton made two open boat journeys, one of which—a treacherous 800-mile ocean crossing to South Georgia Island—is now considered among the greatest voyages in history. Trekking across the mountains of South Georgia, Shackleton reached the island’s remote whaling station, organized a rescue team, and saved all the men he had left behind. That’s badass.

Neil Armstrong

The first man to set foot on the moon. That pretty much means he wins. He was a modern adventurer who traveled to the moon (no easy feat) and took one giant leap for mankind. Neil Armstrong is living proof that when we put our mind to it, there’s no place we can’t explore.

Freya Stark

In 1930, Freya Stark – who had also learned Persian – set out for Persia. The goal of her trip was to visit the Valleys of the Assassins, at the time still unexplored by Europeans, and carry out geographical and archeological studies. The Assassins were fanatical followers of a sect belonging to Shiite Islam, who used religious reasons to justify killing their enemies. They were said to enjoy hashish, which is reflected in the name “hashshashun,” or hashish-smoker. French crusaders derived the word “assassin” from the word “Hashshashun”, which came to mean “murderer” in Romance languages. The reign of the Assassins began in the 11th century and ended in the 13th century after the Mongol conquest.

On the back of a mule, equipped with a camp bed and a mosquito net, and accompanied by a local guide, Freya Stark rode to the valleys near Alamut (= ruins of a mountain fortress castle near the Alamut River), which had not yet been recorded on her map. Malaria, a weak heart, dengue fever, and dysentery plagued her, but she continued her trip and her studies. Back in Baghdad, she received much recognition from the colonial circles; overnight she had gained a reputation as an explorer and scholar to be taken seriously.

 

And here are some inspiring quotes to take you further in your travels:

“Traveling – it leaves you speechless, then turns you into a storyteller.”              – Ibn Battuta

“We travel, some of us forever, to seek other states, other lives, other souls.”        -Anaïs Nin“You can shake the sand from your shoes, but it will never leave your soul.”

 

 

If you like these articles, feel free to pin and share them around.

Happy reading!

Follow us on WeChat and you will find a lot of interesting articles about adventure travel:

 

 

Lanzhou

Lanzhou is the capital city of Gansu Province in northwest China at an elevation of 1518 m (4980 ft). The Yellow River runs through the city and it is definitely worth an afternoon of your time to rent bicycles and cruise along the river for 2-4 hours. The city is the transportation and telecommunication center of the region and is the largest city in western China. Covering an area of 1631.6 square kilometers (629.96 square miles), it was once a key area of trade on the ancient Silk Road. Today, it is a hub for tourists as they begin their adventures out into the Silk Road, with the Maiji Caves to the east, the Bingling Temple Grottoes to the west, Labrang Monastery to the south and the ancient cave paintings of the Dunhuang Mogao Caves to the north.

 

 

With mountains to the south and north of the city and the Yellow River flowing from the east to the west, Lanzhou is a beautiful modern city with both the modern ammenities of a large city and the charm of southern cities. The downtown comprises five districts: Chengguan, Qilihe, Xigu, Honggu and Anning. Among them, Chengguan District, situated in the eastern part of the city, is the center of politics, economy, culture and transportation. Anning District, in the northwest of the city, is the economic development zone as well as the area where most colleges are located.

As a transportation hub, Lanzhou connects western and central China. Flights are frequent from many large cities such as Beijing and Shanghai. With three train stations, it is the termination of the Longhai Railway (Lanzhou – Lianyungang Railway), an important east-west rail route in China. Bullet trains to Urumqi also originate from this city.

Owing to its location on the Silk Road, local cuisine maintains characteristics with an Islamic influence. Locally sourced grass fed beef and lamb are common to most dishes. In fact, Lanzhou Beef Noodles or 兰州牛肉面 are famous all across China and most bowls are dirt cheap and very hearty at around 10-12 RMB. In addition, there are many local snacks that we recommend for those looking to try something new such as Niangpi, Hui Dou Zi (Gray Bean) and Fried Noodles. Although many restaurants serve Islamic food, various cuisines such as hot pot and western food are also offered for travelers. With KFC, Starbucks, Burger King, and a host of western restaurants, you will have no problem finding something you will like to eat.

Zhangye

The Silk Road was a network of trade routes connecting China and the Far East with the Middle East and Europe. Established when the Han Dynasty in China officially opened trade with the West in 130 B.C., the Silk Road routes remained in use until 1453 A.D., when the Ottoman Empire boycotted trade with China and closed them. Although it’s been nearly 600 years since the Silk Road has been used for international trade, the routes had a lasting impact on commerce, culture and history that resonates even today.

From July 15-17, 2018 we took out an amazing couple from America to explore the Silk Road of Zhangye in Gansu Province of Western China.  These incredible mountains are surrounded by the 6,000 meter peaks and the glaciers of the Qilian Mountains and offer one of the most unique and authentic insights into the amazing history of trade and culture of great empires that once were.

Have you ever wanted to see the Silk Road?

Venture with Elevated Trips to see the incredible Hexi Corridor of the Silk Road and walk through 1,500 years of history as you..

  • Get to sleep in a Mongolian Yurt Camp right at the base of Danxia National Park
  • Sample the local cuisine
  • Explore 33 Buddhist cave grottoes on the side of a Monastery tucked high up on a cliff face

You can see a possible itinerary HERE.

Exploring Wild Qinghai

 

Most people have never heard of Qinghai Province.  Located on the northeastern corner of the Tibetan Plateau and with a total population of only 5.6 million people, Qinghai is a wide open, high altitude land of nomads and snow leopards, Tibetan cowboys and wild yaks.  Qinghai also holds a wide array of Tibetan Buddhist monasteries and mosques to dazzle the eye.  Despite its relatively small population, this is a massive land area with 722,000 square kilometers in total area, making it bigger than the individual countries of France, Afghanistan, Thailand, or the whole of the United Kingdom.

Qinghai Province is the source of China’s two largest rivers, the Yangtze River and the Yellow River.  This unique Montana-like Plateau offers towering mountains, red rock canyons, and is full of meandering rivers and alpine lakes.

Want to know where to travel in Qinghai?

Check out our trip locations all over wild Qinghai:

Rebkong

Dawu

Xinghai

Maduo

Yushu

 

This is definitely the place to get off the map and experience #AdventureTravel at its finest!

 

Langmusi (郎木寺) – Taktsang Lhamo (སྟག་ཚང་ལྷ་མོ་)

Langmusi, at 3,345 meters in elevation, is a town that is known for it’s rich Buddhist culture and it’s amazing scenery, tucked away in the crags of 5000 meter mountains. It would be very easy to spend at least 2-3 days here in this quaint wonderland.

Kirti and Serti Monastery

The two main temples in Langmusi are the Kirti Monastery, located on the southern Sichuan side, and the Serti Monastery, located on the northern Gansu side of town. Serti is certainly the more lavish of the two monasteries as it receives some of its funding by the Chinese government, and the monastery in turn supports China’s appointed Buddhist spiritual leaders. Serti, the cleaner and more prestigious of the towns’ two monasteries, shines under the high altitude sun with brilliant golden roofs and is often undergoing major renovations and expansion upgrades.

Kirti Monastery, on the other hand, receives no funding from the government. Consequently, Kirti maintains an older, more organic feel as it’s temples are made wood, mud, aluminum, and cement. The roofs lack the loud colors and glam that adorn the Serti Monastery. Most of the Kirti side is comprised of the slightly tattered but humble living quarters of all the monks who reside there. But, while being a bit more toned down than neighboring Serti Monastery, I’ve found that most of the Tibetan pilgrims that walk and prostrate for months when traveling to Langmusi all go to Kirti, not Serti. In fact, most of the major gatherings of lamas and monks happen at Kirti despite its more rustic character.

Regardless of personality, both monasteries are certainly worth a visit and it is a fantastic experience to walk alongside the pilgrims who have come from 100’s of miles all around the grasslands to land and worship in Langmusi.

 

Hiking and Horse Trekking in Langmusi

Namo Gorge and Huagai god Mountain

Walking through Kirti Gompa and up the valley, you will reach the start of Namo Gorge. You have to pay 30Y at the entrance to the monastery, which gets you access to the monastery itself and the gorge, but it is possible to bypass this if you walk up the road to the right of the ticket office, up and over the hill and down to the start of the gorge.

Once past the ticket gate, there is a wide open field where you might happen to stumble upon young monks playing soccer or relaxing in the grass reading a book. This is the just outside the walls of the Kirti Monastery and as such is the “playground” for the 100’s of monks that reside there. Moving past this area as you follow the river upstream you quickly enter a narrow gorge. Just on the right of this gorge is a statue of a tiger wrapped in Cata scarves and is a small cave, known as a home to local mountain spirits. The cave is no bigger than a modest size apartment but there is a small hole in the backside of the cave where you may find that local Tibetan nomads are trying to wiggle in and out of. Legend has

Once you pass the cave, you will walk alongside the White Dragon River for about 10 minutes until you eventually come to the spring that the river emerges out of. From this point continue up the dirt trail another 20 minutes to another gorgeous open grass valley. This is about as far as most tourists get, so if you continue in the canyon to your right up the fork, you will virtually have the whole gorge to yourself. It is possible to walk for a considerable distance into the gorge and mountains beyond, being surrounded by amazing scenery and peace and quiet. Eventually the trail (if you keep just staying right ) will take you along the side of some brush and over the top of a tableland known as “Huagai god Mountain”. From this view among the sharp rocks of the peak at 4,200 meters you get an excellent view of both Langmusi town and the wide open grasslands.

The hiking in this gorge can be anywhere from 20 minutes to 8 hours. There is really enough here for any level of adventure seeker!

Red Rocks hike

Walking in the other direction from the village – towards the main road – one encounters an interesting sandstone formation or mesa whose top is accessible. To access this, just look up to the Red Rock formations immediately outside of town, and walk a street about 1km out into the open pastures at the bottom of the mountain. From here wind up through an old sheep trail to get on top of the red rock cliffs. The hike up from town is about 2-3 hours and the Prayer flags here on the top are around 3,700 meters. There is a great view looking back on the Gansu side of Langmusi town and this makes for a great half day hike and an excellent picnic ground.

Horse Trekking

One of the town’s must-do activities is the horse trekking. Langmusi offers anything from 1 to 3 day horse treks where you can stay with real Tibetan nomads in their tents. The guides on all their trips are professional and experienced. Liyi, the owner at the horse trekking place speaks excellent English and is a great resource for any questions or tips about Langmusi. They also do biking trips and bike rentals. You can go to the grasslands by yourself with the bike or organize an amazing two-day homestay bike trip directly through them. They also own the Black Tent Cafe across the street – which is highly recommended for a little coffee, cake, or for their smoothies.

Sky Burial

Please beware that the information below might be disturbing to some. A sky burial is where the deceased Buddhist is hauled up a mountain, adorned in prayer wrappings, and left to be taken by the birds. After the birds do most of the work, the body is chopped up and burned. For many Tibetans, a sky burial is an entirely natural and beautiful way to go (and is often considered as a last act of compassion in giving one’s body to nature). I tend to agree and would much rather have a sky burial than be put in some box in field of other boxes. That said, visiting a sky burial site not long after a burial is quite an experience.

If you walk up past the left side of Serti Monastery, you’ll eventually come to a clearing near a hilltop (ask any local around Serti and he or she can point you in the right direction). The clearing has two boxes of axes and knives, prayer flags, and a pile of ashes. Once the birds are basically done with the main job, the remains are burned. However, not everything makes it into the fire, which means the site is literally littered with skulls, hip bones, and other various bits and pieces. We’d come only days after a burial, so some of the bones even had flesh and skin still on them.

I know it sounds gross, but if you’re curious about this sort of thing, I’d say this is a must see, as chances to experience this sort of thing don’t come around too often.

 

Langmusi in General

Langmusi is a sleepy village in a remote breathtaking location predominantly inhabited by a colorful mix of Hui Muslims and Amdo Tibetans. It is said that the provincial borderline runs through the middle of town with Sertri Gompa in Gansu and Kirti Gompa located in Sichuan. The power struggles between the two Gompa may have been the reason for the border location. Both temples have distinct styles making both well worth the visit alone. The surrounding mountains give off a very much alpine flair reminiscent of rural Austria or Bavaria and perfect for hiking and horse trekking.

While there are continually construction projects in all seasons (as in virtually every Chinese town, down to the tiniest backwater), much of the money that tourists bring in appears to be going to renovating and improving Tibetan temples and meeting places, or into local businesses catering to the seeker of Tibetan culture.
At this point [October 2015], the village has developed a budget-friendly backpacker vibe, not unlike Shaaxi village in Yunnan province. Yet, even in high season [the height of the October holiday, and after the swarming hordes of Jiuzhaigou], tourists are relatively few, and this is very much an active religious community with many monks and initiates to be seen walking the roads and playing behind the major monastery. The monks and students are not shy, happy to have a chat in Chinese and to a lesser extent English, and deeply appreciative of even the most basic Tibetan greetings (‘tashi delek’ means “Hello”). The majority of the visitors to this town are Han Chinese, and few if any make the effort to learn any Tibetan phrases.

 

Getting there

There is only one bus every day from Xiahe direct to Langmusi leaving at around 7:40 a.m. (Dec 2014) from the Xiahe Bus Station. 72Y.

If you miss this bus, or if you can’t get tickets, you can take any early morning bus to Hezuo (1 hour from Xiahe) and then take one of the Hezuo(合作)buses to Langmusi. There are a couple buses from Hezuo to Langmusi each day. There definitely is one leaving at 10:20AM.
When you get to Hezuo, you will need to take a taxi across town to the South Bus Station (Nan Zhan – 南站) where the buses leave for Langmusi.

If you were thinking of hiring a car to take you directly from Xiahe to Langmusi, be ready to pay a lot of money. It will cost you at least ¥350 to hire a car for the trip. The bus is only ¥ 71 per person. If you do end up taking a taxi, be sure to ask to take the “scenic route.” The road is a little bumpier than the new highway, and a takes a little longer, but you pass beautiful grasslands, mountains, and tibetan villages along the way.
There are also direct buses to Zoige (Ruo’ergai) in northern Sichuan. There is currently no direct bus to Songpan but the situation may change, as a new highway was completed in 2007.

You can also catch a bus in Jiuzhaigou to Langmusi. There are multiple buses leaving every morning between 7am and 8am. The bus will let you off on the main road outside of Langmusi, not actually driving into town, leaving you with a 1+ km walk, or there will be cars around to get you into town (for a few yuan).
To get out of town up towards Xiahe, there is only one afternoon direct bus a day. You can get morning buses to Hezuo, then a cab to the West Bus Station, then catch a bus to Xiahe. There are many buses to Xiahe each day.


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