A Thru Hiker's Guide to First Aid in the Backcountry

Green Goo Ambassador Andrew Forestell seeks to become a "Triple Crowner," completing all 3 big USA thru hikes. He's finishing up the Pacific Crest Trail in 2018

Photos and text by Andrew Forestell (aka @ReptarkHikes). Photo of Forestell by Judson Pryanovich

I've learned a thing or two about first aid in the outdoors while hiking over 4,000 miles on the Appalachian Trail ('15) and the Pacific Crest Trail ('17). Here's a list of things that may help when it comes to basic first aid out there on the trail. Please note that I'm not a licensed medical professional, I am just sharing what has worked for me.

Feet and Shoes

First and foremost, your feet are taking the brunt of the weight of your body and your pack, so it is imperative that you start off with a good pair of trail runners or hiking boots that fit your feet. This is the number one way to prevent blisters. Shoes that are too small will cause blistering, black toenails, and foot stress. Shoes that are too large will allow your foot to move around in the shoes causing blistering and a lack of secure footing. In my experience, non-waterproof trail runners are the way to go. If (when) your shoes get wet, a breathable trail runner will dry out a lot quicker than a waterproof boot, and they keep sweaty feet at a minimum. Wet shoes equals blistering, athletes foot, and some really horrible smells, so having shoes that dry quickly is a must for me. It's good practice to change and rinse out socks when possible. Ideally you want a good pair of wool socks like Merino Wool, Darntough, or Smartwool and avoid cotton. Letting feet dry out during breaks will help also help your feet stay in great shape, and rubbing some Green Goo Foot Care on them will also help with blisters, athlete’s foot, fungus, dry feet, ingrown toenails, rashes, and cuts.

Knee Issues - Sore joints and Inflammation

Knee issues don't pop up in everyone, but they can easily sideline your hike. To help prevent injury it's good to pack light. If you're carrying a 40+ lb. pack on a thru hike you're carrying too much. Unless you're on a mountaineering expedition or a multiple week trip into the wilderness with no resupply points that's just too much weight on your joints. You should aim for a pack base weight of no more than 15-20 lbs (and 20 is really pushing it). Chances are if your pack without water and food weighs more than that you probably don't need everything in it. I had a base weight of around 16lbs. (which by some is considered heavy) and was able to carry everything I needed in temperatures well into the teens. To see what I carried on trail you can check out this link: https://lighterpack.com/r/95k50n

In conjunction with carrying the lightest loaded pack possible, hiking with trekking poles will also reduce stress on your knees over time. Trekking poles allow you to distribute weight to your arms and take some of the stress off your knees. They also have the added benefit of making you hike slightly faster and can act as a tent poles for some shelters. If you do experience sore knees, consider taking an anti-inflammatory to reduce swelling and pain. I've also used Green Goo's Pain Relief Salve, which puts anti-inflammatory powers right where you need it. I don't personally use them, but for those with chronic knee issues, knee braces are a popular option; talk to your doctor or physical therapist about what type is best for your needs. And finally, just being good to your body and getting some rest and relaxation can (and does) work wonders. Taking a zero day (i.e. day off) can mean the difference between finishing a hike and having to get off trail from an injury that goes from mild to serious.

Wound Care - Cuts, Bruises, Scrapes, and Blisters

Depending on the severity of a scrape or cut it's best to wash out the wound with soap and water; make sure you use filtered water and not directly from (or in!) a water source. Once the bleeding stops I usually apply some First Aid Salve and cover it with a band aid or gauze and KT tape to keep dirt and debris out. Duct tape can also work in desperate times, but I don't recommend it if you have other options. I usually just let bruises be, but once in a while I'll apply pain relief salve for faster healing. Blisters are definitely the most common issue when hiking. Blisters can be prevented with good fitting footwear and preventative maintenance. If you notice a hot spot forming try covering it with KT tape to reduce friction to the area. If a blister does occur, I use a sterilized needle or pocket knife to poke a hole in it and drain the fluid. After rinsing it off, I apply some first aid salve and then cover it with KT tape.

Sunburns and Dehydration

Sunburns are no joke. Especially when the inside of your nostrils are burned from sunlight reflecting off snow. Solar Goo and UPF rated clothing like hats and neck capes can help minimize or eliminate burns before they happen. Night hiking is also another option especially in the desert. Remember that you can get sunburned just as bad in the winter/snow from light reflecting up at you; get them nostrils brah.