Hiking first aid: the kit, the basics, and the prep that matters more

Let me say this clearly before anything else: I am a hiker, not a medic. This is the practical stuff I carry and the preparation I do before a walk, not a substitute for real training. The single best thing you can do is a proper first aid course, and the next best is free: download the British Red Cross first aid app, which walks you through the basics with clear steps for exactly the situations you might meet on a trail. Get it now, while you are sat down with signal, not when you need it.

With that said, most trail first aid is not dramatic. It is blisters, a turned ankle, a sting, a cut, or someone getting colder or hotter than they should. A small kit and a little preparation handle almost all of it.

The checklist: kit and prep

Tick this off as you build your kit and prepare for the walk. It remembers where you got to, and the "Before you go" half is the two minutes of preparation that matters more than anything in the bag. Toggle the solo/remote option for the extra steps if you are heading out alone.

What goes in the kit

The kit in the photo above is my actual setup. Start with a decent base kit like the 130 Piece First Aid Kit: dressings, bandages, wound-closure strips, tape, antiseptic wipes and an emergency foil blanket. Then make it yours, because a shop-bought kit is a starting point, not the finished thing.

The most important additions are personal. Any regular medication you take goes in, with spares, because the walk that runs long is exactly when you are glad of them. If you use an inhaler, it comes with you and lives somewhere you can reach it fast, not buried at the bottom of the pack. Antihistamines earn their place for stings and reactions, and a small stash of painkillers, paracetamol and ibuprofen, makes a real difference on a long day. I also carry oral rehydration salts (Dioralyte) for the day someone is genuinely dehydrated or overheating, which is a different job to the performance electrolytes in the pack. And a strip of aspirin (300mg) goes in too: for a suspected heart attack, chewed by a conscious adult who is not allergic, it is one of the few genuinely useful things a bystander can do while help is on the way. Add blister plasters, a tick remover and a sting relief cream, and a pair of nitrile gloves for dealing with anyone else's injury.

Keep the things you would need in a hurry, the drugs, the blister plasters, the inhaler, in a pocket you can reach without taking the pack off.

The common trail stuff

You do not need to be a paramedic, you need to handle the everyday things calmly and know when it is more than you can manage.

Blisters are the most common by miles. Stop the moment you feel a hot spot, do not walk it out, and cover it before it becomes a blister. Sprains and turned ankles want rest, support and, if you can, elevation, and a support strap in the kit is worth its weight if you have a joint that plays up. Cuts and grazes get cleaned with a wipe and covered. Stings get the sting cream and an antihistamine, and if someone shows signs of a serious reaction that is a 999 situation, not a cream situation. Ticks come off with the tick remover, straight out, no burning or twisting, and keep an eye on the bite afterwards.

Then the two that creep up on people: getting too cold (shivering, clumsiness, going quiet) and getting too hot (headache, feeling sick, stopping sweating). Both are about catching them early: layer up and get moving and fed for cold, or stop, shade, water with electrolytes, and cool down for heat. The Red Cross app covers all of these properly, which is exactly why it is worth having.

The prep that matters more than the kit

Here is the part most gear lists skip, and it is more valuable than anything you can carry. Almost none of it costs a penny, and it takes about two minutes.

Check the weather. Properly, for where you are going and when, not the general forecast for the nearest town. Most trouble on the hills starts with weather nobody planned for.

Tell someone your route and when you expect to be back, and share your live location with them so they can see where you are, then check in from time to time so they know you are fine. If you go quiet and they know your plan, help gets to the right valley fast.

Sort your phone out. Save ICE (in case of emergency) numbers, and set up your phone's Medical ID. On an iPhone it is in the Health app under Medical ID, and on Android it is the emergency information on the lock screen. Fill in allergies, blood type, medication and emergency contacts, and set it so it can be read from the lock screen without your passcode. If you are unconscious, that information can be read by whoever finds you, and it can genuinely matter.

Download what3words so you can give your exact position to the emergency services, and if you walk with a friend, have a quick chat before you set off about any medical history or medication between you. It takes a couple of minutes and it is the kind of thing that is priceless if one of you goes down.

And if you often walk alone or somewhere remote, seriously consider a satellite communicator like a Garmin inReach Mini. It works where there is no phone signal at all, and for a solo walker on quiet ground that is the difference that counts.

When it's more than first aid

If someone is seriously hurt, do not hesitate. Call 999 or 112 and ask for the police, then Mountain Rescue. If you cannot get a call to connect but have a flicker of signal, you can text 999, but only if you have registered beforehand: text the word "register" to 999 now and it takes seconds. Give your location as a what3words or an OS grid reference, describe what has happened, and stay where you are if it is safe to.

If you have no phone at all, the international distress signal is six blasts on a whistle, wait a minute, repeat. It is why the whistle is on the packing list.

Mostly, though, prevention is the whole game. Check the weather, tell someone, carry the kit, know your limits, and turn back when the day tells you to. The best first aid is the incident that never happens.

For everything that goes in the bag alongside the first aid kit, see the what to pack for a day hike guide.