Survival Guide #20: Wilderness First Aid - Remote Medical Care Basics

Preparation
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Wilderness First Aid: Remote Medical Care Basics

Series: 90-Day Survival Guide Sprint — Guide #20
Category: Preparation / Medical
Difficulty: Intermediate
Last Updated: April 2, 2026

:warning: Critical Medical Disclaimer

This guide provides educational information, NOT medical advice or training.

  • This guide does NOT qualify you to provide medical care
  • This guide does NOT replace formal first aid training
  • Seek formal training (WFA, WFR, EMT)
  • Call emergency services when available

Wilderness medicine involves significant risk. Improper care can worsen outcomes.

When This Matters

Wilderness first aid becomes critical during:

Situation Why It Matters
Remote travel Hours or days from medical care
Disaster scenarios Emergency services overwhelmed
Extended outdoor activities Multi-day wilderness trips
Grid failure No 911, no ambulances

The Reality: Wilderness medicine differs from urban first aid:

  • Evacuation may take hours or days
  • Limited equipment (what you carry)
  • No backup (you are the help)
  • Environmental challenges (weather, terrain)

Wilderness Medicine Principles

Key Differences from Urban First Aid

Factor Urban Wilderness
Response time Minutes Hours to days
Equipment Full ambulance What you carry
Evacuation Ambulance Carry, walk, or wait
Communication 911 available May have none
Hygiene Sterile Improvised

Decision-Making Framework

Key Questions:

  1. Is this life-threatening?
  2. Can the patient walk out?
  3. Do we need to carry them?
  4. Can we wait for help?
  5. What resources do we have?

Patient Assessment

Primary Assessment (ABCDE)

Letter Check Action
A - Airway Is it open? Clear obstructions
B - Breathing Are they breathing? Rescue breathing if needed
C - Circulation Pulse, bleeding? Control major bleeding
D - Disability Conscious? Moving? Note mental status
E - Exposure Check for other injuries Protect from elements

Secondary Assessment

Head-to-toe examination:

  1. Head (scalp, face, eyes, ears, mouth)
  2. Neck (tenderness, deformity)
  3. Chest (breathing, tenderness)
  4. Abdomen (tenderness, rigidity)
  5. Pelvis (stability)
  6. Extremities (movement, sensation, pulse)
  7. Back (log roll if spinal injury possible)

Vital Signs

Sign Normal Adult Concerning
Pulse 60-100 bpm <50 or >120
Respiration 12-20/min <10 or >30
Temperature 98.6°F (37°C) <95°F or >103°F
Skin Pink, warm, dry Pale, cool, clammy

Common Wilderness Emergencies

Hypothermia

Signs: Shivering, confusion, slurred speech, drowsiness

Treatment:

  1. Remove from cold/wet
  2. Remove wet clothing
  3. Insulate from ground
  4. Warm core first (chest, neck, groin)
  5. Warm drinks if conscious
  6. Don’t rub extremities

Prevention: Stay dry, layer clothing, eat enough calories

Heat Exhaustion/Stroke

Heat Exhaustion Signs: Heavy sweating, weakness, nausea, headache

Treatment:

  1. Move to shade
  2. Remove excess clothing
  3. Cool with water
  4. Drink electrolyte fluids
  5. Rest

Heat Stroke Signs: Hot dry skin, confusion, unconsciousness

Treatment:

  1. EMERGENCY - Cool immediately
  2. Immersion in cold water if possible
  3. Evacuate urgently

Dehydration

Signs: Dark urine, decreased urination, dry mouth, headache, fatigue

Treatment:

  1. Drink water with electrolytes
  2. Rest in shade
  3. Monitor urine color (should lighten)

Prevention: Drink before thirsty, 3-4 liters/day active

Blisters

Prevention:

  • Proper fitting footwear
  • Moisture-wicking socks
  • Address hot spots immediately

Treatment:

  1. Small blisters: Leave intact, pad around
  2. Large blisters: Drain with sterile needle, leave skin, apply antibiotic
  3. Keep clean and covered

Sprains/Strains

Treatment (RICE):

  • Rest - Stop activity
  • Ice - 20 minutes on, 20 off
  • Compression - Elastic bandage
  • Elevation - Above heart level

Evacuate if: Can’t bear weight, severe pain, deformity

Fractures

Signs: Pain, deformity, swelling, inability to use limb

Treatment:

  1. Immobilize joint above and below fracture
  2. Pad splint materials
  3. Check circulation before and after
  4. Treat for shock
  5. Evacuate

Improvised Splints: Sticks, trekking poles, rolled magazines, SAM splint

Wounds

Cleaning:

  1. Irrigate with clean water (lots of it)
  2. Remove debris
  3. Apply antibiotic if available
  4. Cover with sterile dressing

Closure:

  • Small cuts: Butterfly bandages or steri-strips
  • Large/gaping: Don’t close, pack and cover
  • Puncture wounds: Don’t close, monitor for infection

Infection Signs: Increasing pain, redness, swelling, pus, red streaks, fever

Evacuation Decisions

Immediate Evacuation Required

  • Unconsciousness or altered mental status
  • Difficulty breathing
  • Chest pain
  • Severe bleeding
  • Major fractures
  • Eye injuries
  • Severe allergic reactions
  • Signs of infection with fever

Can Wait/Delayed Evacuation

  • Minor cuts and scrapes
  • Small blisters
  • Mild sprains
  • Minor burns
  • Headache (without other symptoms)

Common Mistakes to Avoid

Mistake Consequence
Not assessing fully Miss life-threatening injuries
Ignoring shock Patient deteriorates
Poor wound cleaning Infection develops
Improper splinting Further injury
Not monitoring Changes missed

Required Tools Checklist

Essential

  • Comprehensive first aid kit
  • Emergency blanket
  • Elastic bandages
  • Adhesive bandages (various sizes)
  • Antiseptic wipes
  • Medical tape

Recommended

  • SAM splint
  • Tourniquet (with training)
  • Prescription medications
  • Wilderness First Aid certification

Sources

  • NOLS Wilderness Medicine
  • “Medicine for Mountaineering”
  • American Red Cross Wilderness First Aid
  • Stonehearth Open Learning Opportunities (SOLO)

:books: This is Guide #20 of the 90-Day Survival Guide Sprint.

Tags: first-aid, wilderness, medical, intermediate, emergency