Anatomy of an Appalachian Trail Thru-Hiker’s First Aid Kit

In addition to being the mom of a 2014 thru-hiker, I’m a registered nurse and EMT.  So I have given Sarah’s first aid kit a lot of thought.

The everyday blisters and foot sores can’t be avoided, of course.  Duct tape is the wrap of choice. She’ll carry moleskin as well. Fact is, nothing much can stick to wet skin.

As an EMT, bad stuff runs through my head when I think of  “First Aid.”  I do triage nursing for my job, so I tend to worry about the life-threatening or debilitating things. Plus, ok, I’m a mom, that’s how we roll.

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So here are the contents in order of importance or life-saving ability:

  • An Epi-Pen. She isn’t allergic to bees or wasps as far as I know, but I’m not sure she has ever been stung. No need to find out on the trail that she IS allergic with full-blown anaphylaxis. She’s an EMT too, so she knows how to use it on herself, or to save someone else’s life.
  • Loperamide, an over-the-counter anti-diarrheal.  Dehydration is life-threatening. It messes up your acid-base balance and can kill. Further, when you get dehydrated, you tend to get diarrhea, which makes you MORE dehydrated. So in case her water filter fails or she gets dehydrated from lack of water one day, and gets diarrhea, she’ll have a way to treat it.
  • Hand-warmers. Hypothermia is not pretty. If you see someone on the trail who is cold and who STOPS shivering, that person’s in trouble and hypothermic. Do everything you can to warm him or her up. You know the drill—remove wet clothes, wrap in dry ANYTHING, and huddle. Give warm (not hot) liquids.
  • Antibiotics. She’ll carry amoxicillin and Doxycline. Both are weapons against the most dangerous animal on the trail: the deer tick. Here’s my advice to her: If you find a tick on you and it has been there fewer than 24  hours, just remove it and walk on. It probably hasn’t  had the opportunity to transfer bacteria.  If the tick was there for more than 24 hours and you removed it less than four days ago, take 200 mg of Doxy at once and that will act as a deterrent to Lyme disease. If she gets symptoms of Lyme, she can take 200 mg a day for 10 days.  (If you explain to your doctor that you’re about to embark on a 6-month hike in the woods, you may be able to get a prescription for antibiotics too).  They’ll also work for an infected blister/sore, a scrape, or a urinary tract infection.
  • Sun screen and lip balm.  Call me crazy—these are important items to carry. You don’t need a lot, but when you are hiking in the sun (whether it is cold outside or hot), you need sunscreen.
  • Packets of antibiotic cream (like Bacitracin or Neosporin).  In addition to possibly warding off an infected scrape or blister, this stuff is mostly white petroleum jelly, so it is super slick. It can be applied liberally to hips that are rubbed raw by your pack belt, feet, thighs… She’ll carry Gold Bond or Desitin powder or miconzole (Did you know there is an anti-monkey butt cream & powder?)  for the dreaded monkey butt and to help stave off other yeastie beasties or a fungus like Athlete’s Foot.
  • Joshua Tree Climbing Salve. I have used this for years to rub on sores and to heal feet and hands demolished by rock climbing. It’s a healing salve of the highest order.
  • Band-Aids. Need I say more?
  • Ibuprofen. Good old Vitamin I. In addition to helping with sore joints, it can lower a fever.
  • Cold meds. I packed four nighttime cold tablets and four daytime tablets. The likelihood of getting a miserable cold while sleeping in close quarters with a bunch of other hikers is pretty high. Cold medicine doesn’t make it go away but makes you feel a little better while it is working its way out of your system.
  • Benadryl. When the mosquitoes strike—and they will—a Benadryl at night can help take the itch away. Ditto with Cortisone cream.
  • Pepto-Bismol. Cures about whatever ails you.

What have I left out? What’s in your First aid kit? Would love to hear from you.


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Comments 1

  • Cassie Gibson : Mar 25th

    I am about to start my NOBO solo journey and decided to see what I missed in my pack. I immediately called my GP for Doxy, wow great tip you’re so right. I’ve had not one but two tick diseases now. Thank you for taking the time to write a meaningful and useful AT thru hiking post!!!



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