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What to pack in a medical kit for a wilderness trip is a large topic to tackle in the space of this column. Therefore, this article instead will focus primarily on five general principles to consider when assembling a medical kit, all beginning with "C":

Factors to Consider When Packing a Medical Kit

The type of medical kit that will accompany a wilderness trip depends on the type of trip, so each trip should have a kit customized for specific purposes. It is difficult to prepare for every circumstance, so a balance must be struck between not being properly equipped and having too many supplies that will not be used. Below are factors that should be considered when packing a medical kit for wilderness activities. (1,2)

  • Purpose of the trip
  • Destination
  • Length of trip
  • Participants’ medical conditions and age
  • Size of the party
  • Level of medical training of members of the group (e.g., WFA, EMT, Paramedic, MD, etc.)
  • Accessibility to contents of kit
  • Storage/stability of medications
  • Time for evacuation or medical rescue/distance from definitive care
  • Risk of loss or diversion (especially narcotics)
  • Replenishment from local sources (for longer expeditions)
  • Diagnostic equipment needed
  • Improvisation (e.g., can splints be fashioned from equipment on the trip such as skis, tent poles, etc.)
  • Bulk, weight, and cost of the kit

Image: http://ecx.images-amazon.com/images/I/91-Naq-gpxL._SY355_.jpg

Types of Medical Kits 

Personal Medical Kit 

All members of a wilderness trip should carry a personal medical kit, even though a larger kit may also accompany the group. It may contain the following: 

Adapted from (3).


The contents of a particular medical kit should be based on the factors discussed above. It is useful to arrange the contents of a medical kit by modules. Try to supply medications with multiple possible uses (e.g., diphenhydramine, epinephrine) and equipment that can be used for more than one purpose, to decrease weight and increase ease of use for multiple members of the group. 

(3) (4)


The following are general guidelines on the types of containers needed to house medical supplies for a wilderness trip, and how to pack them. There are many suppliers of medical kits; empty bags can be purchased and filled with supplies or a pre-made kit may be chosen, bearing in mind the latter may not exactly meet the needs of the trip. (1, 3)

  • Maximal accessibility; unroll or open for easy display
  • Sturdy and lightweight 
  • Easily identified (bright color/marked with reflective material/cross)
  • Dividable (if loss of equipment may occur, e.g., whitewater trip)
  • Able to protect drugs from environmental conditions such as impact, moisture, contamination, light (blister packs, amber containers)
  • Specialized pouches or ice packs and vacuum food/drink flasks for refrigerated drugs (insulin, snake antivenin)
  • Avoid liquids for oral administration to decrease weight and bulk
  • Drugs for parenteral administration preferably packaged in plastic versus glass
  • Label medications with storage/expiration date visible; include drug information (prescribing information, other drug reference)
  • Pack drugs for each medical condition together

The photo below illustrates an example of a comprehensive community kit, one that is suited for expeditions, the medically trained, and for dealing with recreational and environmental hazards. This one was created specifically for a Colorado River trip through the Grand Canyon. 

Photo taken by Nancy Pietroski, PharmD, FAWM; courtesy of Eric Bowman, MD, FACEP, FAWM


Members of a wilderness trip should be fully informed about the drugs, devices, and other equipment being carried, whether for a personal or group medical kit. Medical personnel should be aware of the medical history of the person to whom a drug or intervention is being administered. A medical history form should be filled out by everyone on a trip, and the person(s) responsible for the medical kit should be familiar with the completed form of every participant before the trip commences. (5)

It is also very important to be cognizant of the regulations of countries through which a group will be traveling while carrying medical supplies, especially narcotics. Useful information can be found through the International Narcotics Control Board.


Proper certification is required to administer certain medications, use specific equipment, and perform specific interventions in a wilderness environment. Therefore, no one should be able to access a community or expedition medical kit without the requisite credentials. Various certification levels recognized by all American states include:

  • Consumer (no medical or wilderness certification)
  • First Aid
  • Wilderness First Aid (WFA)
  • Emergency Medical Responder (EMR)
  • Emergency Medical Technician (EMT), Advanced EMT (AEMT)
  • Paramedic
  • Advanced practice registered nurse (APRN, including nurse practitioners), physician assistant (PA)
  • Physician (medical doctor [MD] or doctor of osteopathy [DO])

Consumers can make the decision to take medications from their personal medical kit. Although this varies by state in the U.S. (and countries outside the U.S. have their own regulations), if permitted by state law, a WFA, EMR, and EMT can generally assist with administration of certain prescription medications (for example, nitroglycerin, aspirin, epinephrine autoinjector; oxygen is more restricted), and OTC medications (such as oral glucose, antihistamines). Even when assistance is permitted by state law, it is generally limited to these medications. AEMTs, paramedics, APRNs, and PAs are permitted to administer a wider variety of medications and perform certain interventions that are not allowed for the preceding credentials. Physicians practice at the highest level and can prescribe and dispense/administer all medications (including all controlled drugs) and perform interventions based on their specific training/certification.


(1) Chapter 25. Wilderness Medical Kits. In: Forgey WW, ed. Wilderness Medical Society Practice Guidelines for Wilderness Emergency Care. 5th Ed. Guilford CT: The Globe Pequot Press, 2006: 114-117.

(2) Forgey WW. Chapter 3. Expedition Medical Kit. In: Bledsoe GH, Manyak MJ, Townes WA. Expedition & Wilderness Medicine. New York, New York: Cambridge University Press, 2009: 30-39.

(3) Lipnick MS, Lewin MR. Chapter 91. Wilderness Preparation, Equipment, and Medical Supplies (Chapter 102). In: Auerbach PS. Auerbach’s Wilderness Medicine. 7th Ed. Philadelphia, PA: Elsevier , Inc. 2017: 2272-2301.

(4) Forgey WW. The Expedition Medical Kit. Appendix. In: Bledsoe GH, Manyak MJ, Townes WA. Expedition & Wilderness Medicine. New York, New York: Cambridge University Press, 2009: 709-714.

(5) Forgey WW. Chapter 2. Assessing Expedition Medical Needs. In: Bledsoe GH, Manyak MJ, Townes WA. Expedition & Wilderness Medicine. New York, New York: Cambridge University Press, 2009: 19-29.

Iserson KV. Medical planning for extended remote expeditions. Wilderness & Environ Med 2013;23:366-377.

Hawkins SC, Simon RB, Beissinger JP, Simon D. Appendix A: First Aid Kit Contents for Mountain Travel, Appendix F: Recommended Medications for Mountain Travel. Vertical Aid: Essential Wilderness Medicine for Climbers, Trekkers, and Mountaineers. Burlington, VT: The Countryman Press, 2017.

Header image adapted from: https://www.sellesmedical.co.uk/store/product/3045-Relisport-Sports-Pitch-Side-First-Aid-Kit-in-Handy-Carry-Bag