Disclaimer: I am not a doctor, any advice given here is my personal opinion.

Don’t you dare go for a long-distance trek without a first aid kit. It’s fascinating how much potentially life-saving stuff you can pack in a bag just bigger than your fist. I’ve seen both minimalist 1st aid kits and hysterical ones filled to the brim with all kinds of meds you’ll probably never need. The golden ratio is what we’re aiming for here. I’ve experimented a little over the years, taking more blister related items and cutting down on wild amounts of gauze. The one thing I don’t have is some sort of brace for broken legs – I figure that’s what my Personal Locator Beacon is for. I also receive extensive 1st aid training annually by the Red Cross at my summer job as a horse trekking guide. That’s a tip right there: don’t take stuff you don’t know how to use. Don’t buy ready made kits and assume it has everything you need, be vigilant about which items to take and do your own research. Plenty of outdoor clubs and mountain safety councils give 1st aid courses, I would highly recommend doing one to get some practical experience. Here’s what I take in my kit!

Cheese grated leg after three days in the tussocked Two Thumb Range

Famous encounter with fallen log in the Nelson Lakes

Triangular Bandage

This is an ingenious item. You can use it to secure arm and shoulder injuries, bandage heads, roll it into a doughnut to protect broken skin pierced by branches etc. This is definitely an item you need some practice on before using, so spend a few minutes learning good techniques.

Gauze

Just one roll with a sterile pad attached. To use for bleeding areas too big to be fixed by smaller Band Aids.

Band Aids/hydrogel pads

Normal small ones for minor scrapes + a couple of large ones for bigger surface scrapes. I’ve also used these to prevent skin from breaking under constant pressure, such as on my hips and collar bones – which protruded ever more sharply on the John Muir Trail.

Alcohol swabs

You gotta sterilise broken skin injuries before you dress them to prevent dirt and bacteria causing infections. Some people also carry small tubes of antiseptic cream for this purpose. I only used that on the West Highland Way when I had terrible, fleshy blisters.

As a horse trekking guide at Venabu Fjellhotell I receive annual 1st Aid training by the Red Cross

Immodium

Those yummy anti-diarrhoea pills. They’re pretty punchy, so be careful not to overuse. I started my Te Araroa trek coming off a bout of gastro, so having these were kinda nice. Also, if you mess up you water filtration system and contract giardia, these can get you through to the nearest town.

Ibuprofen

Known as Vitamin I in the hiker world. I’ve met hikers who’ve consumed crazy amounts of these preventatively for joint pain etc. Don’t do that. I’m all for taking painkillers when you need them, but munching even low-scale drugs for no real reason isn’t a great idea. Ibuprofen (Advil) is preferred over alternatives like Paracetamol due to its anti-inflammatory qualities, so they work better if you bust a knee or experience swelling somewhere. Stay away if you are prone to stomach ulcers.

Nail clipper & small scissors

Not much use to have any kind of gauze or tape if you can’t cut it, right? Also, having a pair of scissors can be super handy if you’re repairing gear or struggling with plastic food packaging. A small nail clipper is in my opinion much more precise than nail scissors, and you want to keep your feet happy. Make a general effort to keep your feet clean to avoid sweat build-up, blisters and small sores.

Antibiotics

Before you freak out: this is highly optional. The only reason I carry them (9 pills weighing hardly a gram) is because I sometimes get random urinary tract infections (UTIs). True, I’ve never had one on a trek, and if you drink a sh*t ton of water you can technically flush them out without meds – but I just prefer to be on the safe side. IMPORTANT: do not take antibiotics for symptoms you cannot identify! Antibiotic resistance is a major global health threat, and you should always use them with care. They don’t work for colds or any kinds of viruses, so reserve them for cases where you are competent to self-medicate.

Pack pressure bruises are very common at the start of a trek

Compeed & Hapla Band

How did people deal with blisters and hotspots before Compeed? These wonderful things are blister pads that protect the skin, drain fluid and cushion. They are amazing. Get them. As with all blister treatment: prevention is key. If I’m wearing shoes I know give me hotspots in certain places, I stick on some before I start walking. They come in several sizes to fit your heel, the underside of your foot, toes, everywhere. They can be really expensive in Scandinavia, but I’ve seen them on sale in the UK for just over 3£, I always stock up! Don’t worry if you see white lumps forming underneath the surface after you’ve worn them for a bit. It’s just fluid draining from your blister.

Hapla Band is a soft, thin ultramarathon tape. I ordered a 10m roll back in 2016 and am nowhere near running out. It’s a cheap alternative to Compeed if you want to wrap an entire toe of if you’re less prone to blisters and just need minimal skin protection. It comes off after a while, but does reasonably well with sweat and friction over a day or two.

Stuff I don’t carry that you may want:

Tweezers for pulling out splinters and debris from wounds
Allergy pills and any other meds you take regularly (obviously)
Athletic tape like Leukotape to aid sprains etc, something a bit more sturdy than Hapla Band