Medical Planning

First Aid Kit Philosophy

Prevent problems before they stop mileage
Treat common injuries efficiently
Stabilize serious issues and walk to town
Resupply in towns—do not overcarry
Feet are the highest priority

Target weight: 3-6 oz

Kit Contents

Wound Care

Leukotape (wrapped around straw)
Alcohol wipes (2-4)
Non-stick gauze pads (2)
Medical tape
QuikClot or clotting gauze (1)
Neosporin or antibiotic ointment

Foot & Blister Management (Critical)

Pre-cut Leukotape strips
Sewing needle or safety pin
Benzoin tincture wipe
Anti-chafe stick or balm

Tape early. Do not wait for pain.

Medications

Ibuprofen (6-10 tablets)
Antihistamine (4 tablets)
Anti-diarrheal (4 tablets)
Personal prescription meds

Winter Add-Ons

Lip balm with SPF
Hand cream
Extra Leukotape
Chemical hand warmers (2)

Trail Medical Rules

Use Urgent Care For:

Sprains, strains
Cuts needing stitches
Infections
Dehydration
Respiratory issues

Dental Red Flags (Do Not Wait):

Swelling
Tooth fracture
Abscess
Persistent pain

Carry at All Times:

Temporary dental filling material
Dental wax
Ibuprofen + acetaminophen
Salt packets (warm salt rinses)
Photos of insurance cards and ID

🏥 INJURY PREVENTION & FIELD TREATMENT

Common Trail Injuries + How to Avoid Them

🦶 BLISTERS (Most Common Trail Injury)

Prevention:

✅ Properly fitted shoes (thumb's width at toe, snug heel)
✅ Change socks daily (or twice daily if wet)
✅ Air out feet during breaks (remove shoes + socks for 10 min)
✅ Trim toenails SHORT before hike (prevents toe blisters)
✅ Apply foot powder or BodyGlide to hot spots

Treatment (Drain vs Leave Intact):

Small blisters (<5mm): Leave intact, cover with blister bandage (Compeed/moleskin)
Large blisters (>5mm): Drain carefully
1. Clean with soap/water or sanitizer
2. Sterilize needle with lighter
3. Puncture at edge, drain fluid
4. Leave skin intact (it's natural bandage)
5. Cover with blister bandage
6. Change bandage daily, monitor for infection

When to Take a Zero:

Blisters on BOTH heels (can't walk without pain)
Signs of infection (red, hot, pus, increasing pain)
Blisters covering >30% of foot surface

🦵 KNEE PAIN (2nd Most Common)

Why You Have the Bauerfeind Brace:

Provides stability for downhill hiking (where knee injuries happen)
Hinged design prevents lateral movement
You already know your knee is vulnerable - respect it

Prevention:

✅ Use trekking poles (take 25% of impact off knees)
✅ Shorten stride on downhills (small steps = less impact)
✅ Sidestep steep downhills (switchback even when trail doesn't)
✅ Stretch IT band + quads during breaks
✅ Wear knee brace on long descents

When to Take a Nero/Zero:

Knee pain that doesn't improve with rest breaks
Swelling around kneecap
Pain that changes your gait (you start limping)
Pain on BOTH knees (overuse signal)

Red Flag - Bail to Town:

Can't bear weight on knee
Knee buckles or feels unstable
Severe swelling (knee noticeably larger)

🦶 ACHILLES TENDONITIS / HEEL PAIN

Prevention:

✅ Calf stretches every morning before hiking
✅ Proper shoe fit (not too tight around heel)
✅ Gradual mileage increase (don't jump from 10 → 20 mpd)
✅ Address it EARLY (don't "push through")

Treatment:

Ice during town stops (frozen water bottle on heel)
Ibuprofen (200-400mg, 2-3x daily with food)
Reduce mileage by 30% for 2-3 days
Loosen laces around ankle

When to Zero:

Pain that persists after 3 days of reduced mileage
Pain that worsens during rest (sign of tendon damage)

🩹 CUTS, SCRAPES, TRAIL RASH

Immediate Field Treatment:

Stop bleeding (pressure + elevation)
Clean wound (water + soap if available, or just water)
Apply antibiotic ointment if you have it
Cover with bandage
Change bandage daily

Watch For Infection:

Red streaks extending from wound
Increased pain after 24 hours
Pus or bad smell
Fever or chills

When to Bail to Town:

Signs of infection (above)
Deep cut that won't stop bleeding
Cut near joint that limits movement

🧊 HYPOTHERMIA (Winter-Specific Risk)

Early Signs (You Can Still Self-Rescue):

Shivering
Cold, pale skin
Confusion or poor decision-making
Slurred speech
Fumbling hands (can't work zippers/buckles)

Immediate Action:

STOP HIKING
Get out of wind (tent, shelter, behind rock)
Change into dry clothes
Get into sleeping bag
Drink warm liquids (hot water, soup)
Eat high-calorie food (your body needs fuel to warm up)

When Shivering Stops = EMERGENCY:

This means body is shutting down
Activate Garmin InReach SOS
Do NOT let person fall asleep
Skin-to-skin warming in sleeping bag if with others

Prevention:

Follow GO/NO-GO weather rules
Change out of wet clothes ASAP
Eat frequently in cold weather
Don't push through "I'll warm up when I move"

🌟 NERO vs ZERO: When to Rest

NERO (Near-Zero) - Half Day of Hiking:

Mild soreness but no specific pain
Mental fatigue but body feels okay
Hike 5-8 miles to next shelter/town, then rest

ZERO (Full Rest Day):

Specific injury that needs rest (knee pain, blister, etc.)
Extreme fatigue (can't get out of sleeping bag)
Sick (cold, stomach issues, etc.)
Scheduled town logistics (gear swap, major resupply)

PUSH THROUGH (Keep Hiking):

General soreness (normal for thru-hiking)
Good spirits, eating well, sleeping well
No specific pain points
Weather is favorable

The Rule:

Listen to pain, not discomfort.
Discomfort is normal. Pain is a warning.
If you're asking "should I take a zero?" - you probably should.