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Last summer I was hiking with a group on a steep mountain trail when someone ahead took a bad fall and tumbled several feet down a rocky slope. He was bleeding heavily from a deep laceration on his forearm. The group froze for a moment. I had done a wilderness first aid course the previous spring. My hands moved before my brain fully processed what I was doing — direct pressure, tourniquet from my pack, keeping him still while someone called for help. My training had compressed into muscle memory. The tourniquet stopped the bleeding. The rescue went well.
That moment was worth every hour I spent in training. These are the 10 first aid skills that belong in every prepper’s foundation.
Controlling Severe Bleeding With a Tourniquet
Severe arterial bleeding can be fatal within 3 to 5 minutes. The priority is stopping blood loss immediately. Apply direct pressure first with a gloved hand and a clean cloth or gauze. If direct pressure does not control the bleeding from a limb injury within 60 seconds, apply a tourniquet.
Position the tourniquet 2 to 3 inches above the wound, not over a joint. Tighten until bleeding stops. Note the time of application — write it on the person’s skin with a marker if available. Do not remove once applied in the field. For detailed technique, the Stop Severe Bleeding Tourniquets guide covers application step-by-step.
Treating Shock
Shock is a life-threatening condition where inadequate blood flow fails to deliver enough oxygen to tissues. Symptoms include rapid shallow breathing, pale or ashen skin, confusion, rapid weak pulse, and cold clammy skin.
Lay the person flat. Elevate the legs about 12 inches unless there is a suspected spinal injury or leg fracture. Keep them warm with a blanket — hypothermia accelerates shock. Do not give food or water. Monitor and reassure. Call 911.
Wound Cleaning and Dressing
Infection is a major risk with any wound, especially in field conditions. Clean wounds under running clean water — ideally for several minutes to flush debris. Avoid hydrogen peroxide or iodine for wound irrigation as both damage healing tissue. Use saline solution if available.
Apply a thin layer of antibiotic ointment, then cover with sterile gauze and secure with medical tape. Change dressings daily or whenever they become wet or dirty. Watch for signs of infection: increasing redness, warmth, swelling, pus, or streaking red lines radiating from the wound.
Burn Assessment and Treatment
Assess burns by degree:
- First degree: Red, painful, no blisters (sunburn-level). Cool with running water 10-20 minutes. Cover loosely.
- Second degree: Blistering, intense pain. Cool with water. Do not pop blisters. Cover loosely and seek medical care.
- Third degree: Charred or white skin, numbness. Emergency. Do not cool. Cover loosely with a dry sterile dressing and call 911.
Never apply ice, butter, or toothpaste to any burn.
Recognizing and Treating Hypothermia
Hypothermia occurs when core body temperature drops below 95°F. Early signs: shivering, confusion, slurred speech, clumsiness. Severe hypothermia: shivering stops (paradoxically), severe confusion or unconsciousness.
Move the person out of cold and wind. Remove wet clothing. Insulate with dry blankets starting from the core outward. Add gentle heat sources (body heat, warm water bottles to armpits and groin). Do not rub or massage cold extremities — this can push cold blood toward the core. In the First Aid Guide, the hypothermia section covers both mild and severe presentations with specific rewarming protocols.
CPR and Hands-Only CPR
If a person is unresponsive and not breathing normally, start CPR. Call 911 first, or have someone else call while you begin.
For adults: push hard and fast in the center of the chest (compress at least 2 inches deep) at a rate of 100 to 120 compressions per minute. Allow the chest to fully recoil between compressions. Hands-only CPR (compressions without rescue breaths) is effective for adult cardiac arrest and preferable if you are not trained in rescue breathing. Continue until emergency services take over.
Pro Tip
Take a formal first aid and CPR certification course from the American Red Cross or American Heart Association. Reading about CPR is not the same as doing chest compressions on a training mannequin until the technique is automatic. Certification courses also include hands-on scenarios that build the response muscle memory that matters under stress. Recertify every two years.
Improvised Splinting for Sprains and Fractures
Suspected fractures and severe sprains need immobilization before any movement. In the field, improvise splints using rigid materials — straight sticks, rolled sleeping pads, tent poles — padded with clothing and secured with bandages, strips of clothing, or cordage.
The splint should immobilize the joint above and below the injury. It should be snug but not tight enough to cut off circulation — check fingers or toes for sensation and pulse periodically. Elevate if possible.
Recognizing Stroke Symptoms: FAST
Every minute of untreated stroke causes approximately 1.9 million brain cells to die. The FAST acronym guides rapid recognition:
- F — Face: Ask the person to smile. Is one side drooping?
- A — Arms: Ask them to raise both arms. Does one drift downward?
- S — Speech: Ask them to repeat a simple phrase. Is speech slurred or strange?
- T — Time: If any of the above, call 911 immediately.
Do not wait for symptoms to improve. Time to treatment is everything with stroke.
Anaphylaxis and Epinephrine
Severe allergic reactions can close the airway within minutes. Signs of anaphylaxis: hives, swelling of lips/tongue/throat, rapid heartbeat, wheezing, drop in blood pressure, pale or bluish skin.
If the person has a prescribed epinephrine auto-injector (EpiPen), use it immediately — outer thigh, through clothing if necessary. Call 911 even if epinephrine improves symptoms. Effects can wear off and a second anaphylactic wave can occur. Keep the person lying down with legs elevated.
Heat Exhaustion vs Heat Stroke
Heat exhaustion: heavy sweating, weakness, cool pale clammy skin, fast weak pulse, nausea, muscle cramps. Move to a cool place, loosen clothing, apply cool cloths, give water if conscious. Symptoms should improve within 30 minutes.
Heat stroke: no sweating (hot dry skin), confusion, high body temperature (above 104°F), possible unconsciousness. This is a medical emergency. Call 911 immediately. Rapidly cool the person by any means available — ice water immersion is most effective, or ice packs to neck, armpits, and groin, fan with wet skin.
The First Aid Guide has scenario-specific protocols for all ten of these situations. And for extended wilderness care when emergency services are hours away, the Wilderness First Aid Complete Guide covers long-duration patient management in detail.
These skills take training to do correctly. Read this article. Then take the course.