Guide Skills: What’s in the Kit?

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By Trevor Husted

As part of our Guide Skills Development Series, this next post focuses on the essential items to include in your first aid kit if you are guiding an alpine climb.

Have you taken an opportunity to look into your med kit lately? Perhaps question why something is even in there or maybe restock those used gloves that you forgot to toss out after your last heroic medical incident? While the med kit is something that we consistently lug around as guides it would be great if it was used just for that. Unfortunately, accidents happen and in those instances all that time and effort we have put forth to assemble a bomber med kit proves to be either sufficient or perhaps a little rough around the edges. Needless to say, it is not rocket science and this blog post will address some key items to think about when determining what to put in your very own med kit.

According to a report published in the National Library of Medicine on climbing accidents* falls tended to be the leading cause of injury in alpine and rock climbing with extremities being the most frequently injured body part. Despite all of the hazards involved in mountain sports, accidents tend to be a rare occurrence – that doesn’t mean you shouldn’t be prepared.

Nick Bliss, guide and owner/educator at Bliss Wilderness, an organization specializing in Wilderness Education has managed to see nearly every kind of accident in his 25 years working in the medical field from a fire/ambulance EMT-P to working for Yosemite Search and Rescue (YOSAR) to guiding all around the world. In the backcountry he says the most common injuries tend to involve the lower legs, dehydration, thermal illnesses, or in colder environments, hypothermia. While we may have experience in dealing with these more common injuries, our kits need to be built taking into consideration a larger scale potentially more serious injury. In regards to this Bliss points out that trauma and exposure are the incidents that will be the most serious and/or life threatening.

Bliss also says that while assembling a med kit it is important to create a kit based on the type of the activity you are guiding or participating in; for example, a med kit for mountain biking may look a little different than what you include in your alpine med kit. Also, you may need to create something a little beefier depending on the number of people involved in the trip or expedition, as well as the distance/time away from medical help.

It goes without saying that good preparation is key but so is good education. Bliss encourages guides to refresh their skills as often as they can and to keep in mind that if you don’t use it, you may lose it. Below Bliss puts together what he keeps in his standard guide med kit.

**Medical Disclaimer it is important to understand that the content in this blog is for informational or educational purposes only, and does not substitute professional medical advice or consultations with healthcare professionals.**

Sample Alpine Guide Skills Med Kit:

  • NUMask – CPR mask standard
  • Triangular Bandages (x2)- can be used as a sling and swathe or field tourniquet
  • EpiPen – Bliss says it’s a good item for guides to carry in their kit and falls under the SOP as a WFR. “In a situation with true anaphylaxis an antihistamine like Benadryl will not work quickly enough. Protocol states as a WFR we can ONLY assist with the administration of the epi,” he says.
  • Ace Bandage (6 inch) – creates more coverage and is dynamic: it stretches and it works well as a pressure dressing for bleeding control
  • SAM SPLINT (36 inch) – lightweight, flexible, and clutch for support with a fracture or injured limb
  • Syringe (10cc w/out needles) – high pressure for helping to clean out wounds
  • Trauma Shears – key for safely cutting clothing
  • Saline Solution – can be beneficial for eye care/wash
  • Blister Tape – can take the place of moleskin, blister pads, and duct tape
  • Disposable Medical Gloves (x2)


  • 4×4 Gauze Pads
  • Large and Small Band-Aids
  • Gauze Roll
  • Steri-strips
  • Combat Application Tourniquet (CAT) – While many guides may not include this in their kit, Bliss says that in dealing with a cut artery it could be less than 5 minutes until the person bleeds out and you need to be fast and not trying to put something together last minute
  • Alocane – Emergency burn Gel
  • Benzoin tincture – Bandage adhesive
  • Combat Gauze – utilizes the clotting properties of kaolin to help stop and control bleeding.Medication
  • Benedryl (Diphenhydramine) – Antihistamine – can be used for allergies and also to help with sleep
  • Ibruprofen (Nonsteroidal anti-inflammatory drug (NSAID)) – anti-inflammatory, pain
  • Tylenol (Acetaminophen) – Pain, fever
  • Loperamide (Antidiarrheal)

*Rauch S, Wallner B, Ströhle M, Dal Cappello T, Brodmann Maeder M. Climbing Accidents-Prospective Data Analysis from the International Alpine Trauma Registry and Systematic Review of the Literature. Int J Environ Res Public Health. 2019;17(1):203. Published 2019 Dec 27. doi:10.3390/ijerph17010203


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