Beyond The Basics: The Outdoor Medical Series

Selecting the Right Medical Kit For Your Outdoor Adventures

By Ty Jewell MBE

Whether you're deep in the wilderness, high on a craggy ridge, navigating remote trails, or simply out walking the dog, or with your family, your medical kit is more than a safety net, it's your lifeline.

Yet far too often, outdoor enthusiasts either carry too little or too much, rely on the wrong “off-the-shelf” kit, or stash medical supplies in a poorly organised pouch that’s difficult to access when time matters most.

The ability to select the correct medical kit for your needs is a discipline rarely taught or even discussed. This isn’t about ticking a box, it’s about tailoring your kit to your activity, group, and environment. Or, at a minimum, creating a reliable, generic kit that actually works for you, for every eventuality.

Whether you’re a weekend hiker, a multi-pitch climber, a paddler heading into remote backwaters, or an expedition leader, just like your boots, tent, or water filter, your first aid and medical kit should be considered essential. Not optional. Every time.

Here’s the start of this series of articles that dissects all of the necessary elements of a medical kit’s contents, and the case utilised to carry it. We will explore how to ensure you’ve got the right gear, in the right size, in the right place, for the right people, when it counts.

So What’s The Need To Carry A Medical kit? The Lethal Triad of Trauma

What every trip, journey, expedition or remote medic should know.

When the emergency services or support can be delayed due to environment, distance or availability, in serious trauma, especially with major bleeding , the body can quickly fall into a deadly cycle called the lethal triad. This includes:

Hypothermia – The Body Gets Too Cold

• Blood loss, shock, wet clothes, wind, and cold air all drop the body’s core temperature.

• Even a small drop in body temp affects how blood clots. Why it matters:

Cold = slower clotting = more bleeding = more cold.

Acidosis – Blood Becomes Too Acidic

• When the body doesn’t get enough oxygen (due to blood loss), it makes lactic acid.

• This acid builds up in the blood and makes things worse.Why it matters:Acidic blood damages organs, weakens the heart, and stops clotting from working properly.

  
  

Coagulopathy – Can’t Stop the Bleeding

• The blood’s natural ability to clot will break down.

• This happens faster if the person is cold, acidic, or has had a lot of fluids without clotting

  factors.

  
  

Why it matters:

• Without clots, bleeding keeps going, internally or externally, and the situation spirals fast.

  
  

The Vicious Triad Cycle

• Each part of the triad makes the others worse:

• Blood loss → Cold → Can’t clot

• Blood loss → Poor oxygen → Acid builds up

• Acid + Cold → Clotting fails → More bleeding This will lead to shock, organ failure, and death.

This will lead to shock, a life-threatening condition where the body isn’t getting enough blood flow, meaning vital organs like the brain, heart, and kidneys don’t get enough oxygen and nutrients to function properly. This lack of perfusion, if not treated quickly, it can lead to organ failure and death.

The Size of the Problem: Kit Volume vs Kit Value

Medical kits should reflect your trip's duration, remoteness, risk level, and group size and demographic.

• Overpacking adds bulk, slows access, and may tempt you to leave the kit behind. This can also lead to it being difficult to close again if opened.

  
  

• Under-packing leaves you dangerously underprepared and exposed.

Examples:

• Solo or short hikes (1–2 people, <1 day): For solo or short hikes a small personal kit can suffice. This might fit in a belt pouch, top flap or side pocket. This includes essentials as more support or people are close.

• Group day trips (3–6 people, 1 day): Medium kits for group day hikes, paddling trips, or climbing days. Include additional items to allow for more remote locations, more people and further from support or restock.

• Multi-day or remote expeditions (6+ people, 1+ days/nights): This will require a more and the most comprehensive kit. Support is hours or days away, restock is unlikely or difficult and your population at risk is increased or more specific.

  
  

Choose by Activity: Match Kit to Risk

There’s no one-size-fits-all when it comes to small kits. Tailor your kit to the risks. Here’s a few, subtle differences that can help save space and make your kit specific to your needs.

Breakdowns:

• Hiking/Trekking: Foot and blister care, insect repellent, antihistamines, tick remover/tweezers, blanket.

• Climbing/Mountaineering: Finger tap, hand care, a case attachable to a belt or rope, shelter.

• Canoeing/Kayaking: Waterproof carrier, carrier that floats, rehydration salts, blister care that fits hands, blanket.

• Ski Touring/Snow: Cold-resistant storage, hand warmers, shelter, heated blanket.

• Vehicle-based Expeditions: These can allow for more extensive kits since they don’t need to be carried on person. This makes space for blankets, splints, and shelter items suitable for larger groups

Every trip, activity and population risk needs its own and individual assessment in order to ensure specifications fit. In a similar way that climbing activities have differences to kayaking ones, not all climbing activities are the same.

Individual Item Matter: The Right Tools For The Job

“In an emergency, you don’t rise to the level of your expectations, you fall to the level of your training and equipment.”

This quote emphasises that preparation and practice are more crucial than your aspirations when facing pressure or challenges. If pre-hospital medicine isn’t your normal field of operations, in a medical emergency your fine motor skills can suffer, visibility can be low, and adrenaline clouds thinking.

Always consider and allow for human factors and do everything you can to increase and enable your own bandwidth. Selecting appropriate items is key.

Don’t fill empty space just for the sake of it or cram in gear you won’t know how to

use. Be deliberate, preparation can make the difference.

• Scissors: Small or folding trauma shears might save space and weight but make sure they still cut fast and clean, and you can use them when it’s all going wrong.

• Dressings: Wide trauma dressings (e.g. 10cm Israeli) offer better compression, insulation and coverage than thin gauze.

• Splints: Rolled SAM splints are space-saving and versatile. Your imagination is your only limit with these pieces of kit.

• Gloves: Carry multiple pairs that actually fit. Ill-fitting gloves waste time and space. Potentially purchase some better quality pairs that don’t break on every rubble surface you touch.

Repackaging items in labelled ziplocks or vacuum-sealed bundles can reduce weight and increases accessibility.

Human Factors & Bandwidth in Medical Situations

When something medical goes wrong in the field, on a journey, or even at home, it’s not just your gear or training that matters. Human factors play a big role too.

These include:

• Stress

• Fatigue

• Fear

• Distraction

• Team dynamics

• Poor communication

All of these can affect how you think, react, and make decisions.

Your brain only has so much space to handle tasks under pressure, this is called bandwidth. In a crisis, your mental bandwidth shrinks, making it harder to:

• Think clearly

• Follow steps

• Remember what to do

• Notice key details

  
  

Why It Matters

• Even simple medical tasks can feel overwhelming when you’re cold, scared, or under time pressure. Mistakes happen more easily, not because people aren’t smart or capable, but because humans are human.

  
  

What Helps

• Keep things simple: Use checklists, lay gear out clearly, know your gear and be practiced with your gear.

• Work as a team: Speak up, assign clear roles and leaders (good followership is just as important as good leadership)

• Slow down to go fast: Take a breath, prioritise safety

• Complete pre-task briefs

• Practice ahead of time: Skills fade in stress if they’re not second nature

  
  

Bottom Line

In an emergency, your brain can get overloaded. Planning, teamwork, a medical kit that has been made deliberately to support you and keeping it simple can help you perform better, even when it’s all going wrong.

Personal vs Shared: Who’s Your Kit For?

One of the most overlooked aspects of medical kit selection is who you're intending to treat. Is this a personal kit for solo use, or are you carrying gear that may be used on others, family friends, clients, or strangers?

Personal Kits: Specific, lean, and familiar.

A kit designed just for you can be leaner, more specific, and tuned to your personal needs. You likely know your own allergies, medications, and thresholds for discomfort so you can strip out what you won't use and double down on what you will. Key considerations:

• Include your own prescription meds (in waterproof containers).

• You can pack items you are trained and confident using.

• Account for allergies, chronic conditions, and worst-case scenarios.

• Add ID, allergy info, and emergency contacts in case you're unconscious and a stranger finds/uses your kit.

• Ensure someone else could use your kit on you in the worse case scenario. make sure it is clearly labelled, accessible, and intuitive.

  
  

With a personal-use kit, space and weight are easier to manage. But you'll want to be absolutely sure you've accounted for self-care in worst-case scenarios, including an injury to your dominant hand or the need to signal for help.

Shared/Group Kits: Robust

If you're leading a group or expect to treat others, even informally, your kit should be more robust, allow for redundancy, and flexible. This includes:

• Extra common items such as gloves, plasters, painkillers.

• A range of sizes of items to allow for different people’s shapes, sizes and ages.

• Broader medication spectrum (with appropriate training).

• Include documentation (especially for professional roles).

• Build capacity for serious trauma, multiple injuries, or environmental exposure.

You should assume that not everyone will tell you about pre-existing conditions upfront. It's wise to build a "worst-case" buffer into shared kits: enough gear for at least one significant trauma, two simultaneous moderate injuries, or a group-wide issue like food poisoning or environmental exposure.

In group scenarios, you’re packing not just for treatment, but for confidence and decision- making under pressure.

The Carriage Itself: Build on a Good Foundation

Your medical gear is only as good as your ability to access and protect it. Invest in a purpose- built pouch, bag or box, preferably with.

What are we looking for:

• Waterproof/water-resistant fabrics (PVC, Cordura). Is wipe clean material necessary?

• Colour-coded compartments or clear labels.

• MOLLE compatibility or secure attachment options.

• Reflective or high-visibility markings.

• Bright internal linings (red/orange).

Avoid basic stuff sacks. Under pressure, rummaging through an unlabelled black pouch can cost lives. Roll-outs, clamshell zips, and hard-shell mini cases offer superior organisation.

Empty space isn't the enemy, always consider empty space, this can be used for multiple advantages such as assisting carriage with casualty belongings, gear separation and emergency improvisation.

Cost Considerations: Budget Smart, Not Bare

Quality medical gear isn't always cheap, but that doesn't mean you need a hospital in your backpack, but don’t go bargain-basement either.

• Entry level personal kits (Basic contents): £25–50

• Customised mid-range kits (group or extended day use): £75-150, including branded trauma dressings, quality tape, splints, and medications.

• Professional kits for expedition use or professional responders: £200-400+ depending on advanced equipment and medications.

The temptation to go for pre-packed kits is understandable, but many commercial options can be padded with low-value items or lack the essentials for outdoor scenarios.

Build your own or modify a base kit to suit your environment and knowledge. Remember, if doing this professionally, always check insurance and the level and that you are covered to operate. This can depend on scope of practice and legal access.

Off-the-Shelf Kits: The Good, The Bad, and the Realities

There's no denying the appeal of ready-made first aid kits. They're neatly packaged, often CE- marked, and marketed as "adventure-ready" or "compliant". Some ready made kits are good, some not so good. But this all depends on the use and user.

Off-the-shelf kits are often built to meet generic specifications, not your personal or specific needs.

They often aim to satisfy workplace regulations (like BS 8599-1 in the UK), basic home use, or general-purpose outdoor activity. While this makes them easy to purchase, it can make them frustratingly unsuitable in practice.

The Good

• Convenient for beginners.

• Often a solid base to customise.

• Durable packaging and some decent items.

The Bad

• Often low-quality gear (tiny scissors, too many plasters).

• Poor trauma readiness, often lacking decent bleed control such as haemostatic packing and other decent trauma care items.

• Medication usually excluded.

• Rarely activity or risk-specific.

  
  

Nonetheless, these can be a great to treat as a foundation, not a finished product. Strip it down, replace what doesn't serve your environment or experience level, and add in the equipment that's right for you, your team, and your terrain. With a little customisation, a basic kit can become a trusted tool.

But it won't get there on its own.

When Off-the-Shelf Kits Are Worth It

Some, especially those developed by specialist companies, rescue teams, or medical/outdoor specialists and professionals, are the product of real-world experience and extensive research. These kits are often field-tested in demanding environments and refined based on feedback from medics, mountain leaders, and expedition teams.

Trusted providers are companies such as MERE or LifeSystems. Both have researched, tested and dependable off-the-shelf packs, but also allow different levels of personalisations and restocking.

You'll find thoughtfully curated contents in these higher-tier kits, including:

• Activity-specific tools.

• High-quality materials.

• Smart organisation for quick access.

• Gear aligned to real-world medical and rescue guidelines.

  
  

Brands that research with wilderness/adventure medical societies and guidelines, military medics, or Search and Rescue teams often produce excellent kits that are more than just convenient, they're credible. While they may come at a higher price point, they can save time, research, and repacking effort, especially for those newer to building their own systems or working in semi-professional environments.

Just remember: even the best pre-built kits should be reviewed and adapted to your specific trip, knowledge level, population at risk and destination.

Know How to Use It: Confidence and Competence

Gear alone is not enough. Take real training from qualified, relevant providers.

Consider a decent and credible medical course or trauma response training, from a credible and registered provider. Ideally align this with your adventure type (climbing, water sports, mountaineering).

Like some off-the-shelf medical kits, off-the-shelf medical courses such as First Aid At Work are seldom sufficient for these activities. It's no use carrying a tourniquet if you don't know when, where, or how to apply it. It is a good idea to research a training provider with practical experience in these fields as it will allow first hand top tips and real experience from practitioners in extreme environments that can't be taught by most hospital, ambulance, event based generic instructors.

Even simple improvisation with non-medical equipment or wound cleaning techniques can be the difference between a self rescue and a helicopter evacuation.

What Can all of This do To Support The Fight With The Lethal Triad

Control bleeding early

• Use tourniquets, pressure, haemostatic dressings, trauma dressing and improvisation.

Keep the casualty warm

• Get them off the ground

• Use bivvy bags, foil blankets, hot water bottles, body heat

• Cover the head, chest, and neck – where most heat is lost

• It’s easier to keep someone warm who has body heat. It is difficult to create warmth for someone without.

Evacuate early

• Time matters. Get them to a place with surgical or advanced care quickly

Final Thoughts: Preparedness is Power

Every adventure carries inherent risks. Being ready doesn't just protect your own safety, it can allow you to help teammates, fellow adventurers, or even strangers you encounter along the trail.

The right medical kit won't guarantee a perfect outcome, but it does increase your options. Build it carefully. Pack it intentionally. Train with it regularly. Then stash it accessibly and hope you never need it.

Build it smart. Pack it with purpose. Train with it often.


Because out there, far from help, your kit isn’t just gear. It’s your edge.

Looking Ahead: What’s Actually in the Bag, Why and What’s Its Purpose?

Choosing the right size and structure of medical kit is only the start of the story.

In the next section of this series, we'll dive deep into the specific components that make up an effective outdoor medical kit and just as crucial, why it's there.

We'll break down:

• Must haves

• Nice-to-haves

• Items that are often included but rarely useful

• Items that are rarely included that are useful

• Must have information and techniques for improvisations (Medical kit utilisation for non- medical tasks - Non-medical kit/equipment utilisation for medical tasks)

• You'll also get detailed comparisons between pre-built commercial kits and custom builds, from budget-friendly setups to professional-grade expedition packs.

• Animal care

• How much does your family know about your medical kit. Discussions with children, friends and family.

• Public access bleed kits, what’s in them and where to find them

  
  

Whether you're building your first kit from scratch or refining one you've carried for years, this upcoming guide will give you the clarity and confidence to ensure your kit is more than just a box of plasters. It will be a reliable, tested, mission-ready part of your adventure carriage that you are both confident and competent in utilising.

About the Author

Ty Jewell MBE


MCPara | DipSR | GInstr | ESEEM | MAEEM | IMM

Ty Jewell MBE is a Specialist - Advanced Paramedic with a focus on Austere and Specialist Rescue and pre-hospital medicine. With over 16 years of distinguished service in the British Army, much of it spent on operations globally with elite and specialist units around the globe,

Ty brings a unique blend of operational experience, research, medical innovation, and strategic leadership to every environment he works in.

His career has seen him operate and command as a Solo Paramedic, within multidisciplinary and multinational teams, and as Medical Director and Clinical Lead for some of the most extended evacuation timelines seen in modern military operations. His final military appointment was as the Chief Army Paramedic, a national level advisory role responsible for shaping the future of pre-hospital care across UK Defence and NATO.

Ty is a highly decorated clinician, specialist operator and operational leader, having received the Member of the Most Excellent Order of the British Empire (MBE) in Her Majesty's New Year’s Honours List for life-saving innovation, medicine in operations and development of medical protocols now used globally. His work spans frontline trauma care, strategy, clinical governance, education, political protection, and specialist rescue, while also advising government, emergency services, and international agencies on risk, capability, and command.

Ty continues to maintain his operational currency and clinical credibility across a wide spectrum of environments. He is actively engaged in pre-hospital and critical care research, regularly works within the NHS and HEMS (Helicopter Emergency Medical Services), and serves in various command, advisory, and clinical roles for counter-terrorism units, TV and film production teams, elite rescue services, and hostile environment consultancy. He is also the key medical Director for UKRO (United Kingdom Rescue Organistation), production Hostile Environment Training, and numerous specialist response organisations.

As a Founding Director of The Soteria Group, Ty leads a world-class provider of rescue, medical and specialist training, operations research, and consultation. With a dynamic faculty of highly qualified, operationally active instructors and clinicians, The Soteria Group delivers bespoke, high-fidelity, immersive training and real-world operational support, both in the UK and internationally. From blue light response teams and clinical oversight, policy development, specialist - advanced instruction and mentorship, and medical direction in austere environments. The Soteria Group is setting new international standards in rescue and medical capability. The company's ethos is simple yet powerful:

Comprehensive RESEARCH leading confident, safe and effective RESCUE, creating results and RESILIENCE.

Ty holds membership with the Faculty of Pre-Hospital Care (Royal College of Surgeons Edinburgh), UKRO (Medical Director – Rope Rescue), the Austere and Extreme Environment Medicine Faculty, and is a Graduate Member of the Institute of Search and Technical Rescue. He is also an area representative for the College of Paramedics.

A passionate BASE jumper, surfer, climber, and motorcyclist, Ty combines physical resilience with an insatiable drive to teach, learn, and lead. His interests in crew resource management, human factors, and remote medicine keep him at the cutting edge of pre-hospital care. As a clinician, instructor, strategist, and operator, Ty Jewell continues to push the boundaries of pre-hospital medicine and specialist rescue excellence, developing capabilities, and empowering teams wherever he goes.