By a High-Altitude Mountaineering & Wilderness Survival Expert – 20+ Years in the Field
Introduction: When You Have Nothing But Knowledge
On a remote glacier at 5,200 meters, a teammate of mine slipped into a crevasse. He survived, but his arm was broken. We had run out of splints two days earlier. What saved him wasn’t a kit — it was skill.
In wild terrain — be it jungle, high alpine, or desert — gear fails, gets lost, or runs out. When that happens, your most powerful tool is your improvisation skills.
This guide will teach you how to treat bleeding, fractures, burns, hypothermia, sprains, and more — with what nature or your pack offers.
1. The First Rule: Don’t Panic, Prioritize
Before touching the wound or person, follow the wilderness triage sequence:
🔺 DRSABCD (Modified for Wilderness)
- D: Danger — Check surroundings: rocks, falling ice, animals.
- R: Response — Is the person conscious?
- S: Send for help — Use radio, satellite phone, or signal fire.
- A: Airway
- B: Breathing
- C: Circulation — Control bleeding immediately.
- D: Disability — Check for spinal or head trauma.
Time is your enemy. But poor decisions cost more than time. Stay calm, assess clearly.
2. Stopping Bleeding Without a Kit
🩸 Technique: Direct Pressure & Elevation
- Use: Shirt, neck gaiter, bandana, even moss or clean snow in emergencies.
- Press hard for 5–10 minutes.
- Elevate the wound above heart level, if possible.
🧦 Improvised Pressure Dressing
- Clean cloth + sock/strap = secure wrap
- Twist a stick into a knot to increase pressure if needed (only if bleeding is severe — not for every case)
❗ Caution: Avoid tourniquets unless:
- Arterial bleeding is life-threatening
- You’re hours from help
- You know what you’re doing (and mark the time applied)
3. Treating Fractures and Sprains with What’s Around
🦴 Improvised Splints
- Use: Trekking poles, tent poles, branches, ice axe handles
- Wrap with: shirt sleeves, shoelaces, bandages, climbing slings
Technique:
- Immobilize above and below the injured joint.
- Add padding using socks or spare clothes.
- Never overly tighten – you must maintain circulation.
🦶 Ankle Injuries
- Fill a boot with cloth or moss for support.
- Bind to the opposite leg using straps or rope to create a natural crutch.
- For walking: a stick or ski pole becomes a cane.
4. Burns, Blisters, and Wound Cleaning
🔥 Burns (From Stove, Fire, Sun)
- Cool it immediately: stream, snow, cool wet cloth for at least 10 minutes
- Don’t pop blisters
- Aloe vera from natural sources can soothe minor burns (if you’re in tropical areas)
Cover burn with clean cloth — a buff or bandana soaked in boiled water (then cooled) works well.
🥾 Blisters
- Use duct tape (a climber’s miracle item) to prevent friction
- For drainage: sterilize needle with fire, then puncture side (not top)
- Apply clean gauze or bandage — moss works in a pinch
💧 Wound Cleaning
- Flush with clean water — or boil snow
- Avoid soap inside open wounds (irritates tissues)
- If no bandage: layer folded leaves (non-toxic), moss, or sterilized cloth
- Change dressing daily
5. Hypothermia & Heat Loss: Insulate, Don’t Rub
❄️ If someone is hypothermic:
- Do NOT rub limbs — it drives cold blood to the heart
- Remove wet clothing
- Wrap in dry layers: sleeping bag, emergency blanket, even dry leaves
- Share body heat — skin-to-skin inside sleeping bag works in extreme cases
- Warm sugary drink (if conscious) helps — NO caffeine or alcohol
6. Improvised Items Every Climber Should Carry
These aren’t in most first aid kits — but they’ve saved lives in my expeditions:
| Item | Use |
|---|---|
| Duct tape | Wound closure, blister prevention, gear repair |
| Paracord or shoelaces | Splinting, slings, shelter |
| Buff / Bandana | Pressure dressing, sling, filter |
| Zip-lock bags | Wound irrigation, sterile storage |
| Trekking poles | Crutches, splints, tent support |
| Multi-tool / knife | Cutting, sterilizing tools, opening coconuts |
| Plastic bags / trash liners | Waterproof wrap, insulation |
| Alcohol pad / hand sanitizer | Disinfection (cuts & hands) |
7. When to Evacuate
Even with excellent field treatment, some injuries require evacuation:
- Deep cuts with uncontrolled bleeding
- Open fractures (bone through skin)
- Head trauma with confusion or vomiting
- Infections (worsening redness, fever, pus)
- Chest pain, difficulty breathing
- Spinal injuries — immobilize and do not move unless absolutely necessary
Use mirrors, whistles, GPS beacons, or signal fires if communication fails. In jungle zones, smoke is still the best signal.
8. Final Words: The Body is Fragile, But the Mind is Powerful
Improvised first aid isn’t just about technique — it’s about staying resourceful under pressure.
When kits are lost and help is far, the real medic is you — and the wild becomes your clinic. Know your environment, trust your instincts, and remember: you don’t need everything, you just need to know enough.
Train hard. Prepare deeply. And may you never need these skills — but be ready if you do.
