Outdoor first aid basics: what to know before you go

An outdoor day goes better when you have thought through what you would do if something went wrong. This page is a planning aid built from American Red Cross and NHS pages on a few common problems. It is general information and not first aid training, and conditions differ from person to person. The Red Cross pages we opened promote first aid classes, and a class is the place to learn the hands-on steps.

Deciding when to call

The Red Cross wording is consistent across its pages: call 9-1-1 and get equipment if the person requires immediate emergency medical treatment. Its bleeding page puts scene safety and checking for signs first, then calling, then giving care. The NHS pages use the United Kingdom numbers, 999 for emergencies and 111 for non-urgent advice, so check the number that applies where you will be. On heatstroke, hypothermia and sprains with warning signs, the NHS pages say not to drive yourself: ask someone to drive you or call an ambulance. Our trip-planning checklist covers general preparation for a day out.

Bleeding

The Red Cross wounds page lists signs that suggest serious blood loss: blood flowing continuously or spurting, a rapid, weak heartbeat, rapid breathing, pale, gray or cool moist skin, and an altered level of responsiveness. The life-threatening bleeding page gives the same instruction to call 9-1-1. We have not described the hands-on steps for controlling bleeding here, because that is best learned in a class.

Sprains and strains

For a sprain, the NHS describes self-care for the first two to three days in five steps it calls PRICE. Protect the injury with a support or supportive footwear, rest it and avoid weight on it, use a cold pack for up to 20 minutes every 2 to 3 hours, wrap it in a compression bandage during the day, and elevate it on a pillow. It advises avoiding heat, alcohol and massage during the first couple of days.

The NHS also lists reasons to seek care sooner. See a GP if it is getting worse or not improving. Use NHS 111 or an urgent treatment centre if the injury is very painful, swelling or bruising is large or increasing, or you cannot bear weight or walk more than a few steps. Call 999 or go to A&E if you heard a crack, the body part looks misshapen or angled oddly, it is numb or tingling, or the skin looks blue, grey or cold. For prevention, see balance and falls outdoors.

Heat illness

The NHS lists heat exhaustion symptoms such as tiredness, dizziness, headache, nausea, heavy sweating with pale clammy skin and strong thirst. Its advice is to move the person somewhere cool, remove extra clothing, give water or a rehydration drink, and cool the skin with water, fanning or cold packs wrapped in cloth. Improvement is expected within about 30 minutes. If not, or if heatstroke is suspected, call 999. The NHS calls heatstroke a medical emergency, with signs including very high temperature, hot skin that is not sweating, fast breathing, confusion, seizures or unconsciousness.

The Red Cross page on exertional heat stroke lists confusion, seizure, unresponsiveness and a rapid, weak heartbeat among the signs. It says to call 9-1-1, and its preferred cooling method is immersion up to the neck in cold water for 15 minutes or until the person is no longer confused. If that is not possible, it names options such as ice packs, cooling towels and a cold shower, and cooling continues until emergency personnel arrive. Our page on heat, cold and weather looks at planning around the weather.

Cold injury

The NHS says frostbite can occur when skin is exposed to temperatures of 0 degrees Celsius (32 degrees Fahrenheit) or below. Early signs include chilled, stiff skin, numbness or stinging, pain and redness or paleness. It advises moving indoors, removing tight items such as gloves, rings and boots, warming the area in warm, not hot, water, and not rubbing it or using a fire, radiator or heat lamp. Call 999 or go to A&E for hard, frozen skin, swelling with loss of feeling, blisters, or constant shivering, slurred speech, slow breathing, tiredness or confusion, which can signal hypothermia.

For hypothermia, the NHS lists shivering, pale, cold, dry skin, slurred speech and confusion. It advises moving the person to shelter, removing wet clothing and wrapping them in a blanket, and says to call 999 if you think hypothermia is present. Pacing a long outing helps too; see pacing and energy outdoors.

The short version

Decide before the trip who will call emergency services, and know the right number for your location. Red Cross and NHS pages agree that serious bleeding, heat stroke, frostbite with hard skin and hypothermia need urgent help. Learn the hands-on steps in a proper first aid class, and ask your clinician what changes for your condition.