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Wilderness First Aid in BC — What to Treat, What to Evacuate
In a BC campground an ambulance may be forty minutes away. On a forest service road it may be four hours and a helicopter. Everything below is written for that gap.
On this page
The first sixty seconds
Before you touch anyone, run the sequence. It takes fifteen seconds and it prevents the two classic errors: becoming a second casualty, and treating a scraped knee while somebody bleeds out.
- Scene safety. Is the rockfall still coming? Is the animal still there? Is the water still moving? Do not enter a hazard to reach a patient.
- Get a headcount. How many people, how many hurt.
- Airway, breathing, circulation. Are they awake and talking? Talking means airway and breathing are working — move on.
- Stop major bleeding. This outranks everything except an unmanaged airway.
- Spine caution if there was a fall, a struck head or a vehicle. Support the head, do not move them unless they are in danger where they lie.
- Then everything else, and while you work, decide: can we walk out, or do we call?
Severe bleeding
- Direct pressure, hard, with the heel of your hand, on the wound. Not a light dab through a gauze pad — pressure that hurts, sustained for at least ten minutes without lifting to peek.
- Do not remove soaked dressings. Pile new ones on top; removing the clot restarts the bleed.
- Pack a deep wound with gauze pushed firmly into the cavity, then apply pressure over it.
- Tourniquet for a limb bleed you cannot control: high and tight on the limb, above the wound, tightened until the bleeding stops even though it hurts a great deal. Write the time on it or on the patient's forehead. Do not loosen it. Modern practice accepts several hours of tourniquet time — a limb is recoverable, blood volume is not.
- Treat for shock: lie them down, insulate from the ground, keep them warm, nothing to eat or drink if surgery looks likely.
A commercial tourniquet (CAT or SOFTT-W) costs about $40 and weighs 80 g. If your group carries an axe, a saw or a chainsaw, or you paddle whitewater, carry one and learn it.
Hypothermia and heat illness
Hypothermia — BC's actual leading environmental risk
Covered in depth on the shelter page. The short version: watch for the "-umbles" — stumbles, mumbles, fumbles, grumbles. Shivering stopping is deterioration, not recovery. Get them out of the wind, strip wet clothing, insulate above and below, wrap the head, and give warm sweet drinks only if fully alert. Handle a severely hypothermic person gently; rough handling can trigger cardiac arrest.
Heat exhaustion and heatstroke
The BC Interior hits 40°C, and the 2021 heat dome killed hundreds of people in this province. This is not a desert-only problem.
- Heat exhaustion: heavy sweating, weakness, nausea, headache, cool clammy skin, fast weak pulse. Move to shade, lie down, elevate legs, remove excess clothing, cool with water on skin and airflow, sip water with electrolytes.
- Heatstroke is a life threat: core temperature above 40°C, altered mental status — confusion, aggression, seizures, unconsciousness — with skin that may be hot and dry or still sweaty. Cool aggressively and immediately: water over the whole body, fan hard, ice or cold packs to the neck, armpits and groin, immerse in a cold creek if one is there and it is safe. Call 911. Cooling comes before transport.
Anaphylaxis and severe allergic reaction
Wasps become aggressive in BC from late July through September, and a nest under a picnic table is a routine campground event. Most stings are painful and nothing more. Anaphylaxis is different and fast.
Recognise it: swelling of the lips, tongue or throat; hoarse voice; difficulty breathing or wheeze; widespread hives; vomiting; collapse; a sense of impending doom. It can develop within minutes.
- Epinephrine auto-injector into the outer thigh, through clothing if needed. Do not hesitate and do not wait to "see if it gets worse". Epinephrine given early to someone who did not strictly need it is far safer than epinephrine given late.
- Call 911. Every anaphylaxis case needs hospital assessment even if it resolves — a second wave can follow hours later.
- Lie them flat with legs raised unless they are struggling to breathe, in which case let them sit up. Do not stand them up.
- A second dose after 5–15 minutes if there is no improvement and you have one.
- Antihistamines treat hives. They do not treat anaphylaxis. Do not substitute.
If anyone in your group carries an auto-injector, everyone else must know where it is and how to use it. In a real event the patient often cannot.
Burns, fractures, sprains and wounds
Burns
Cool with clean cool running water for 20 minutes — this is effective up to three hours after the burn and it genuinely reduces depth. Do not use ice, butter or toothpaste. Cover loosely with clean non-stick dressing or cling film. Remove rings and watches before swelling starts. Evacuate any burn that is larger than the patient's palm, or on the face, hands, feet, genitals or across a joint, or that is white, leathery or painless (full thickness).
Fractures and dislocations
Splint it in the position found, padded, immobilising the joint above and below. Check circulation, sensation and movement beyond the injury before and after splinting — a splint that kills the pulse is worse than no splint. Trekking poles, a sleeping pad rolled into a gutter, and a triangular bandage will splint almost anything. An open fracture — bone through skin — is an emergency evacuation with the wound covered.
Ankles and knees
Rest, ice or cold creek water, compression wrap, elevation. Then the real question: can they walk out with a pole and a strapped ankle, or is this a carry? Decide before dark, not after.
Wounds
Irrigate hard with clean or treated water — pressure matters more than antiseptic, and a syringe or a punctured bottle cap does the job. Remove visible dirt. Close only clean, fresh, straight cuts with strips; leave punctures, bites and dirty wounds open and dressed. Any animal bite — including a dog — needs medical assessment for infection and rabies risk. In BC, bats are the main rabies concern: any bat contact, or a bat found in a sleeping area, is a same-day medical call.
The kit, and the course
A kit that lives in the car and never gets opened is decoration. Build one you actually understand.
- Nitrile gloves, 2 pairs
- Trauma dressing or two, plus 10 x 10 cm gauze, roller bandage, triangular bandage
- Tourniquet (CAT/SOFTT-W) if your activities justify it
- Wound closure strips, tape, blister care (moleskin or hydrocolloid)
- Irrigation syringe, tweezers with fine points (also your tick tool), small scissors
- Ibuprofen, acetaminophen, antihistamine, anti-diarrhoeal, personal medications
- Prescribed epinephrine auto-injector if anyone in the party has one — and a spare
- Emergency bivvy bag, chemical heat packs
- Headlamp with fresh batteries, whistle, permanent marker (for tourniquet times and notes)
- SAM splint or a rolled foam pad
- A written card with everyone's allergies, medications and emergency contacts
Take a course. Wilderness First Aid (16–20 hours) is the standard for anyone spending real time in BC backcountry, and Wilderness First Responder (70–80 hours) is the standard for guides and trip leaders. Nothing on this page is a substitute for practising on a real body with an instructor correcting you.
Frequently asked questions
Do I have to pay for a mountain rescue in British Columbia?
No. Ground and inland search and rescue in BC is carried out by volunteer SAR groups and is not billed to the person rescued. Delaying a call out of fear of a bill is the more expensive mistake — it turns daylight rescues into night operations.
What is the single most useful first aid item to carry?
For BC conditions, an emergency bivvy bag — hypothermia is the most common serious problem and the one you are most likely to have to manage for hours. After that, gloves, a trauma dressing, and a prescribed epinephrine auto-injector if anyone in the group needs one.
How do I know if someone needs evacuation rather than first aid?
Evacuate for: altered mental status, chest pain, difficulty breathing, uncontrolled bleeding, an open or angulated fracture, a burn bigger than the patient's palm or on face/hands/feet/joints, suspected spinal injury, severe hypothermia or heatstroke, anaphylaxis, or any injury that stops someone walking out under their own power before dark.
Should I use a tourniquet?
For a limb bleed you cannot stop with firm direct pressure and packing, yes — high and tight above the wound, tightened until bleeding stops, with the time written down. Do not loosen it once applied. Modern trauma practice accepts hours of tourniquet time.
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Not legal or medical advice. Current regulations, park signage and professional training override this page. Emergency 911 · RAPP wildlife line 1-877-952-7277 · Report a wildfire 1-800-663-5555. Updated 2026-08-04.