Trailside First Aid

Trailside First Aid

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Robertson's day job and other day jobMy Day Job and other Day Job

It was a sunny spring afternoon, and after a few months off the bike I was finally back at it. The planned ride for the day was a simple affair, nothing too crazy, just enough to spin out the legs and get back into the swing of things. A few miles in and I was having fun, but it was clear my skills were rusty. I came to an intersection, left for the easy flow trail, right for the jumps. My eagerness got the better of me, and despite knowing better I went right. Jumps it was. Not even thirty seconds later I dead-sailored a jump, tumbling to the ground in a mass of twisted limbs and a cloud of dust. A quick self-inspection revealed a long, deep gash on my right leg that was bleeding freely. I had packed plenty of water, snacks, spares for the bike, but no first aid kit. After some deliberation, I sacrificed the sleeve of my jersey to stem the bleeding, limped the bike back to my car, and drove to the ER for stitches.

My name is Robertson Pearce, and I am a Knolly Grassroots rider with a focus on Enduro racing. During the week, I work as a physician with a current focus on Military Combat Medicine.

Robertson mid-race

Since I started mountain biking, I have had my fair share of crashes, giving me concussions, sprained ankles/wrists, and more cuts and bruises than I can count.

I have seen a lot of injuries. We as mountain bikers often pride ourselves on being prepared for what mishaps may occur on a ride. We carry water, food, tools, tubes, and a multitude of spares. But something we often, myself included, neglect to bring is a first aid kit. Now when many of us think about a “first aid kit”, we may think of:

Red Cross first-aid kitphoto credit: American Red Cross/

This small kit or this other MASSIVE kit

As an avid practitioner of taping things to my frame to avoid wearing a pack on rides, I understand the issue. No one wants to be bogged down carrying tons of heavy first aid gear on the off chance that they might need it. But what many don’t realize is you don’t need all that much stuff! The trick with packing first aid kits, just like packing gear for rides, is to tailor what you bring (and how much of it!) by how long your ride is, how remote it may be, and even the potential risk of injury (rider skill, technicality of the trail, etc.); by doing so you can have just the right amount of stuff and always be prepared.

For the sake of brevity, we’ll break it down into three typical scenarios: a standard “local ride”, an “all day epic”, and a multi-day bikepacking ride (or even just a long ride in a very remote location). We’ll go over individual injuries in a separate post and today just talk about what first aid items you should consider bringing. For most people, I recommend buying a premade kit as I’ve found it’s cheaper than buying all the needed items individually and removes a lot of the guesswork, though you can make your own if desired.

Local Ride:

This is your standard ride, a half day affair. Maybe you know the trails like the back of your hand, maybe they’re new. Perhaps you’re riding solo, maybe you’re with a big group. The important thing is this ride is in an area where help is not more than a quick phone call away. If an injury happens, you just need to bide time until the cavalry rolls in (or if it’s something minor, patch it up and continue on). For this sort of ride I bring what I call the “boo-boo kit”, which consists of a few band-aids, alcohol wipes, larger gauze for bigger cuts, and perhaps a few common meds like ibuprofen and Benadryl for allergic reactions. These type of kits are often sold as a “0.5 first aid kit” or “boo-boo kit”. These can easily fit in a shorts pocket or in a #enduro fanny pack if, like me, you avoid wearing packs like the plague.

Robertson's "boo boo" kitMy “boo-boo” kit. Compressed gauze and gloves (top right) could be deleted to save space.

All day epic:

This is the big ride, the one you plan days to weeks out, the type that you commit a whole day to finishing. You have to bring snacks and plenty of water, so you’ll likely be wearing a backpack for this. The main difference between this and the “local ride” above is that you may not be near a hospital. That ambulance may take a while to get there, and you may not even have cell service. With that increased isolation often comes amazing trails, but also increased risk. If an injury were to occur, you may find yourself having to make due for prolonged periods of time until help arrives (or you bring yourself or others to the help). The main idea here is to have a similar type of items as your lighter kit, just more of them. This allows treating multiple people or changing bandages over time if it’s a long haul to extraction. For these types of kits, search for “day hike” or “day trip” first aid kits or, again, you can make your own.

Robertson's "all day" kitMy “all day” kit, including a packing pouch. Banana for scale.


Many of us have read long articles or photo-stories about some group’s epic bikepacking adventure. Perhaps they’re on the Colorado trail, or hut-hopping in New Zealand. Some even go so far as to bikepack through ultra-remote areas of South America, the Himalayas, or the Alps. What unites all of these trips (besides the epic views, amazing photos, and memories to last a lifetime) is the sheer remoteness of them. For most bikepacking trips, you’re out in the wilderness, often with no cell phone service, for days at a time. It doesn’t take much to imagine the difficulty of getting a medical evacuation if an injury were to occur in such a place.

Of course, that risk is certainly part of the experience, but being prepared for the worst is still a good idea. For these types of rides, look for first aid kits marketed for multi-day, multi person trips (often sold as “backpacking” first aid kits) to make sure you have plenty to go around if an injury were to occur. For these more remote trips it’s also a good idea to bring a GPS rescue beacon or satellite messaging device to call for help if you’re out of cell range.

Robertson's "multi-day" kitMy “multi-day” kit, including packing pouch. Banana for scale.

That wraps up this post about first aid kits. Next time we’ll go over a few common mountain bike trailside injuries and how to treat them using the first aid kit supplies and a few common mountain bike spares.

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