Wilderness First Aid: Wound Management

Skiing on a pristine Spring day. Can you guess the location?
KHESkiing on a pristine Spring day. Can you guess the location?

Spring in the Northeast: Depending where you go exploring, you can encounter a range of trail conditions. Let’s pretend we are in Maine. It has been a fantastic winter, with lots of snow. This is great news! You can sneak in an additional day of cross-country skiing.

The morning temperatures hover just below freezing, making the groomed trails a bit icy and fast. After skiing for approximately 20 minutes, you & your partner encounter a steep, wide downhill.

Your partner, who is a little uncomfortable with the conditions and his skis, wipes out at the base of the hill. You see him stand up and wave you down. The snow he landed in, off the side of the trail, is deep and soft although it does have a crusty top layer.

After successfully navigating down the hill, you ski over to your partner. He just finished adjusting his hat & sunglasses and is brushing off the remnants of snow from his jacket. He turns to you and says, “I’m good. You ready to keep going?”

And you say, “No,” because the lower half of his face is covered in blood. It’s actually dripping from the end of his nose. It looks bad, very bad.

Now what?  Work through the Patient Assessment System (PAS) to determine your next steps.  After you outline a plan, compare it to the recommendations below.

Pause. Don’t panic. 

The good news: Your partner is alert and conscious. You both have wilderness first aid training. You both have first aid kits in your daypacks. This is a popular trail, and you’ve already seen other folks out skiing. You aren’t concerned about your ability to get more help, if needed.


Your partner didn’t lose consciousness. He didn’t run into a tree, boulder, person, etc. when he fell. There is no life-threatening injury present but yikes, it sure does look bad.


You determine, from what the patient shares with you and a more detailed assessment, that your partner sustained several facial abrasions from the icy top layer of snow but no broken bones, deep lacerations or other significant injuries.


Abrasions, esp. on the head & face, bleed a lot. Stop the bleeding, evaluate the injury site, clean and cover the wound.

“Hmm,” you think, “he looks pretty good.” After providing your partner with a bandage for his nose, you are free to continue skiing and enjoy the day. An injury that looked awful turned out to be no big deal.

Disclaimer: This information is provided as a general resource. The AMC recommends all outdoor leaders take a Wilderness First Aid (WFA) course to learn how to recognize and treat common health issues. For a list of Wilderness First Aid courses offered by the AMC, please visit: https://activities.outdoors.org/search/

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Kristi Hobson Edmonston

AMC Outdoors, the magazine of the Appalachian Mountain Club, inspires readers to get outside and get engaged. Learn more.