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Administering first aid in a cave is harder than almost anywhere else. You are far from help, often in a tight, wet, or cold environment, with no cell service and a potentially long wait for rescue. Minor injuries that would be easy to treat on the surface can become serious problems underground.
This page covers basic first aid considerations for caving environments. It is not a substitute for proper first aid training, and we strongly recommend that at least one person in every caving group holds a current Wilderness First Aid (WFA) or Wilderness First Responder (WFR) certification or higher. If someone is seriously injured in a cave, call emergency services as soon as someone can get to the surface.
Challenges of First Aid in Caving
Caving creates first aid challenges that you won't encounter anywhere else:
Remote Locations: Caves are often far from the nearest road, let alone medical help. If something goes wrong, you are on your own until someone can get to the surface and call for assistance.
Limited Mobility: Tight passages and confined spaces make it difficult to reach an injured caver, move them, or perform basic care. What would be straightforward on the surface becomes a serious challenge underground.
Environmental Hazards: Darkness, cold, and wet conditions can make injuries worse quickly. Hypothermia is a real risk even when the initial injury is minor.
Communication Barriers: Underground, there is no cell service. You cannot call for help until someone physically reaches the surface, which can take hours.
Prolonged Evacuation Times: Cave rescues are among the most complex and time-consuming rescue operations there are. Many take several days or longer. Do not wait to call for help; the sooner emergency services are contacted, the better.
These are the realities of caving emergencies, and they are exactly why preparation and training matter so much. If you want to pursue specialized cave rescue training, reach out to the National Cave Rescue Commission (NCRC).
First Aid Kit
First Aid Kit
A well-equipped first aid kit is important for addressing injuries and emergencies during caving trips. The list below is not comprehensive, but covers some key items worth including in your caving first aid kit:
Wound Care Supplies
Adhesive Bandages: Various sizes for minor cuts and abrasions.
Sterile Gauze Pads: For dressing larger wounds.
Non-Adherent Pads: To prevent sticking to wounds.
Antiseptic Wipes: For cleaning wounds.
Medical Tape: Hypoallergenic tape for securing dressings.
Elastic Bandages: For wrapping sprains or securing dressings.
Butterfly Closure Strips: For closing small, shallow cuts.
Nitrile Exam Gloves: Multiple pairs to protect caregivers.
Medications
Pain Relievers: Such as ibuprofen for pain management.
Antihistamines: For allergic reactions.
Anti-Diarrheal Tablets: To manage gastrointestinal issues.
Personal Medications: Any prescribed medications specific to team members.
Additional Items
Tweezers: For removing splinters or debris from wounds.
Emergency Blanket: To prevent hypothermia.
Duct Tape: Versatile use for repairs and securing bandages.
Triangular Bandage: For creating slings or as a pressure dressing.
Notebook and Pencil: For recording patient information.
Water Treatment Tablets: For purifying water.
WAG Bag: A waste containment system for human waste in environments where burial is not appropriate.
Ziploc Style Bag: Containment for used gloves and bandages.
Ski Straps: For creating splints and holding gear together.
Regularly inspect and replenish your first aid kit to ensure all items are in good condition and have not expired.
Hypothermia Kits
Hypothermia is a real risk in caves, where cold and wet conditions can affect you faster than you might expect. Many cavers consider hypothermia kits as an essential for every trip. Below is a list of recommended items to include in your hypothermia kit, along with their purposes:
Emergency Poncho or Blanket: An emergency poncho or blanket, often made of reflective material or plastic, retains body heat well, providing warmth and protection against the cold.
Candle: A candle serves as a compact heat source, offering light and warmth in emergencies. If the candle is used under the poncho or emergency blanket, it can provide considerable warmth to an individual; just be careful not to burn yourself, gear, or the poncho/blanket.
Waterproof Matches or Lighter: Waterproof matches or a reliable lighter are used for lighting the candle, especially in damp cave conditions where standard matches may fail.
Regularly inspect and familiarize yourself with the operation of these items to ensure they function correctly when needed. Check out Derek Bristol's website for a great example of an Emergency kit.
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