On the hill: call 999 or 112
For an injury, illness or someone lost or overdue, dial 999 or 112 and ask for the Police, then Mountain Rescue.
Source 64
Chest pain or fainting: call 999
Call 999 if:
- You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
- The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
- You have chest pain and feel sweaty, sick, light-headed or short of breath.
- Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.
Sources 65, 66
The heart: check first, and know the signs
Sudden cardiac death while hiking was linked with a previous heart attack, coronary artery disease, diabetes and high cholesterol in men over 34. See your GP before a big trip, build up regular hill walking, and take the first day easy.
Call 999: chest pain that feels tight or like squeezing on your chest; chest pain that's spreading to your arms, neck or jaw; severe difficulty breathing (you're gasping, choking or not able to get words out); lips or skin that are pale, blue or grey (on brown or black skin this may be easier to see on the palms of the hands); or someone who has passed out and is not responding normally. It could be a heart attack. Don't drive yourself to A&E.
Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem. If you've been diagnosed with angina, get help from NHS 111 too if it feels worse than before, is happening more often, lasts longer or happens when you're resting.
The PAR-Q+ (Physical Activity Readiness Questionnaire for Everyone) asks about a heart condition or high blood pressure, chest pain, dizziness or losing consciousness, other long-term conditions and their medicines, a bone or joint problem that activity could make worse, and being told to exercise only under supervision. If you answer yes to any, check with your GP or a qualified exercise professional first. If you're over 45 and not used to hard exercise, ask a qualified exercise professional before the hardest sessions, and delay if you're ill.
Sources 10, 67, 68, 69
Heatstroke
The NHS says to call 999 for signs of heatstroke: still being unwell after 30 minutes of resting somewhere cool, being cooled and drinking; a very high temperature; hot skin that isn't sweating; a fast heartbeat; fast breathing or breathlessness; confusion and lack of coordination; a seizure; or loss of consciousness.
Source 70
Hypothermia and frostbite
Call 999 or go to A&E (accident and emergency) for hypothermia, such as shivering, pale cold skin, slurred speech, slow breathing, tiredness or confusion, and for frostbite with hard, frozen skin, swelling and loss of feeling, or blisters. Mountain Rescue England and Wales lists the signs to watch for in others: "Disorientation, confusion, shivering, tiredness, pale complexion and loss of circulation in hands or toes", adding that children and older people are especially at risk.
Sources 71, 72, 18
An ankle injury after a slip or fall
Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.
Same day (NHS 111 or an urgent treatment centre): after an injury, you can't put weight on it or walk more than a few steps, the pain is very bad or getting worse, there is a lot of swelling or bruising or it is getting worse, it feels very stiff, or it's not feeling any better after treating it yourself. Get the same help if you also have a very high temperature, or feel hot, cold or shivery: this could be an infection. If you think it's broken, don't treat it yourself.
Same day: a sudden snap or pop at the back of the heel or calf, or a feeling of being kicked there, then walking flat-footed and being unable to push off, stand on tiptoe or climb stairs. It could be an Achilles tendon rupture or a broken heel bone. Go to A&E or a minor injuries unit, or contact NHS 111.
See a doctor or physiotherapist if:
- An ankle that keeps giving way months after a sprain.
Sources 73, 74, 75
A knee or other leg injury
Call 999 or go to A&E if you heard a crack, the injured part has changed shape or points at an odd angle, it's numb or tingling, or the skin has turned blue or grey or is cold. Get help from NHS 111 if it's very painful or swollen, you can't put weight on it or walk more than a few steps, or a knee locks or gives way.
Go to A&E (accident and emergency) if you've injured your knee and it has changed shape, it becomes very swollen very quickly, you felt a pop or snap, you can see bone sticking out, or it's bleeding heavily. Don't drive yourself: ask someone to take you, or call 999 if the pain means you can't move your leg to get there.
Get advice from NHS 111 now: you cannot move the knee or put any weight on it, or it is very painful, badly swollen or has changed shape, or it locks, gives way or clicks painfully. A pop, quick swelling and a knee that gives way point to an ACL injury: our ACL injury guide says what to do.
Source 76
Knee pain on descents: the pain rule
Our knee guides use this rule: rate your knee pain from 0 to 10 during and after exercise; 0 to 2 counts as safe, up to 5 as acceptable and above 5 as too much, and your knee should be back to its usual level by the next morning.
Sources 77, 78
A fall, for older hikers
Call 999 if you or someone else has fallen and may have hurt the head, back, neck or hip, or cannot get up. Get help from NHS 111 after a fall if you may be in pain, injured or unwell.
Call 999 or go to A&E: severe hip pain after a fall or injury, or you cannot stand, walk or put weight on the leg. In an older adult this can be a broken hip; the leg may be at an odd angle or look shorter. Don't drive yourself.
Source 79
Unusual breathlessness
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
Source 80
Altitude: get medical help straight away
The NHS says to get medical help immediately, and go 300 to 1,000 m lower if you can, if someone with altitude sickness feels very unwell, is confused, has problems with balance or coordination, sees or hears things that aren't there, is short of breath at rest, has a cough with frothy or bloody spit, has blue or grey skin, lips, tongue or nails, or is very sleepy or hard to wake.
Source 81
During a session
A joint pain that is sharp, gets worse during a session, lingers into the next day or changes how you move is a reason to use an easier version, and to see a GP or physiotherapist if it keeps happening (the rule in our plans).
Source 82
Stop the session if
You feel any pain or become unwell, as the NHS advises for its Pilates videos, and especially for chest pain or pressure, unusual breathlessness, dizziness or fainting. If you have a health problem, an injury or any symptoms, get advice from a healthcare professional, such as a GP, before you start.
Source 83
Before you start
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
Source 83