A comparison of historical versus proposed physical employment standards for flight paramedics performing helicopter winch rescue

BACKGROUND: Paramedics working in helicopter teams undertake water and land rescues. Historical assessments of role-related fitness were not developed using physical employment standards methodology. OBJECTIVE: To compare the historical selection tests with new tests developed via contemporary scientific methodology. METHODS: Candidates undergoing selection to the role of flight paramedic (n = 14; age 37±5 yrs, body mass index BMI 26±4 kg.m2) undertook existing paramedic selection tests on land and in water, measurements of task duration, maximum heart rate (HRmax), rate of perceived exertion (RPE6 - 20) and capillary blood lactate (Lacmax) were recorded. These results were compared to the same variables in experienced paramedics (n = 14; age 44±5 yrs, BMI 25±3 kg.m2) who undertook the new tests. RESULTS: Land task duration (existing 17±2 min vs. proposed 7±2 min, p < 0.05) HRmax (existing 186±13 b.min–1 vs. proposed 173±11 b.min–1, p < 0.05), and Lacmax (existing 23±3 mmol.L–1 vs. proposed 8±2 mmol.L–1, p < 0.05) were higher in the existing test compared to the proposed tests. Water task duration (existing 12±2 min vs. proposed 10±1 min, p < 0.05) was longer in the existing test, but HRmax (existing 166±18 b.min–1 vs. proposed 167±15 b.min–1, p = 0.90), Lacmax (existing 11±4 mmol.L–1 vs. proposed 11±4 mmol.L–1, p = 0.90) did not differ. RPE6 - 20 did not differ between groups for water or land. CONCLUSIONS: The historical land-based physical tests for paramedics differed from the proposed tests, however the water-based tests had similar duration and physiological demands. Use of tests not developed via established scientific methodologies risks eliminating candidates suitable to work in the role, or including candidates that are not.