A Descriptive Physical Profile of Western Australian Male Paramedics

The bookmark method to establish minimum performance standards for intensive care flight paramedics performing helicopter winch rescue

We aimed to use the bookmark method to establish minimum standards for selecting intensive care flight paramedics. Two subject matter expert (SME) focus groups reviewed nine videos of decreasing duration showing land and water helicopter rescue tasks. Focus Group 1 (FG1, n = 10) viewed videos individually off-site, whilst Focus Group 2 (FG2, n = 9) attended a face-to-face session. All SMEs selected the video they judged as the appropriate pace for the task then reviewed feedback. For both groups, the process was repeated until 80% agreement was achieved, or three rounds were completed (whichever occurred first). FG1 and FG2 achieved agreement after two rounds for the land task. For the water task, FG1 did not reach agreement. FG2 reached consensus after two rounds. The selected task durations were similar. The bookmark method is valuable to determine performance standards for performing winch rescue, and SMEs are more likely to reach consensus when face-to-face.

Comparison of swimming versus running maximal aerobic capacity in helicopter rescue paramedics

Swimming is a critical task for helicopter rescue paramedics and aerobic capacity is assessed in this occupation to determine job suitability. We evaluated one treadmill-based and one pool-based assessment of maximal aerobic capacity (V̇O_2peak) in 14 helicopter rescue paramedics. There was a small absolute difference (p = 0.11, d = 0.46) between V̇O_2peak in the swim (45.5 ± 7.8 ml.kg^-1.min^-1) compared to the run (48.5 ± 5.5 ml.kg^-1.min^-1), with a moderate relationship noted (r = 0.74, 95% CI [0.35-, 0.91], p = 0.0023). Whilst not interchangeable, run V̇O_2peak was a predictor of swim V̇O_2peak. Maximal blood lactate was similar (p = 0.93) in swim (13.4 ± 3.8 mmol.L^-1) and run (12.2 ± 3.0 mmol.L^-1), and maximal heart rate 13% lower (p < 0.0001) in the swim (162 ± 11 bpm) versus the run (186 ± 10 bpm). To estimate swimming V̇O_2peak in paramedics a treadmill test is sufficient but does not replace assessment of swimming proficiency. Practitioner Summary: We developed a swim protocol to assess maximal aerobic capacity in helicopter rescue paramedics. Compared to a treadmill-based test, our swim protocol generated 20% lower submaximal V̇O₂ and 6% lower V̇O_2peak. Although not interchangeable, a treadmill V̇O_2peak test is indicative of maximal aerobic capacity in rescue paramedics whilst swimming. Abbreviations: HEMS: helicopter emergency medical service; PES: physical employment standards; ICFP: intensive care flight paramedic; RPE: rating of perceived exertion.

Assessment of Cardiometabolic Health, Diet and Physical Activity in Helicopter Rescue Paramedics

Objective: Shift work is an established risk factor for weight gain, cardiovascular disease, Type II diabetes mellitus, and impaired health-related quality of life (HRQoL). Prolonged exposure to shift work is common in paramedics and other emergency medical service (EMS) providers. Sub-populations of EMS workers may have varying health outcomes when exposed to shift work, but the reasons for this have not been investigated. We sought to describe cardiometabolic health, dietary patterns, physical activity, and health-related quality of life (HRQoL) in a sample of experienced intensive care flight paramedics (ICFPs) working for a Helicopter Emergency Medical Service (HEMS).Methods: Fifteen paramedics (median age 45, IQR 42-48 years) were recruited to undertake a range of health assessments. These included a food frequency questionnaire to assess dietary patterns, sampling of biomarkers to determine cardiometabolic health risk, maximal aerobic capacity assessment via treadmill running and assessment of HRQoL via the SF-36 survey. In an extension of the study protocol, ten of the fifteen participants wore a physical activity monitor for one year.Results: Median (IQR) weight was 79.9 (72.3-89.3) kg, body fat percentage 23.3 (21.9-26.5) %, body mass index (BMI) 25.1 (21.9-27.4) kg.m², and waist to height ratio 0.48 (0.45-0.54). Dietary analyses showed high discretionary food intake. Biomarkers of cardiometabolic health risk were all within normal range. HRQoL was 86.2/100 for physical health and 85.1/100 for mental health. V̇O_2max was 47.0 (43.0-54.6) mL.kg^-1.min^-1. The ten participants that wore activity monitors completed 11,235 (8334-15,380) steps per day and undertook 50 (12-98) minutes per day/350 (84-686) minutes per week of moderate to vigorous physical activity. The least amount of physical activity was conducted on day shifts.Conclusions: For ICFPs included in this study, HRQoL, cardiometabolic and physical activity outcomes are representative of good health. Although shift work influences the amount of physical activity, ICFPs exceeded minimum recommendations even when rostered to duty. Despite lengthy careers in EMS, ICFPs demonstrate an excellent health profile that is likely due to high physical activity levels and healthy BMI. This information may be useful in guiding health interventions in the wider EMS workforce.

Physical Health Status of Emergency Care Providers in South Africa

Background: Emergency care providers (ECPs) have a physically, mentally, and emotionally demanding profession. Therefore, they are predisposed to cardiovascular and other non-communicable disease risk factors. Objectives: The objective of the study was to determine the physical health status of ECPs in the North West province of South Africa through a selected anthropometric and other health parameter test battery. Methods: Ninety-one ECPs (64 males, 27 females) took part in the study voluntarily for health screening tests including body mass index (BMI), lean body mass (LBM), resting heart rate (RHR), blood pressure (BP), skinfold measurement, waist circumference (WC), waist-to-hip ratio (WHR), fasting blood glucose (FBG), and total cholesterol (TC). The collected data were subjected to statistical analysis using the Statistical Package for Social Sciences (SPSS) version 25 (IBM). Results: The participants demonstrated a mean BMI of 28.2 ± 5.5 kg/m2, body fat of 26 ± 7.6 %, and LBM of 58.6 ± 10 kg. Significant differences were seen in height (170.5 ± 6.2 vs. 160.7 ± 5.3 cm), BF% (22.5 ± 5.3 vs. 34.2 ± 6.2 %), and LBM (62.3 ± 8 vs. 49.2 ± 8.2 kg) between males and females (P ≤ 0.05). Mean systolic BP was 122 ± 15 mmHg, and diastolic BP was 81 ± 10 mmHg. Mean WC was 90.8 ± 11.4 cm. Other health parameters included mean FBG of 5.1 ± 2.4 mmol/L and mean TC of 4.9 ± 0.7 mmol/L. Significant differences were seen in WHR (0.88 ± 0.04 vs. 0.79 ± 0.06) between males and females (P ≤ 0.05). Conclusions: A significant number of ECPs presented with cardiovascular and other NCD risk factors such as hypertension, obesity, high WC, elevated FBG, and abnormal levels of TC. This can be attributed to the nature of their occupation such as working irregular shifts leading to sleep deprivation, being exposed to psychological trauma, poor nutrition during shifts, and/or lack of exercise. Stress management is an important part of these workers’ rehabilitation program. A well-formulated employee wellness program is required to set remedial measures in place.