Page 43 - JSOM Fall 2021

Physiological Response in a Specialist Paramedic

During Helicopter Winch Rescue in
Remote Wilderness and Extreme Heat

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Ben Meadley *; Ella Horton, BBiomedSci (Hons) ;
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Luke Perraton, PhD ; Karen Smith, PhD ; Kelly-Ann Bowles, PhD 5
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ABSTRACT
Tasks performed by search and rescue (SAR) teams can be One of the most physically demanding tasks performed by he-
physically demanding. SAR organizations are faced with licopter rescue paramedics is rescue via external winch (also
mounting challenges due to increased participation in recre- known as a hoist) from the helicopter. The frequency of utili-
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ation in remote locations and more frequent extreme weather. zation of this rescue technique in civilian SAR varies. How-
We sought to describe the physiological response and the ever, in the modern era, organizations and personnel working
methods for data collection during helicopter emergency med- in specialist rescue teams face mounting challenges. In regions
ical service (HEMS) winch rescue from remote wilderness in that have undergone extended lock-down periods to abate
extreme heat. A flight paramedic sustained 81% of maximum the progression of the COVID-19 pandemic, there have been
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heart rate (Vo ~44.8 mL/kg/min) for ~10 minutes at a rate substantial increases in participation in outdoor recreational
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of perceived exertion of 19/20, and a relative heart rate of pursuits in remote areas, placing added demand on emergency
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77.5% in 37.1°C. Maximal acceptable work time for this task services. Additionally, the progression of climate change and
was calculated at 37.7 minutes. Our data collection methods increased frequency of extreme weather events mean that or-
were feasible, and the data captured demonstrated the level of ganizations must appropriately select and train their specialist
physiological strain that may be encountered during HEMS personnel in the context of both an increasing workload and
SAR operations in austere environments and hot climate. It is volatile climate. 8
essential that SAR teams that perform physically demanding
tasks use a scientific approach to adapt and evolve. This is nec- Our multidisciplinary research group is developing a scientif-
essary to ensure personnel are appropriately selected, trained, ically validated PES for helicopter rescue paramedics. As part
and equipped to respond in an era of increasing demand and of primary work to investigate methods for data capture in the
extreme environments. HEMS SAR environment, we describe the in-field assessment
of physiological parameters in a specialist paramedic conduct-
Keywords: search and rescue; helicopter emergency medical ing a land winch rescue. The data provide insight into the
services; paramedic; aerobic capacity; human performance physical demands of contemporary civilian SAR operations
by specialist paramedics working in HEMS, and we suggest
considerations for research, role equipment, and selection of
personnel.
Introduction
Personnel working in military and civilian Special Operations Setting
units such as helicopter emergency medical services (HEMS) The state of Victoria, Australia, covers an area of approxi-
may be categorized as tactical athletes. These staff perform mately 237,629 km including remote and difficult-to-access
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physically demanding tasks that may include rescue from re- terrain and more than 2,000 km of coastline. Ambulance Vic-
mote wilderness, vessels, or marine environments. Specialist toria (AV) is the provider of HEMS in Victoria, and an intensive
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units usually develop physical employment standards (PES) care flight paramedic (ICFP) may be deployed to an incident via
when recruiting team members, and these should arise from winch. AV HEMS operations have been described in previous
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evidence-based and validated processes to identify those suit- work. Written informed consent was obtained from the indi-
able for the role. Scientifically validated PES may reduce vidual participant described in this report. Capture of data was
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the risk of employees suffering injury and ensure the ability approved by the Monash University Human Ethics Research
of personnel to perform their required duties. Additionally, a Committee (Project Nos. 16340 and 17784) and Ambulance
validated PES provides a barrier to legal challenges should an Victoria Research Committee (Project R18-033). Anthropo-
applicant be unsuccessful when applying to a specialist unit. 3 metric, body composition, and maximal aerobic capacity data
*Correspondence to benjamin.meadley@monash.edu
1 Ben Meadley is a PhD candidate and Dr Karen Smith is a scientist in the Department of Paramedicine and the Paramedic Health and Wellbeing
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Unit, Monash University, Frankston, Australia. They are also both affiliated with Ambulance Victoria, Doncaster, Australia. Ella Horton is
affiliated with the Department of Physiology and the Paramedic Health and Wellbeing Unit, Monash University, Frankston, Australia. Dr Luke
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Perraton is affiliated with the Department of Physiotherapy and the Paramedic Health and Wellbeing Unit, Monash University, Frankston, Aus-
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tralia. Dr Kelly-Ann Bowlesis affiliated with the Department of Paramedicine and the Paramedic Health and Wellbeing Unit, Monash University,
Frankston, Australia.
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