Physiological demands of rescue roles in real life and simulations: a review

Background: Paramedics involved in technical rescue face significant environmental and physical challenges that necessitate physiological resilience and high levels of fitness, yet there is limited evidence on the type of fitness standards this role requires. This review aims to elucidate the physical demands made on technical rescue paramedics. Methods: A rapid evidence review was conducted, with MEDLINE and CINAHL Complete from inception to March 2024 searched for articles regarding the physiological demands on technical rescue paramedics during both live and simulated operations. Title and abstract screening were performed, along with critical appraisal and a narrative synthesis. Results: Four themes materialised: occupational demands; environmental factors; personal physical strain; and operational experience. Each play a part in contributing to the high physiological demands on paramedics engaged in technical rescue. Those lacking the underpinning technical skills, such as new starters, may find the physiological demands more challenging. Conclusion: Technical rescue paramedics have a highly demanding physical job. Fitness standards must be maintained to ensure optimum clinical performance.