Paramedic physical fitness requirements and physical preparation of students for the paramedic role: A narrative review

PURPOSE: To summarise evidence and identify knowledge gaps regarding: physical demands and fitness requirements for a paramedic role; existing fitness testing and physical employment standards (PES); and how paramedic students are physically prepared within tertiary education for the paramedic role. METHODS: A range of sources such as electronic databases (e.g. CINAHL), references lists, and search engines indexing grey literature were searched using the PCC framework as shown in Table 1. The search was conducted to identify published peer reviewed studies and grey literature providing evidence on these topics. RESULT: The available evidence identifies paramedics as an unhealthy population, and indicates paramedics have a physically demanding role and there is a need for pre-employment fitness testing and fitness maintenance. However, there appears to only be regular fitness monitoring and testing in specialised roles. This population suffers a high incidence of injury, cardiovascular disease, and obesity. Existing pre-employment fitness requirements are often unclear in how they link to the role of the paramedic, inconsistent between paramedic services, and unvalidated, without published physical demands analyses and PES. Minimal preparation, if any, is provided to student paramedics for the physical aspects of the paramedic role. RELEVANCE: Australia’s existing paramedic pre-employment physical fitness assessments are not standardised across jurisdictions and frequently do not appear to directly relate to the essential requirements of the role. There is increasing evidence of the need for standardised essential minimum levels of fitness, that are based on the identified physical demands of the daily tasks performed by paramedics. There is minimal literature regarding student and graduate paramedics’ physical fitness and physical activity levels, as well as preparation needs for the role. Physically prepared student paramedics along with validated physical fitness screening assessments are vital to paramedic physical health, safety, longevity in the role, and the efficient provision of patient care.