Physical Requirements
Although survival training is important, it is even more important that team members and hospital administration understand that the transport environment requires physical capabilities beyond those expected of personnel who function only in a hospital or clinic.
Team members may be required to lift patients or to carry heavy equipment, often with little or no help. Personnel need to be agile enough to maneuver within the confines of a transport vehicle and dexterous enough to perform procedures in a moving environment. In addition, they should not be unduly prone to motion sickness or should have mastered techniques to mitigate the effects of motion sickness. Most aircraft are subject to weight restrictions that vary with type of aircraft and the location and distance of the flight. These restrictions are likely to prevent very large team members from participating in at least some transports. Team members with certain chronic illnesses or disabilities may also be unable to perform all expected duties. Likewise, pregnancy may temporarily preclude participation and, at a minimum, medical clearance by the team member's obstetrician should be provided. In addition, certain medical conditions may permanently or temporarily preclude participation in transports. Unlike the situation in a hospital, the transport team has few options should a member become incapacitated while on duty. If the team member is suddenly unable to function, patient care and crew safety might be compromised. Therefore, rules precluding team participation under certain circumstances are reasonable. For example, team members with sinusitis, otitis media, or upper respiratory infections may be temporarily unable to fly, whereas those with uncontrolled seizures or uncontrolled diabetes mel- litus might be completely removed from transport duty because of risks to themselves and others. These issues are best addressed by a policy clearly and specifically stating the physical requirements for team membership (Fig 9.3). These policies should be drafted with the assistance of the human resources department and legal counsel. Team members should be encouraged to maintain physical fitness, and it is reasonable to make continued participation dependent on the results of regular (eg, annual) physical fitness testing.
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