When is a medevac crewmember simply too fat to fly?

In the age of discrimination lawsuits and the Americans with Disabilities Act, it's a sensitive topic. After all, we live in the land of liberty, and increasingly that means the freedom to plop oneself in a recliner, turn on the TV and mindlessly masticate. The United States is the second fattest industrialized nation in the world (Mexico recently climbed to No. 1) and we got there the old-fashioned way: We ate it. As a nation, we stand defiant: God, guns and girth. And, as long as I can do my job, whose business be it if I outweigh my own sedan?

As it turns out, it's the business of the government — now the nation's leading provider of healthcare — and your employer. The problems related to obesity have been a boon to late-night fast food joints and the electric scooter business but bad for nearly everyone else, with overweight individuals posting disproportionate rates of virtually every malady and disease save in-grown toenails, and running up the national medical tab to unsustainable levels in the process. 

Weight is a very bad thing when it comes to aircraft, particularly helicopters. Transporting overweight patients presents its own challenges, but the problems created by overweight pilots and paramedics are readily apparent. The need for an obese crewmember to move about what is usually a tight cabin and render medical care, or the need to either offload fuel before a mission or take on more fuel by stopping enroute to the hospital because the crew is supersized are just some examples. Add unknown variables to the equation such as even the smallest amount of airframe ice, and the flight becomes perilous, if not deadly.

Beyond weight, fitness in flight matters. Paramedics need to be able to lift patients, sometimes hold them down, focus on attaching lines, monitors and other items in a banking, vibrating, loud, sometimes hot and cramped work space. Being fit and nimble makes performing this complicated ballet easier and safer and helps fight off the impacts of fatigue.

For years, law enforcement and firefighters have had physical qualification standards for new hires and now are increasingly looking at mandating them for the entire span of a first responder's career as a means of fighting unfitness and bloat on the job.

The benefits are obvious. A 1997 FBI study found that fit law enforcement officers were far less likely to be assaulted than those perceived as "soft targets." A more recent study commissioned by the London Metropolitan Police of its forces found that half the males and one-third of the females were overweight. The study recommended yearly physical fitness tests for all officers with fines, and even dismissals, for those who failed to measure up.

Expect this trend to spread. Right now, behind closed doors, it's being discussed at the nation's leading helicopter EMS companies. When is a medevac crewmember too fat to fly? We may soon have an answer.