Inside the Rescue Harness

What Stress Data Reveals About Hoist vs. Rope Operations

When you’ve hung beneath a helicopter on a rope, swinging above cliffs, forests, or icy rivers, you don’t forget it. I’ve been there—suspended in the harness, focusing on hand signals, wind gusts, and the patient waiting below. These are among the most challenging and complex missions there is.

And now, for the first time, we have solid scientific data comparing two of the most common rescue techniques: rope operations and hoist operations.

A research team led by Håvard Mattingsdal at the Norwegian Air Ambulance Foundation set out to answer a deceptively simple question: Which method places more workload and stress on the crew—pilots, physicians, and rescuers?

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How the Study Worked

The study was no simulation. Crews flew 55 standardized missions in real alpine, forest, gorge, and vertical terrain in Western Norway. Each mission was flown twice: once with a rope and once with a hoist, in randomized order.

• Workload was measured using the NASA Task Load Index (TLX), a well-validated tool capturing mental demand, effort, frustration, and more.

• Physiological stress was tracked through heart rate and heart rate variability.

The crews were experienced: 4 pilots, 3 physicians (anaesthesiologists), and 4 rescuers (trained paramedics/nurses).

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The Findings

The results were remarkably consistent across roles and terrains: