Cardiac events are the leading cause of line-of-duty death across fire, EMS, and law enforcement — and most are preventable. We deliver evidence-based physical and cardiac evaluations that identify risk before it becomes a crisis.
Why This Matters
The demands of emergency response are unique. Routine physicals and submaximal testing may miss health problems that only surface under the kind of maximal physiological stress first responders face on every shift.
Over 25 years of testing, spanning over 9,000 tests in first responders, rigorous and comprehensive physical testing has proven to be an essential component of cardiovascular screening. Structured health surveillance through periodic testing is imperative to maintaining work readiness throughout the careerspan.
Who We Serve
Each first responder group carries a distinct cardiovascular risk profile shaped by the nature of their work. Our evidence-based protocols are designed to screen for all of it.
Fire suppression accounts for just 1–5% of annual duty time, yet cardiac events drive 45–63% of all firefighter line-of-duty deaths. Heat stress, peak exertion, and adrenaline surges are primary triggers in personnel with undetected coronary disease.
Source: NIOSH · U.S. Fire Administration 2025 LODD Report
Chronic sleep disruption, high-acuity stress, and repeated physical demands compound cardiovascular risk across a career. 11% of on-duty EMS deaths are cardiac, with risk increasing sharply after age 45.
Source: PMC cardiovascular risk analysis
Officers carry 1.7× the cardiovascular disease burden of age-matched civilians, with an average life expectancy of 57 years vs. 79 for the general public. Shift work, sedentary patrol, and acute stress spikes drive long-term cardiac risk.
Source: NIH/NCBI · Smith et al., J Am Heart Assoc. 2018
Why Us
In addition to NFPA 1580 physicals and risk stratification, we tailor the testing battery based on the latest science — including a physician-supervised maximal treadmill test and additional bloodwork based on individual health status. I have worked with some firefighters for over 20 years and ushered many into a healthy retirement.
All maximal treadmill stress tests are physician-supervised — not administered and reviewed later, but monitored in real time by a physician who can act immediately on what the ECG shows.
Our Facility
Our testing environment is built around the equipment and technology needed to conduct physician-supervised maximal stress tests and comprehensive first responder evaluations.
What We Test
To address current and future issues, it is imperative to examine a variety of blood and urine tests for cardiovascular, metabolic, and cancer risks — combined with a maximal treadmill test and a battery of strength and endurance tests to effectively evaluate cardiovascular and muscular abilities.
Physician on-site throughout cardiovascular testing.
Blood and urine collected up to one month prior to evaluation day.
Results integrated with cardiovascular data for a complete risk profile.
How It Saves Lives
There is no one definitive test. Both by the breadth of testing and the testing over time, we are able to detect changes, catch problems early, and realign health trajectories. These outcomes represent real people who went home.
An apparently healthy 42-year-old with no prior symptoms required six bypass surgeries after significant changes were detected on their maximal treadmill stress test. Without physician-supervised maximal testing, there was no clinical pathway to find this — until it becomes an emergency on the fire ground.
Through regular blood screening over many years, we helped detect what became the first presumptive case of prostate cancer identified in Colorado through a first responder health program. Longitudinal testing — not a one-time physical — made this possible.
A pre-retirement firefighter had arrhythmias detected at maximal effort during treadmill testing. A stent was placed. The timely detection enabled them to receive benefits through the Colorado Firefighter Heart Trust — and to retire healthy rather than as a statistic.
Partner with First Responder Performance to make evidence-based cardiac screening part of your department's culture of safety.
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