Guidelines Hope to Help Tired EMS Workers

Fatigue remains a widespread problem for EMS workers because many work 24-hour or longer shifts and get little sleep.

by Ben Schmitt, The Pittsburgh Tribune-Review / January 23, 2018

(TNS) - The lives of EMS workers often revolve around high tension and stress.

They're often the first to respond for patients during their moments of greatest need, be it a heart attack, motor vehicle crash or other emergency.

Being sharp and on their game is paramount.

“We are required as clinicians in the field to make decisions quickly in austere environments, without much information,” said Daniel Patterson, a paramedic for Parkview EMS in O'Hara. “You have to be clear and alert to make those decisions.”

Fatigue remains a widespread problem for EMS workers because many work 24-hour or longer shifts and get little sleep.

“It's a huge problem systemwide,” Patterson said.

A new analysis, written by a team led by University of Pittsburgh School of Medicine scientists and published last week in the journal Prehospital Emergency Care, recommends five guidelines to help reduce EMS burnout.

“All EMS personnel have a responsibility to report for duty well-rested, and EMS employers have a responsibility to proactively identify fatigue, determine when fatigue is a threat, and mitigate fatigue with strategies informed by evidence-based recommendations,” the paper's authors wrote.

The guidelines consist of five recommendations:

• Conducting surveys to measure and monitor EMS personnel fatigue.

• Limiting EMS shifts to less than 24 hours in duration.

• Allowing EMS workers to nap on duty during down times.

• Making sure workers have ample access to caffeine.

• Providing education and training in fatigue risk management.

“This is not intended to be prescriptive, the whole point is to give administrators something to stand on,” said Patterson, who is also the analysis' lead author and assistant professor of emergency medicine at the University of Pittsburgh School of Medicine. “There has been no real guidance or direction in how to manage EMS fatigue and that has to change.”

Patterson and colleagues came up with the guidelines after reviewing more than 38,000 journal articles, conference presentations and other publications about fatigue and shift work. They started work on the analysis in 2015.

There are currently more than 800,000 EMS workers and 21,000 EMS agencies in the country. Nearly 37 million EMS calls go out annually in the U.S. with 28 million EMS transports.

Patterson and his team hope the guidelines help alleviate all aspects of EMS fatigue. One wrong decision can come with serious consequences.

“The safety of the clinician, of the patient and the public are all at risk due to fatigue,” Patterson said. “Operating the ambulance is only one aspect of EMS care. Most of the work EMS clinicians do is actually patient care.”

The research was funded by the National Association of State EMS Officials and the National Highway Traffic Safety Administration.

Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991, or via Twitter at @Bencschmitt.


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