On June 16, 2017, an EMT was crim- inally charged for the death of her patient. The EMT was driving an
ambulance when she fell asleep at the wheel
and crashed into a tree. The 55-year-old male
patient died on scene.
On May 24, 2017, an ambulance crashed
in Duanesburg, N. Y. The 64-year-old patient
died on scene. News reports suggest that the
driver fell asleep at the wheel just moments
before the crash.
In another case, on Feb. 14, 2017, a 77-year-
old male patient was being transported by
ambulance between two facilities. The ambu-
lance crashed around 5: 40 p.m. local time and
the patient died on scene. The driver informed
authorities she fell asleep while operating
Are these just isolated events or indicators of a
more widespread problem? Perhaps it’s the latter.
In the 24-day period between July 12 and August
4, 2017, three ambulances in the state of Maine
crashed and all three events were believed triggered by the driver falling asleep while driving.
In March 2015, a patient being transported
via ambulance died following a crash that was
precipitated by the driver falling asleep.
On March 5, 2013, an ambulance crashed
and rolled over around 4: 45 a.m. on Interstate
90 in South Dakota. The state police reported
that the EMT driver fell asleep.
Although we don’t have the details of these
events, many of which involved reported sleepiness or fatigue, most of us with any experience
in EMS can imagine the sequence of events
that led to these outcomes and how fatigue
may have played a role.
This article will address fatigue in the EMS setting and discuss factors that may contribute to
fatigue and how fatigue affects EMS clinicians.
Statements and stories of clinicians from
across the country are included. The identi-ties of those interviewed are kept confidential
with the use of aliases. I will present recently
released evidence-based guidelines for fatigue
risk management in EMS and describe how
local administrators can adopt these recommendations to begin to better manage fatigue.
My aims for this article are to emphasize the
role that fatigue plays in everyday EMS operations, and to stress the compelling need to manage fatigue guided by the best available evidence.
Evidence-based recommendations for combatting fatigue in EMS
By P. Daniel Patterson, PhD, MPH, MS, NRP