Fatigue is a complex concept and there are
many variables that may contribute to EMS
clinicians being impaired by fatigue.
Fatigue refers to “a subjective, unpleasant
symptom, which incorporates total body feelings ranging from tiredness to exhaustion creating an unrelenting overall condition which
interferes with an individual’s ability to function to their normal capacity.”
Does EMS have a fatigue problem? According to previous research, more than half of
EMS clinicians report severe mental and/or
If the industry has a fatigue problem, are
administrators and individual clinicians prepared to address it? This is unlikely, as there’s
no known repository of model fatigue risk management programs for EMS operations. There’s
little information about different approaches
or best practices pertaining to mitigation of
fatigue in EMS. Most administrators and
managers aren’t prepared to address fatigue
in the workplace.
The National Sleep Foundation (NSF) recommends that adults obtain between seven
and nine hours of sleep per 24-hour period.
Most adults in the United States report seven
hours of sleep per night,
13 yet one-third report
inadequate sleep in the previous 24 hours.
Most EMS clinicians don’t meet NSF recommendations for sleep and many report inadequate sleep. Half of EMS personnel sleep only
six hours every 24 hours with more than half
reporting poor sleep quality,
12 and 70% report
some problems with sleep.
Many of us have partners or know of col-
leagues who regularly report getting little or no
sleep between shifts. Nancy is a paramedic in
the Northeastern U.S. with 15 years of expe-
rience as a paramedic. “I get between five and
six hours of sleep per day,” she reports. “I am
capable of dealing with little rest during the
week, yet when the end of the week comes,
I’m a zombie.”
She goes on to say, “There are times that
I’m up all night on a 24-hour shift, and that
just destroys me.”
Jamie is a paramedic with five years’experi-
ence in a busy urban system in the Northeast.
She works a rotation of six days on followed
by two days off. “I get as little as three hours
of sleep between shifts for six days straight,”
she says. “It’s dangerous as hell. It’s horrible.
There are times when I dread going to work.
Shift modification can be an important part of an agency’s fatigue risk management strategy. Based on
the evidence, it's recommended that EMS personnel work shifts that are less than 24 hours in duration.