Effects of Sleep Deprivation on Fire Fighters and EMS ... - NAEMT

<strong>Effects</strong> <strong>of</strong> <strong>Sleep</strong> <strong>Deprivation</strong> on Fire Fighters and EMS Responders
Wildland fire fighters have the Wildland Fire Safety & Health Reporting Network, SAFENET,
which is a method for reporting and resolving safety concerns encountered in wildland fires.
Reviewing the last three years <strong>of</strong> reported events (2003 to 2006), communication issues were
the leading category contributing to reported incidents. Of 494 incidents (2003 to 2006), 38
appeared related to human perceptual errors, including fatigue (Bailey, 2007). Fatigue was a
clear contributor in six <strong>of</strong> the serious accidents, three <strong>of</strong> which resulted in rollover vehicle
crashes. Fatigue when driving can lead to poor judgement, inattention, vehicle wandering and
falling asleep at the wheel. Wildland fire fighters <strong>of</strong>ten travel to and from worksites in 15
passenger vans, which when loaded with occupants become top heavy and prone to rollovers.
The most notable fatigue-related incident was when eight crew members were killed in a traffic
accident after spending the previous 11 days fighting a forest fire. The crew had been demobilized
the previous evening. Weather was sunny and dry, and the crew had been on the road about three
hours when the crew driver attempted to pass a semitrailer on a downhill left-hand curve, in a
marked no-passing zone. The van struck an oncoming semitrailer head on. This particular patch <strong>of</strong>
road is known for frequent accidents. Alcohol may have played a role in the incident (http://
www.ohsu.edu/croet/face/incidents.cfm).
SAFENET (http://safenet.nifc.gov/) was developed on the recommendations <strong>of</strong> the
Wildland Firefighter Safety Awareness Study. SAFENET is a component <strong>of</strong> the National
Interagency Fire Center and reports can be submitted anonymously by anyone,
although it is recommended that the first line supervisor complete the SAFENET form. It
is a tool and format to identify and remedy safety concerns <strong>of</strong> wildland fire fighters.
4.7 Work Hours and EMS Responders
As mentioned, EMS responders’ work a wide variety <strong>of</strong> types <strong>of</strong> jobs with different work structures.
As demands for emergency medical services have accelerated, increases in work load and
employee dissatisfaction have resulted in changes in shift structure. Those occurrences have allowed
prospective assessment <strong>of</strong> different work formats. At one site, EMS personnel changed from 24 to
12 hour shifts, using a rotation with 3 days <strong>of</strong> 12 hour shifts, 2 days <strong>of</strong>f, 2 days <strong>of</strong> 12 hour shifts, 3
days <strong>of</strong>f. With the 12 hour schedule, both at 2 months and at 1 year, employees perceived that
they were more productive and felt better, with less family and social disruption from their work.
Interestingly, an index <strong>of</strong> emotional exhaustion decreased immediately after the change, and
although other indices remained improved with the reduction in shift duration, the emotional
exhaustion dimension returned to baseline after one year (Boudraux et al., 1997).
The city <strong>of</strong> Austin changed EMS staffing to distribute shorter shifts to the busiest sites. They reported
their staff survey findings that led to the change. Prior to the change when 24 hour staffing still was
in effect, most paramedics felt the demands for overtime were excessive, and one-third reported
working more than 24 hours without sleep in a single week . The majority felt that 24 hour shifts
resulted in a decrement in their abilities, and most (72%) reported that 12 hours was the maximum
time that it was safe to take calls at the busiest stations (http://www.austinchronicle.com/ gyrobase/
Issue/story?oid=oid%3A388475).
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