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Impaired consciousness isn’t just for EMS patients

Use the EMS “Go to Sleep” checklist to see if lack of sleep is making you or your partner dangerous to one another, your patients and the community

Who among has not worked enough overtime to render us less than 100 percent? EMS is a difficult way to make a living that’s made more difficult by the culture of long shifts, low pay and extreme stress.

We handle the stress remarkably well considering the amount of responsibility that is dumped on us. Most of us thrive on the thrill of the challenge, the chance to make profound differences in other people’s lives, and even the opportunity to serve our fellow man during their darkest hours.

Yet, EMS has the ability to crush a person not prepared for what lies ahead, leaving them emotionally and physically drained. We owe it to ourselves, our employer and especially the people on the other end of our response to bring our best on every call.

Nothing more dangerous than a lack of sleep
The most destructive and career-destroying part of the job is without a doubt lack of proper sleep. Most of us are secretly proud of our ability to perform with precious little sleep. We delude ourselves into believing that working exhausted comes with the territory.

Most often the last person to realize they have crossed the line into ineffectiveness is the chronically sleep-deprived EMS provider. That is where a good partner is critical.

We need somebody to slap sense into us when we become senseless. A good partner has our back and is not afraid to tell us enough is enough, go home, hit the rack and recharge.

Being the bad guy is difficult. Nobody wants to tell their partner that they are irrational, dangerous and plain old grumpy or giddy from a lack of sleep.

The EMS “Go the F--- To Sleep” checklist
To make your self-assessment or your partner assessment go a little more smoothly, I have compiled the following checklist to know when it is time for lights out.

10. The last three patients have the same vital signs: BP 120/80, HR 80, Resp. 18.

9. You can’t remember your last call.

8. All of your patient’s look the same.

7. No one can you read your writing, or your normally illegible writing is legible.

6. The average word count for your ePCR narratives is six.

5. Patients begin asking, “Are you OK?”

4. You smell coffee and Red Bull every time you pee.

3. You need to punch the station address into the GPS to get back to quarters.

2. The empty stretcher, unchanged since you dropped your patient at the hospital, looks like a great place to have a little nap.

1. You keep asking, “Am I dreaming?”

It will be difficult to argue one’s effectiveness after answering the questions on the checklist honestly. EMS is a tough job for tough people, but even the toughest among us need to know when enough is enough.

If you answered yes — for yourself or your partner — to one or more of these questions, you are fatigued. Or, to borrow a phrase from the best-selling bedtime book for parents of young children, “Go the F--- To Sleep.”

Captain Michael Morse (ret.), mmorsepfd@aol.com, is the bestselling author of Rescuing Providence, Rescue 1 Responding, City Life and Mr. Wilson Makes it Home. Michael has been active in EMS since 1991 and offers his views on a variety of EMS and firefighting topics, focusing mainly on the interaction between patient and provider as a well-respected columnist and speaker. Captain Morse is a Johnson/Macoll fellow in literature from the Rhode Island Foundation.