Nap time in EMS?

Being tired while at work is nothing new to EMS. But is it putting your life, and others in danger?

As you read this, are you tired?

Earlier this week, a responder from Walker County, Ga., was charged with reckless driving after he crashed an ambulance into an oncoming car.

The Chattanooga Times Free Press reported Gerald Zigner was in the 11th hour of a 24-hour shift when he allegedly fell asleep at the wheel.

The ongoing investigation into the crash, which left a passenger in the car with serious injuries, brings up the issue of driver fatigue as a possible causal factor.

Being tired while at work has been talked about both in popular media as well as in our industry press. I remember articles being published in the 1990s that highlighted the ability to work safely when tired.

I can empathize with that, as many of you can. When I was a younger medic, pulling 16, 24 and 48 hour shifts was "no big deal." Hey, I could go home at the end of a 24-hour-shift and remain perfectly functional for the entire day, go to bed at a reasonably normal time, and go back to work the next day and do another 24-hour-shift.

In reality, I was a bit delusional with myself. First, I really didn't stay fully awake the next day; I took mini and micro-naps in the morning and afternoon. If the shift was fairly busy, I found myself taking longer to write a patient care report, or driving more slowly to calls.

By the end of the third 24-hour-shift, there were times that I know I fell asleep while waiting at a red light at 4am. Why? Because when I woke up with a startle, I looked at my partner and she was asleep as well.

Many of us are still working long shifts. We experience cycles of wakefulness and sleepiness throughout the day. We artificially get past the sleepy part of the cycles with caffeine and sheer willpower at times.

But we don't do very well for longer periods of time. Many studies have shown that precision, accuracy and service levels drop as we get tired, while the rates of crashes, injuries and even deaths go up.

It may be true that in some systems where call volume is low, that working extended hours may be safe. That assumes that one can "bank" sleep hours, and work practices are in place to promote napping when appropriate. Working a 24-hour-shift and being awake for much of it? That's an issue.

We know that we work in a hazardous job. It doesn't make sense that we promote that environment by being tired.

About the author

Art Hsieh, MA, NRP teaches in Northern California at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. An EMS provider since 1982, Art has served as a line medic, supervisor and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook writer, author of "EMT Exam for Dummies," has presented at conferences nationwide and continues to provide direct patient care regularly. Art is a member of the EMS1 Editorial Advisory Board. Contact Art at and connect with him on Facebook or Twitter.

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