Fatigue Rolls an Ambulance

Another interesting article to come out of Canada this week is an article about ambulance rolling into a ditch after the paramedics inside fell sleep due to extreme fatigue. This occurred in Manitoba. The two paramedics fell asleep and rolled their vehicle into a highway ditch at 7 AM while returning from a call. They had been working all day the previous day and then have had numerous calls throughout the night so they’d gotten no opportunity to sleep. Long travel times in rural Canada and other rural areas means that this could happen in many places.

Just Culture and Ambulance Accidents

One of the things I like about this article is the officials there are not necessarily looking at the paramedics for being at fault. They are looking at examining the need for enacting rules and regulations about the number of consecutive hours that a paramedic can be on the job before they have to have some mandatory rest time. We do that for long haul truck drivers. We require them to have a mandatory rest period each day before they can start driving again. Why do we force paramedics to be up for 24 hours not only driving a vehicle but attempting to provide high-quality medical care. It really doesn’t make a lot of sense to me.

I like that this article is focusing on the fact that they were fatigued and that fatigue was work-related.That doesn’t always happen here in the United States. I think part of that is the function that Canada has a nationalized healthcare system and or at least a local healthcare system the paramedics are part of. Healthcare is not part of public safety so the response to something like this is a little bit different. It might be much different here in a fire department or police based system where they have a different attitude about such things.

When mistakes or errors in judgment happen because of the way a workplace is arranged or setup, there should be little blame on the individuals forced into a bad position. We have talked about this in the past. Organizations have to adjust their cultural attitude toward safety and errors when something happens. There should be a culture of “Just Culture” that treats that person appropriately and the incident is treated as an educational opportunity and not as an opportunity for disciplinary action.

Adopting Just Culture for Error Reporting

I hope that the American organizations out there will look at something like this and agree that they need a similar approach. We need to get rid of 24-hour on-call for paramedic units in busy areas because it just doesn’t make sense as call volume goes up. We just talked about the aging population increasing call volume. As call volume goes up and people become more and more busy in on the job it just does not make sense to run somebody 24 hours straight. Those agencies are just asking for a lawsuit and medical errors.

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Check out the links and full episode video and audio for this week’s episode – West Nile Virus Treatment and Episode 299.

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