Finally in the news is an article from EMS1.com that talks about workplace fatigue in EMS and medical and safety errors. It tells the story of a medic, after over 30 hours on duty, who got a needle stick on a call because they were tired and not paying proper attention. I urge you to read the article and think about your workplace situation.

24 Hour Scheduling and EMS Errors

fatigued-paramedic-tiredDo you work 24’s that end up being 30’s or 35’s? The continued trend out there to putting fire-based EMS systems on fire system schedules is one that is alarming me. It scares me for just this reason.

Fire departments run much fewer fire calls than an EMS system’s call volume. A 24 hour schedule works for them because in all but the most unusual situations, there is ample opportunity for some sack time when a firefighter gets fatigued.

But with an EMS unit in the same metropolitan system, they are running nearly continuously in that time frame meaning there isn’t time for meals, let alone time to hit the bunk for a nap. When you add in overtime, you get the picture of what can and does happen all too often.

Call for a National EMS Work/Rest Standard

There needs to be a national standard for EMS and other medical professions similar to that used for pilots, truckers and other occupations where public safety is at risk. EMTs and paramedics should be required to get a certain amount of sleep between shifts and the length of those shifts should be no longer than 12 hours.

The argument has always been to exempt emergency services from these types of rules because they respond to emergencies and that makes them, somehow, supermen. REALLY? I know there will be those rare mass casualty situations, natural and man-made disasters that will require those long hours, but the vast majority of what we do can be called routine situations and transports that probably don’t even require an emergency response.

What do you think? How many hours do you work and still feel safe to handle patient care? I want to hear back from you so leave a comment in the link below this article or in the show notes and let me know. I look forward to hearing from you!

Follow up on the links to this news item and all the other articles and resources in this week’s episode show notes – Statewide Pit-Crew CPR Standards and Episode 431.

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5 Responses to Overtired EMS Providers Prone to Medical Errors

  1. chris says:

    Firefighters working 24 hours shifts cross-trained as paramedics should NOT be working that shift schedule. It’s dangerous for both the professional and patient. Firefighters do not have super powers. Many medics in fire based EMS systems work alongside undertrained basic medically trained firefighters who cannot adequately assist a firefighter paramedic who essentially works and critically thinks alone on a call, errors are bound to happen, add in long shifts with zero sleep is a recipe for disaster. After 20 hours, studies show it’s the equivalent of being mildly intoxicated.

  2. podmedic says:

    Thanks for the comment Chris! I agree with you. It’s interesting how some of the social media responses to this make statements like the medic needs to “Power Thru” the fatigue. I hope you’ll come back and comment again on other articles and episodes here at the MedicCast.

  3. DAC says:

    Absolutely agree. I’m a paramedic in a high volume, high acuity environment. We work 12 hour shifts, that can turn into 14-16-18 hours at times. Add that to paperwork, and at times 4 shifts back to back of 14+ hours- and it is exhausting. We average about 10-12 calls per 12 hour shift, with an 80% transport average. At times we are understaffed, overworked, and we get A LOT of frequent flyers. We also have a high incidence of people in our area that feel 911 is for every minor illness and injury. A majority are non compliant with medications and regular PCP visits-so they use the ambulance and ER as their PCP. An old, and far too common story to be sure. Proper staffing, 8-12 hour shifts, and a shift to the Department of Health oversight and away from the Department of Transportation. I have made mistakes due to being tired, or working while sick due to a ridiculous attendance points policy, and it scares me at times. Anyone that says to “power through” needs to find a different career. Those are the medics that kill patients due to their own exhaustion, and careless mistakes.

  4. Brooke says:

    A huge part of the problem are unions fighting to keep the long shifts so providers can work fewer days a month. In every other profession, unions have fought for work time restrictions due to safety, so I don’t know why in EMS, the exact opposite is the case. I agree there needs to be a regulation. But from whom? Since EMS is not really health, not really public safety, and not really transportation, no one is really claiming responsibility for this. Even CAAS is unwilling to create a standard, due to wide variations in EMS service models across the country. We know there are problems, so we need to work on solutions. Where to start…that should be your next article!

  5. podmedic says:

    I’ll see what I can do as far as solutions. Maybe I can set up an EMS leadership interview to see what they see as possible solutions. Thanks for the comment!

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