Medevac Foundation Sleep-Wake Patterns and Real-Time Fatigue Reduction in EMS Clinicians (Phase 2)

Photo by Jim Duell.

The overarching goal of this this study is to address the MedEvac foundation priority of educational techniques and technologies and improve HEMS safety by determining if overall sleep quality and intra-shift fatigue of HEMS clinicians can be improved with real-time assessment and intervention.

Principal InvestigatorDave Hostler, PhD

Funding Agency: MedeEvac Foundation and University of Pittsburg

Period: 2016-2017

Abstract: Fatigue is an “unpleasant symptom incorporating feelings of tiredness to exhaustion creating conditions that interfere with the ability to function in a normal capacity.” Recent data show that half of clinicians in ground and air-medical based Emergency Medical Services (EMS) operations suffer from fatigue and are at elevated risk of a negative safety outcome. Existing fatigue risk management programs and systems may not have the intended impact. Experts believe the future of fatigue risk management is real-time assessment and intervention of fatigued workers.

Recently, we completed the first pilot randomized trial that tested real-time assessment of fatigue and sleepiness in EMS clinicians. The SleepTrackTXT pilot randomized trial successfully enrolled 100 paramedics, flight paramedics, flight nurses, emergency room nurses and several emergency physicians to participate over 90-days and use text-messages to report feelings of fatigue and sleepiness during shift work. Participants in the intervention group received strategy messages in real-time if they reported high levels of fatigue, sleepiness, or difficulty concentrating at the beginning or during shift work. The study was a success, and participants answered 88.1% or 36,073 text messages. Participants in the intervention group that worked extended shifts (e.g., 12-hour shifts) reported lower levels of fatigue at the end of shift compared to participants in the control group (p<0.05). At the end of the study, participants reported high satisfaction with the SleepTrackTXT tool as the primary means for assessing fatigue in EMS settings.

The overarching goal of this this study is to address the MedEvac foundation priority of educational techniques and technologies and improve HEMS safety by determining if overall sleep quality and intra-shift fatigue of HEMS clinicians can be improved with real-time assessment and intervention.