Sleep study investigates real-time fatigue
MedEvac Foundation International (MFI) has announced that it has approved grant funding for Dr Daniel Patterson to investigate sleep-wake patterns and real-time fatigue reduction in air-medical EMS clinicians
MedEvac Foundation International (MFI) has announced that it has approved grant funding for Dr Daniel Patterson to investigate sleep-wake patterns and real-time fatigue reduction in air-medical EMS clinicians.
The medical transportation community requires that emergency care be available 24-hours a day. Shift work requires the prehospital emergency clinician to diverge from normal circadian sleep cycles and be alert when the pressure to sleep is greatest, said MFI. While the Foundation highlighted that recent data suggests a link between sleep, fatigue, and safety in the EMS setting, the data are limited to cross-sectional designs and subject to recall and measurement bias. The proposed study is intended to provide detailed prospective observational data to address questions regarding pertaining to the relationships between shift duration, sleep/wake cycles, and behavioural alertness.
The overarching goal of the study is to address the Foundation’s research priority of ‘Educational techniques and technologies aimed at improving patient care, critical decision making, safety, or other areas pertinent to transport medicine’. Dr Patterson, along with several colleagues, intends to accomplish this goal by performing a multi-site study of air-medical EMS clinicians. The Foundation Board has approved Phase 1 of the study, which will involve a prospective observational study of sleep/wake cycles, shift work duration, intershift recovery, fatigue, and behavioural alertness (i.e. psychomotor vigilance). The analysis of Phase 1 data will focus on differences between 12-hour versus 24-hour shifts.
MedEvac Foundation International commented: “This study will have a significant impact on the transportation community. First, the debate on shift duration (shorter versus longer shifts) is ongoing and unresolved. Many EMS systems use extended shift periods in light of low patient volume and resource limitations. Other systems use shifts of shorter duration. The relationships between shift duration, sleep, fatigue, and performance are complex and the data to support a prescribed shorter or longer shift schedule are limited.”
Dr Patterson and colleagues also proposed a Phase 2 for their study. Phase 2 will be considered for funding upon completion and presentation of Phase 1. Phase 2 would involve an experimental study design, and test novel fatigue risk management intervention that uses real-time assessment and intervention to improve alertness of EMS clinicians during shift work as well as their overall sleep health.