How to protect sleep-deprived EMS personnel

By Ginger Locke

EMS responders are unfit to drive a vehicle at the end of a sleep-deprived 24-hour shift. That's because long shifts with inadequate sleep makes driving a risk to the responder and others on the road.

Multiple studies demonstrate that prolonged wakefulness is comparable to drunk driving. Twenty-one hours of wakefulness produces impairment of the same magnitude as a 0.08 percent blood alcohol content [1].

When I read accounts of EMS personnel dying in vehicle collisions on the way home from work, like EMT Susan Elizabeth Kersey, I consider sleep deprivation as the possible culprit. Undeniably, some form of state or federal regulation would improve the current practice of EMS providers logging unsafe numbers of hours worked consecutively.

Until external regulation is forced upon us, we must monitor and care for ourselves by creating safe sleep rooms. Inside a safe sleep room, a tired medic can get some sleep before driving home from their shift. In order for the room to work, we need to first agree that important, potentially lifesaving sleep is happening inside the safe room.

Key features of the safe sleep room
Depending on available space, the safe sleep room may be the usual bunk room transformed into a safe sleep room by placing a sign on the door. The sign would indicate that coworkers are getting much-needed sleep prior to driving home from shift.

Inside the room, it is critical to block out light with blackout shades and cover electronic lights. A white noise machine is a great way to dampen the inevitable noises of station duties.

When to activate the safe sleep room
The trouble with sleep deprivation is that it cannot be measured objectively, like alcohol intoxication. So how can you tell if you or your partners are too drowsy to drive? Here are some signs of driving drowsy [2]:

• Frequent blinking, longer duration blinks and head nodding.
• Having trouble keeping one’s eyes open and focused.
• Yawning and eye-rubbing.

There is no substitute for sleep. Sleep debt can only be paid back with sleep. If you note symptoms of drowsiness in yourself or your partners, sleep for at least 45 minutes and allow at least 15 minutes after waking to fully rouse before starting to drive [3].

We’ve got to take care of each other
Culturally, the idea of a crew staying at the station past the end of their shift can challenge the norms. It’s customary for off-going crews to provide hand-off reports to on-coming crews and yield the space to the new crew. This is where we have to take care of one another by observing who is too impaired by sleep deprivation to drive.

Unlike long-haul truckers and airline pilots, there is no external bureaucracy regulating how much EMS providers sleep. The decision to take care of ourselves is the only option we have.

Nothing is more important than letting a sleep-deprived coworker get the sleep they need to function on the roadways. Create a safe room to sleep off the sleep deprivation inherent in the long shifts common to EMS.

Create a safe sleep room in your station with signs, white noise machines and window coverings. (Image courtesy Ginger Locke)

About the author
Ginger Locke is Associate Professor of EMS Professions at Austin Community College. She believes medics can have long, healthy careers and her professional endeavors revolve around this idea. Interact with her on Twitter and Facebook.

References
1. Arnedt JT, Wilde GJ, Munt PW, Maclean AW. “How do prolonged wakefulness and alcohol compare in the decrements they produce on a simulated driving task? Accid Anal Prev 2001; 33(3): 337-44

2. drowsydriving.org

3. Horne, J.A., and Reyner, L.A. (1996). Counteracting driver sleepiness: Effects of napping, caffeine, and placebo. Psychophysiology. Volume 3 Issue 33, pp. 306-309.

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