The Dangers of Sleep Deprivation

As any parent of a young child will tell you, the morning after “spring forward” can prove challenging when trying to rouse your kiddos out of bed for school. When the clocks change, our internal clock becomes out of sync with our current day-night cycle, creating a lot of tired faces over the breakfast table.

If just a one-hour change can have such an impact, what about the havoc shift work plays on our bodies? In this month’s Cases with a Twist, authors David Page and Will Krost discuss a case in which sleep deprivation impacts not only patient care, but also provider safety, leading to a scenario where providers cover up an accident so as not to face any repercussions.

Fatigue in EMS is a big problem. Providers working in systems with little downtime may also be working second jobs, further impacting their ability to rest after their shift ends. And the physical impairments related to fatigue are serious. A study by researchers in Australia showed that being awake for 18 hours produced an impairment equal to a blood alcohol concentration (BAC) of .05, and .10 after 24 hours.  

Reducing fatigue-related accidents is on the NTSB’s most wanted list for transportation safety improvements in 2016. Nearly 20% of the 182 major NTSB investigations completed between 2001 and 2012 identified fatigue as a probable cause, contributing factor or finding. The National Association of State EMS Officials (NASEMSO) and NHTSA’s Office of EMS have also made it a priority with the formation of a new initiative to address EMS fatigue risks. According to their data, greater than half of EMS providers report fatigue at work and half get less than six hours sleep per day. For more information, see emsfatigue.org.