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The Fatigue Insider Blog

Fatigue Risk Management in EMS

Oct 31, 2018 ISS Comments (0)

Fatigue continues to be a widespread problem for Emergency Medical Services (EMS) personnel. Both mental and physical fatigue can affect EMS personnel, due to the intensity of the job and working shifts, which we know disrupts normal patterns of sleep and circadian rhythms. Studies have found significantly higher levels of fatigue and mental health issues amongst paramedics, as well as significantly poorer sleep quality compared to other industries.

Near misses and accidents involving EMS personnel, where fatigue was a contributing factor, continue to occur. Earlier this year, an Emergency Medical Technician in the USA was killed when the technician driving the ambulance fell asleep at the wheel, colliding into another vehicle.

Evidence-based Guidelines for Fatigue Risk Management in EMS were recently published in the Prehospital Emergency Care journal recommend:

  • The use of fatigue surveys to measure and monitor fatigue in EMS personnel
  • Shifts to be shorter than 24 hours in duration
  • Access to caffeine as a fatigue countermeasure
  • The opportunity to nap while on duty in order to mitigate fatigue
  • Education and training on fatigue-related risks
 
The guidelines also remind us that fatigue management is a shared responsibility between EMS personnel and employers.

For more information on fatigue risk management in EMS, contact us via Facebook , LinkedIn , Twitter or comment below.


 
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REM - The sleeping brain's favourite tune

Oct 24, 2018 ISS Comments (0)

"When the day is long... And the night, the night is yours alone" to sleep a full 7-8 hours! Although it may seem like your body ‘shuts down’ during sleep, it is an active time for your brain and many physiological processes. During sleep, your brain goes through different stages, with some lighter stages of sleep (referred to as stages 1 and 2), and some deeper stages of sleep (stages 3 and 4). There is also a fifth stage of sleep known as rapid eye movement sleep, or REM sleep. It is during this stage that your heart rate increases, your breathing becomes more irregular and dreams are most likely to occur.

A normal night-time sleep period occurs in cycles of approximately 90 minutes. The duration of sleep stages within each cycle changes throughout the night and varies person to person. Typically, a sleep cycle will begin with a period of non-REM sleep followed by a very short period of REM sleep. The duration of REM sleep increases with the cycles while you are sleeping. Throughout a full night's rest, the average person will spend 20-25% of their sleep in REM.


REM sleep is the restorative part of our sleep cycle. It is very important for emotion regulation and memory and is also the peak of protein synthesis at the cellular level, which keeps many processes in the body working properly. Decreased sleep duration interferes primarily with REM sleep and dreaming since the body devotes deeper non-REM sleep to shorter hours of sleep. A recent study has shown that REM sleep loss is associated with increased inflammatory responses, increased risk for obesity, and memory problems.

For more information on REM sleep, contact us via Facebook , LinkedIn , Twitter or comment below.

 

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Driver fatigue - it's not all about microsleeps

Oct 17, 2018 ISS Comments (0)

A lot of us have been fatigued behind the wheel and battled to keep our focus on the road. We've relied on the usual tactics to try to keep ourselves awake including winding the windows down and belting out our best rendition of Madonna as it's blaring through the speakers (ok, maybe just some of us!). Nodding off, or experiencing microsleeps, is really the worst case scenario. But being fatigued while driving can be enough to impair you alone, without actually experiencing a microsleep. 

Someone who is fatigued will often experience slower reaction times, reduced ability to concentrate and delays in interpreting information. Driving in this state could easily result in a traffic incident or accident. 

The human body will naturally cycle through intervals of sleepiness and alertness, better known as the circadian rhythm. The window of circadian low (WOCL) is a period between 2:00 a.m. and 6:00 a.m. for those adapted to a usual day-wake/night-sleep schedule. During the WOCL, a reduction in physical & mental performance, alertness and body temperature. We also experience a low in the circadian rhythm in the afternoon, known as the postprandial dip, commonly referred to as the post-lunch dip or siesta time. According to the New Zealand Government's Ministry of Transport, fatigue-related fatal and serious injury crashes peak during the WOCL and postprandial dip.

To avoid driver fatigue, we recommend to:

  • Avoid driving during periods when you would normally asleep
  • Allow yourself some time to wake up from your sleep before driving
  • Share the driving where possible
  • Plan breaks every 2 hours when driving for long periods of time
  • Have a coffee nap (read our previous blog post here)

For more information on driver fatigue, contact us via Facebook , LinkedIn , Twitter or comment below.


 


 

 

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Are sleeping pills a good option?

Oct 10, 2018 ISS Comments (0)

Have you ever been prescribed sleeping pills? Prescription medication to aid sleep during times of transient sleep loss can provide much-needed relief. They can be quite effective at helping you fall asleep, however, if misused it is very easy to become dependent on the use of the medication, either physically or emotionally.

 

In a 2012 study, researchers compared over 10,000 people who took sleeping pills with nearly twice as many people with similar health histories who did not take sleeping pills. It was found that those who took sleeping pills were more than four times as likely to have died during the study’s 2.5-year follow-up as those who didn’t take them. While the study shows an association between sleeping pills and death, it does not prove them as the cause. The problem may lie in overuse or activities that are undertaken while experiencing the drowsy side-effects of sleeping pills, such as driving or operating heavy machinery. 

 

Sleeping pills are not the long-term answer to sleep problems and should only be used for short periods of time because of tolerance to the drug and the risk of dependency. It is important to follow the advice given to you by your doctor. Also, never take sleeping pills when travelling on aircraft. As tempting as it can be to take them to help you sleep on the plane, they effectively immobilise you, increasing the risk of DVT dramatically due to blood pooling, usually in the lower part of the body. Click on some of our older blog posts below the best tips to battle jet lag without sleeping pills:

 

High & Dry: Keeping hydrated while flying

Beware of the Dark Side: Using light to reduce jet lag

Melatonin - should you use it?

Around the world in... 52 hours?

For more information on sleeping pills, contact us via Facebook , LinkedIn , Twitter or comment below.

 

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Fatigued cabin crew

Oct 03, 2018 ISS Comments (0)

The airline industry is a growing 24/7 operation, boasting an estimated 39 million flights to be flown worldwide by the end of 2018. Flying passengers across the country, or even across the globe, can create a variety of different challenges for cabin crew, including extended duty periods, highly variable schedules, possible frequent time zone changes, and increased passenger loads.

A study has shown a link between the job characteristics of cabin crew and fatigue. The graph below is an indication of the main work factors that contribute to fatigue amongst cabin crew workers, according to union representatives. Long hours and lack of rest are seen as the main offenders.


 

Other factors that may contribute to cabin crew fatigue include, but are not limited to:

  • Consecutive duty days
  • Length of layovers
  • Timezone changes
  • Delays
  • Availability for breaks
  • Availability of a healthy meal
  • Passenger disruption
  • Aircraft type swaps

In 2016, a bill was pass that requires airlines to provide cabin crew with a minimum 10-hour rest period between shifts, matching the requirement for pilots. The bill also included a requirement for cabin crew to be included in Fatigue Risk Management Systems, which until that point was only applied to pilots.

In Australia, there are currently no civil aviation regulations governing duty times and rest requirements for cabin crew. Their duty limitations are set contractually, and minimum standards are set by the country in which the cabin crew are employed. Cabin crew are our first responders to a safety event - is it time they are included in fatigue regulations?

 

For more information on cabin crew fatigue, contact us via Facebook , LinkedIn , Twitter or comment below.

 


 

 

 

 

 

 

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