BACKGROUND: Administrators of Emergency Medical Services (EMS) operations lack guidance on how to mitigate workplace fatigue, which affects greater than half of all EMS personnel. The primary objective of the Fatigue in EMS Project was to create an evidence-based guideline for fatigue risk management tailored to EMS operations. METHODS: Systematic searches were conducted from 1980 to September 2016 and guided by seven research questions framed in the Population, Intervention, Comparison, Outcome (PICO) framework. Teams of investigators applied inclusion criteria, which included limiting the retained literature to EMS personnel or similar shift worker groups. The expert panel reviewed summaries of the evidence based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The panel evaluated the quality of evidence for each PICO question separately, considered the balance between benefits and harms, considered the values and preferences of the targeted population, and evaluated the resource requirements/needs. The GRADE Evidence-to-Decision (EtD) Framework was used to prepare draft recommendations based on the evidence, and the Content Validity Index (CVI) was used to quantify the panel's agreement on the relevance and clarity of each recommendation. CVI scores for relevance and clarity were measured separately on a 1-4 scale to indicate consensus/agreement among panel members and conclusion of recommendation development. RESULTS: The EtD framework was applied to all 7 PICO questions, and the panel created 5 recommendations. PICO1: The panel recommends using fatigue/sleepiness survey instruments to measure and monitor fatigue in EMS personnel. PICO2: The panel recommends that EMS personnel work shifts shorter than 24 hours in duration. PICO3: The panel recommends that EMS personnel have access to caffeine as a fatigue countermeasure. PICO4: The panel recommends that, EMS personnel have the opportunity to nap while on duty to mitigate fatigue. PICO5: The panel recommends that EMS personnel receive education and training to mitigate fatigue and fatigue-related risks. The panel referenced insufficient evidence as the reason for making no recommendation linked to 2 PICO questions. CONCLUSIONS: Based on a review of the evidence, the panel developed a guideline with 5 recommendations for fatigue risk management in EMS operations.
BACKGROUND: Administrators of Emergency Medical Services (EMS) operations lack guidance on how to mitigate workplace fatigue, which affects greater than half of all EMS personnel. The primary objective of the Fatigue in EMS Project was to create an evidence-based guideline for fatigue risk management tailored to EMS operations. METHODS: Systematic searches were conducted from 1980 to September 2016 and guided by seven research questions framed in the Population, Intervention, Comparison, Outcome (PICO) framework. Teams of investigators applied inclusion criteria, which included limiting the retained literature to EMS personnel or similar shift worker groups. The expert panel reviewed summaries of the evidence based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The panel evaluated the quality of evidence for each PICO question separately, considered the balance between benefits and harms, considered the values and preferences of the targeted population, and evaluated the resource requirements/needs. The GRADE Evidence-to-Decision (EtD) Framework was used to prepare draft recommendations based on the evidence, and the Content Validity Index (CVI) was used to quantify the panel's agreement on the relevance and clarity of each recommendation. CVI scores for relevance and clarity were measured separately on a 1-4 scale to indicate consensus/agreement among panel members and conclusion of recommendation development. RESULTS: The EtD framework was applied to all 7 PICO questions, and the panel created 5 recommendations. PICO1: The panel recommends using fatigue/sleepiness survey instruments to measure and monitor fatigue in EMS personnel. PICO2: The panel recommends that EMS personnel work shifts shorter than 24 hours in duration. PICO3: The panel recommends that EMS personnel have access to caffeine as a fatigue countermeasure. PICO4: The panel recommends that, EMS personnel have the opportunity to nap while on duty to mitigate fatigue. PICO5: The panel recommends that EMS personnel receive education and training to mitigate fatigue and fatigue-related risks. The panel referenced insufficient evidence as the reason for making no recommendation linked to 2 PICO questions. CONCLUSIONS: Based on a review of the evidence, the panel developed a guideline with 5 recommendations for fatigue risk management in EMS operations.
Authors: Indira Gurubhagavatula; Laura K Barger; Christopher M Barnes; Mathias Basner; Diane B Boivin; Drew Dawson; Christopher L Drake; Erin E Flynn-Evans; Vincent Mysliwiec; P Daniel Patterson; Kathryn J Reid; Charles Samuels; Nita Lewis Shattuck; Uzma Kazmi; Gerard Carandang; Jonathan L Heald; Hans P A Van Dongen Journal: J Clin Sleep Med Date: 2021-11-01 Impact factor: 4.062
Authors: Elizabeth A Donnelly; Paul Bradford; Matthew Davis; Cathie Hedges; Doug Socha; Peter Morassutti; Sathish Chandra Pichika Journal: J Am Coll Emerg Physicians Open Date: 2020-06-15
Authors: Remle P Crowe; Antonio R Fernandez; Paul E Pepe; Rebecca E Cash; Madison K Rivard; Robert Wronski; Sarah E Anderson; Tory H Hogan; Rebecca R Andridge; Ashish R Panchal; Amy K Ferketich Journal: J Am Coll Emerg Physicians Open Date: 2020-01-27
Authors: Nicola Magnavita; Paolo Maurizio Soave; Walter Ricciardi; Massimo Antonelli Journal: Int J Environ Res Public Health Date: 2020-11-08 Impact factor: 3.390
Authors: P Daniel Patterson; Leonard S Weiss; Matthew D Weaver; David D Salcido; Samantha E Opitz; Tiffany S Okerman; Tanner T Smida; Sarah E Martin; Francis X Guyette; Christian Martin-Gill; Clifton W Callaway Journal: Trials Date: 2021-03-16 Impact factor: 2.279
Authors: Wahaj Anwar A Khan; Russell Conduit; Gerard A Kennedy; Ahmed Abdullah Alslamah; Mohammad Ahmad Alsuwayeh; Melinda L Jackson Journal: Clocks Sleep Date: 2020-06-08