Fatigue as a Systems Problem: Policy, Culture, and Risk in EMS

Have you ever had a close call falling asleep because you were exhausted from working your EMS shift? While we often acknowledge fatigue in EMS as an issue, we must do more to address and operationalize the education, policy, and system design of this dangerous problem.

Hosts Maia Dorsett, Rob Lawrence and Hilary Gates are joined by fatigue expert P. Daniel Patterson, PhD, NRP, Associate Professor in the Department of Emergency Medicine at the University of Pittsburgh along with Stephanie Louka, MD, EMT, an EMS physician at the Virginia Commonwealth University Medical Center. Stephanie shares a gripping firsthand story of a post-shift crash where she became a patient. The episode explores the science—and the lived reality—of fatigue in EMS. From the biology of fatigue to evidence-based strategies like tactical napping and sleep banking, this episode challenges educators and leaders to rethink how we prepare clinicians not just to treat patients, but to survive the job. You'll hear how leaders must confront the cultural and organizational barriers of this issue to keep crews, patients and the public safe.

Fatigue isn’t just a wellness issue—it’s a safety issue. What will you change after listening?

Ginger Locke highlights the episode's key points with her "Mindset Minute."

Mentioned in the episode:

2024 Systematic Review of Evidence-Based Guidelines for Prehospital Care https://pubmed.ncbi.nlm.nih.gov/39373357/

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