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Sleep Deprivation Shore 2010


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Shore EMS Conference 2010

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Sleep Deprivation Shore 2010

  1. 1. Shore 10th Annual EMS Conference Sleep Deprivation Christiana Fire Company Christiana, DE February 7, 2010
  2. 2. Outline Sleep Deprivation-Chronic Sleep Loss Physiologic Effects Risk Factors Potential Legal Liability Options
  3. 3. EMS Work Hours
  4. 4. Sleep Deprivation Sleep Deprivation linked to increased errors in tasks involving: Alertness Vigilance Quick decision- making
  5. 5. Long Work Hours Decreased ability to think clearly Feelings of depression Feelings of stress Irritability
  6. 6. Chronic Sleep Loss Decreased ability to think clearly Decreased ability to handle complex mental tasks Decreased ability to form new memories Decreased ability to solve problems Increase in health complaints Musculoskeletal problems Higher body weights Greater risk of obstructive sleep apnea Increased cardiovascular disease Increased cancer
  7. 7. Crashes Fatigue is a major factor in motor vehicle crashes Drivers at high risk for sleep- related crashes, including: 1. Younger drivers lacking sleep due to demands of school, jobs, late socializing and poor sleep habits 2. Shift workers 3. Drivers using alcohol or other drugs 4. Those with sleep disorders
  8. 8. EMS Work Hours
  9. 9. EMS Work Hours Fewer than 6 hours of sleep during one sleep-wake cycle affects: Coordination Judgment Reaction time
  10. 10. EMS Work Hours “People with 24 hours of sustained wakefulness performed tasks that involve tracking at a level comparable to those with a BAC of 0.10%” New England Journal of Medicine (2002) In all 50 states, it is illegal to drive with a BAC of 0.08% or higher
  11. 11. EMS Work Hours Driving an emergency vehicle under sleep deprived conditions can have devastating consequences
  12. 12. EMS Work Hours
  13. 13. EMS Work Hours “People who drive after being awake for 17-19 hours performed worse than those with a 0.05% BAC.” Occupational and Environmental Medicine (2000) Motor vehicle collisions are the leading cause of on-the-job fatalities for EMS personnel. Annals of Emergency Medicine (2002)
  14. 14. EMS Work Hours Criminal Consequences New Jersey “Maggie’s Law” Sleep deprived driver qualifies as a reckless driver who can be convicted of vehicular homicide in NJ A person commits vehicular homicide when he causes the death of another by driving a motor vehicle recklessly Proof that the defendant fell asleep while driving or was driving after having been without sleep for a period in excess of 24 consecutive hours may give rise to the inference that the defendant was driving recklessly
  15. 15. EMS Work Hours NJ Vehicular Homicide Second degree crime Imprisonment of 5-10 years Fine of up to $150,000 Or both
  16. 16. EMS Work Hours Civil Liability Faverty v. McDonald’s Restaurants of Oregon, Inc. 133 Or App 514, 892 P2d 703 (1995) HS student asked to leave work because he was sleepy Caused motor vehicle crash & was killed Critically injured another driver
  17. 17. EMS Work Hours Civil Liability Faverty v. McDonald’s Restaurants of Oregon, Inc. 133 Or App 514, 892 P2d 703 (1995) Critically injured driver files negligence claim Employee scheduled for too many hours without adequate time for rest Employer should have foreseen employee working 3 shifts in 24 hour period would pose risk to themselves and other motorists
  18. 18. EMS Work Hours Civil Liability Faverty v. McDonald’s Restaurants of Oregon, Inc. 133 Or App 514, 892 P2d 703 (1995) Court rejects McDonald’s claim that employee volunteered to work additional shifts Court equated management liability to bartender who serves drink to “visibly intoxicated” person who “volunteers” to pay for the drink
  19. 19. EMS Work Hours
  20. 20. EMS Work Hours Sleep deprivation & fatigue in the workplace Poor concentration Absenteeism Accidents Errors Injuries and fatalities
  21. 21. EMS Work Hours 64% of ATCEMS medics found it “difficult” or “very difficult” to stay awake during 24-hour shifts 61.8% felt their health would improve with shorter shifts 44% of medics reported nodding off several times a month during their shifts
  22. 22. EMS Work Hours 29% said they provide less than optimum care at end of a 24-hour shift 50% had accidents or near- misses due to fatigue 5% had fallen asleep while driving an ambulance
  23. 23. EMS Work Hours Shortened to 12-hour shifts at busiest EMS stations Reduced work week from 56 hours to 48 hours Requires 10 hours off between each shift
  24. 24. EMS Work Hours Is this an issue within your organization? What steps have you taken?
  25. 25. EMS Work Hours Options Maximum allowable consecutive work hours Maximum amount of time an employee must have to recuperate before returning to duty Defined number of hours between last alcoholic beverage and the start of a shift Consideration of fitness to drive home following a shift
  26. 26. EMS Work Hours May drive maximum of 11 hours after 10 consecutive hours off duty May not drive after 60/70 hours of duty in 7/8 consecutive days
  27. 27. EMS Work Hours FAA Regulations limit pilots to: Minimum of 10 hours off- duty every 24-hour period Maximum scheduled duty period of 14 hours Flight limit of 8 hours between rest periods
  28. 28. Work Hour Management Those who work long duration shifts can improve their well being by leading healthy lifestyles. Chronic sleep deprivation may not be recognized, and it is important for firefighters and EMS personnel to acknowledge their need for and maximize their ability to achieve adequate sleep.
  29. 29. Work Hour Management Coping with long work hours may be facilitated by identifying workers at higher risk for difficulties in adjusting, such as those with sleep disorders. Fatigue is a risk for motor vehicle crashes, and commuting home following long duration shifts may be an especially vulnerable time for workers.
  30. 30. Work Hour Management Firefighters, EMS personnel, their families and management need to work collaboratively to structure work hours and circumstances to meet the needs of professional excellence and the well being of the employee.
  31. 31. Watching Each Other Forgetful Fixated Poor decisions Apathetic Slowed reaction Lethargic time Bad mood Reduced Nodding off Vigilance Poor Communication
  32. 32. Questions? Chief Lawrence E. Tan New Castle County EMS Department of Public Safety 3601 North DuPont Highway New Castle, DE 19720-6315 E-mail: Office: 302-395-8185