AMU Emergency Management Health & Fitness Original Public Safety

Combating Fatigue among First Responders in Emergency Medical Services

By Allison G. S. Knox
Contributor, EDM Digest

Many public service employees often struggle with fatigue. Because emergency medical technicians (EMTs) and paramedics do not earn a lot of money, they routinely work two jobs back-to-back to make ends meet.

While working two jobs helps first responders financially, this situation has dangerous repercussions for patient care. Fatigued EMTs or paramedics are often too tired to make good patient care decisions.

Also, fatigued  first responders driving a motor vehicle or an ambulance are less able to react quickly to avoid traffic or obstacles in the road, thus increasing the potential for accidents.

Fatigue Problems Have Forced National Organizations to Take Action

Fatigue issues among first responders have become so serious that the National Safety Council (NSC) recently announced guidelines and recommendations to help EMT agencies overcome employee fatigue. The five recommendations are excellent ways to combat this serious issue:

  • Use fatigue and sleepiness surveys to measure and track staff fatigue.
  • Limit shifts to less than 24 hours.
  • Make caffeine accessible.
  • Allow opportunities for on-duty naps.
  • Provide education and training on fatigue risk management.
Making Changes to Allow First Responders to Handle Fatigue

Educating employees to manage fatigue is important. Even more important, agencies must work to create a culture in which working too many hours without sleep is not acceptable. By changing the existing culture, agencies may reduce the cases of EMTs and paramedics suffering from fatigue.

Ultimately, the issue of fatigue will need to be addressed one agency at a time until the problem no longer exists in the industry. Perhaps wages will increase as well, eliminating the need for first responders to work second jobs.


Allison G.S. Knox

Allison G. S. Knox teaches in the fire science and emergency management departments at the University. Focusing on emergency management and emergency medical services policy, she often writes and advocates about these issues. Allison works as an Intermittent Emergency Management Specialist in the Administration for Strategic Preparedness and Response. She also serves as the At-Large Director of the National Association of Emergency Medical Technicians, Chancellor of the Southeast Region on the Board of Trustees with Pi Gamma Mu International Honor Society in Social Sciences, chair of Pi Gamma Mu’s Leadership Development Program and Assistant Editor for the International Journal of Paramedicine. Prior to teaching, Allison worked for a member of Congress in Washington, D.C. and in a Level One trauma center emergency department. She is an emergency medical technician and holds five master’s degrees.

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