Those of us who have ever worked rotating, overnight or long shift schedules know all too well the inherent difficulties in feeling consistently well-rested and the potential for compromised performance due to fatigue.

Now a new study funded by the MedEvac Foundation International will attempt to match some hard data to the problem by observing air medical EMS clinicians and investigating their sleep/wake patterns. It also will examine the relationship between shift duration, sleep/wake cycles and behavioral alertness.

In announcing the study, the Foundation said its goal was to develop "educational techniques and technologies aimed at improving patient care, critical decision making, safety or other areas pertinent to transport medicine."

Phase 1 has been approved and will be a multistate study involving the study of sleep/wake cycles, shift work duration, intershift recovery, fatigue and behavioral alertness (i.e., psychomotor vigilance). The analysis of Phase 1 data will focus on differences between 12-hour versus 24-hour shifts.

According to the Foundation, "The debate on shift duration (shorter versus longer shifts) is ongoing and unresolved. Many EMS systems use extended shift periods in light of low patient volume and resource limitations. Other systems use shifts of shorter duration. The relationships between shift duration, sleep, fatigue and performance are complex and the data to support a prescribed shorter or longer shift schedule are limited."

Rick Sherlock, MedEvac Foundation International CEO, said the study's particulars should not only contribute to "better workplace environments, the safety of our industry's professionals, and of every patient-in-need, but it will help improve the level of patient care to an optimal level."

A decision on funding of a second phase of the study is pending. Tentatively, it would consist of an experimental study design aimed at testing fatigue risk management intervention coupled with real-time assessment and intervention designed to improve alertness of EMS clinicians during shift work as well as their overall sleep health.

The study is being conducted by Dr. Daniel Patterson and researchers from the University of Pittsburgh Department of Emergency Medicine. Patterson brings a unique perspective to the topic as a nationally registered paramedic (NREMT-P) and an assistant professor in the Department of Emergency Medicine at the University of Pittsburgh School of Medicine.

He works in the field a minimum of one clinical shift every week. From 2008 to 2009, Patterson served as an ad-hoc member of the National EMS Advisory Council's safety subcommittee established by the Secretary of Transportation Mary Peters in 2006. In July of 2010, he was appointed by Secretary of Transportation Ray LaHood to a two-year term on the National EMS Advisory Council.