Air Medical Journal
Volume 26, Issue 1 , Pages 45-49 , January 2007

Sleep debt and outside employment patterns in helicopter air medical staff working 24-hour shifts

  • Michael A. Frakes, APRN, CCNS, CFRN, CCRN, EMTP

      Affiliations

    • LIFE STAR/Hartford Hospital, Hartford, CT
    • Boston MedFlight, Boston, MA
    • Corresponding Author InformationAddress for correspondence: Michael A. Frakes, LIFE STAR/Hartford Hospital, 80 Seymour Street, P.O. Box 5037, Hartford, CT 06102-5037
    • ,
  • John G. Kelly, RN, MBA, CFRN, CCRN, CEN, EMTP

      Affiliations

    • LIFE STAR/Hartford Hospital, Hartford, CT
    • Boston Medical Center, Boston, MA

References 

  1. Frakes MA , Kelly JG . Shift length and on-duty rest patterns in rotor wing air medical programs . Air Med J . 2004;23:34–39
  2. Howard SK , Rosekind MR , Katz JD . Fatigue in anesthesia . Anesthesiology . 2002;97:1281–1294
  3. Van Dongen HP , Dinges DF . Circadian rhythms in fatigue, alertness, and performance . In:  Kryger MH ,  Roth T ,  Dement WC editor. Principles and Practice of Sleep Medicine . 3rd ed.. Philadelphia: Saunders; 2000;p. 391–399
  4. Gander PH , Gregory KB , Connell LJ , Graeber RC , Miller DL , Rosekind MR . Flight crew fatigue IV: Overnight cargo operations . Aviat Space Environ Med . 1998;69:B26–B36
  5. Monk TH . Shift work . In:  Kryger MH ,  Roth T ,  Dement WC editor. Principles and Practice of Sleep Medicine . 3rd ed.. Philadelphia: Saunders; 2000;p. 600–605
  6. Frakes MA , Kelly JG . Off-duty preparation for overnight work in rotor-wing air medical programs . Air Med J . 2005;24:215–217
  7. Krueger GP . Fatigue, Performance, and Medical Error . In:  Bogner MS editors. Human Error in Medicine . Hillsdale, NJ: L. Erlbaum Associates; 1994;p. 311; 326
  8. Pilcher JJ , Huffcutt AI . Effects of sleep deprivation on performance: a meta-analysis . Sleep . 1996;19:318–326
  9. Jha AK, Duncan BW, Bates DW. Fatigue, sleepiness, and medical errors. In Agency for Healthcare Research and Quality. Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Rockville, MD: Agency for Healthcare Research and Quality.
  10. Cox TK . Stress and sustained performance . Work & Stress . 1989;3:12–29
  11. Krueger P . Sustained work, fatigue, sleep loss and performance: a review of the issues . Work & Stress . 1989;3:129–141
  12. Dawson D , Reid K . Fatigue, alcohol and performance impairment (scientific correspondence) . Nature . 1997;388:235
  13. Carskadon MA , Dement WC . Nocturnal determinants of daytime sleepiness . Sleep . 1982;5(suppl 2):S73–S81
  14. Salvendy G . In: Handbook of human factors and ergonomics . 2nd Ed.. New York: Wiley; 1997;
  15. Smith-Coggins R , Rosekind MR , Hurd S , Buccino KR . Relationship of day versus night sleep to physician performance and mood . Ann Emerg Med . 1994;24:928–934
  16. Smith-Coggins R , Rosekind MR , Buccino KR , Dinges DF , Moser RP . Rotating shiftwork schedules: can we enhance physician adaptation to night shifts? . Acad Emerg Med . 1997;4:951–961
  17. Akerstedt T , Torsvall L . Shift work: shift-dependent well-being and individual differences . Ergonomics . 1981;24:265–273
  18. Akerstedt T , Kecklund G , Knutsson A . Manifest sleepiness and the spectral content of the EEG during shift work . Sleep . 1991;14:221–225
  19. Akerstedt T . Sleepiness as a consequence of shift work . Sleep . 1988;11:17–34
  20. Tucker P , Smith L , Macdonald I , Folkard S . Shift length as a determinant of retrospective on-shift alertness . Scandinavian Journal of Work, Environment and Health . 1998;24(Suppl 3):49–54
  21. Gold DR , Rogacz S , Bock N , et al.   Rotating shift work, sleep, and accidents related to sleepiness in hospital nurses . Am J Public Health . 1992;82:1011–1014
  22. Parks DK , Yetman RJ , McNeese MC , Burau K , Smolensky MH . Day-night pattern in accidental exposures to blood-borne pathogens among medical students and residents . Chronobiol Int . 2000;17:61–70
  23. Marcus CL , Loughlin GM . Effect of sleep deprivation on driving safety in housestaff . Sleep . 1996;19:763–766
  24. Scott AJ . Shift work and health . Prim Care Clin . 2000;27:1057–1079
  25. Kuhn G . Circadian rhythm, shift work, and emergency medicine . Ann Emerg Med . 2001;37:88–98
  26. Hawkins MR , Vichick DA , Silsby HD , Kruzich DJ , Butler R . Sleep and nutritional deprivation and performance of house officers . J Med Educ . 1985;60:530–535
  27. Hart RP , Buchsbaum DG , Wade JB , Hamer RM , Kwentus JA . Effect of sleep deprivation on first-year residents' response times, memory, and mood . J Med Educ . 1987;62:940–942
  28. Rubin R , Orris P , Lau SL , Hryhorczuk DO , Furner S , Letz R . Neurobehavioral effects of the on-call experience in housestaff physicians . J Occup Med . 1991;33:13–18
  29. Robbins J , Gottlieb F . Sleep deprivation and cognitive testing in internal medicine house staff . West J Med . 1990;152:82–86
  30. Taffinder NJ , McManus IC , Gul Y , Russell RC , Darzi A . Effect of sleep deprivation on surgeons' dexterity on laparoscopy simulator . Lancet . 1998;352:1191
  31. Denisco RA , Drummond JN , Gravenstein JS . The effect of fatigue on the performance of a simulated anesthetic monitoring task . J Clin Monit . 1987;3:22–24
  32. Reznick RK , Folse JR . Effect of sleep deprivation on the performance of surgical residents . Am J Surg . 1987;154:520–525
  33. Deaconson TF , O'Hair DP , Levy MF , Lee MB , Schueneman AL , Codon RE . Sleep deprivation and resident performance . JAMA . 1988;260:1721–1727
  34. Weiniger MB, Vora S, Hendon CN, Howard SK Smith BE, Mazzei WJ, et al. Evaluation of the effects of fatigue and sleepiness on clinical performance in on-call anesthesia residents during actual nighttime cases and simulated cases. Paper presented at: Evaluating Patient Safety and Reducing Errors in Health Care; November 8-10, 1998, Rancho Mirage, CA.
  35. Drazen JM . Awake and Informed . N Engl J Med . 2004;351:1884
  36. Landrigan CP , Rothschild JM , Cronin JW , Kaushal R , Burdick E , Katz JT , et al.   Effect of reducing interns work hours on serious medical errors in intensive care units . N Engl J Med . 2004;351:1838–1848
  37. Lockley SW , Cronin JW , Evans EE , Cade BE , Clark JL , Landrigan CP , et al.   Effect of Reducing Interns Weekly Work Hours on Sleep and Attentional Failures . New England Journal of Medicine . 2004;351(18):1829–1837
  38. Bonnet MH , Arand DL . The use of prophylactic naps and caffeine to maintain performance during a continuous operation . Ergonomics . 1994;7:1009–1020
  39. Rosa RR . Extended workshifts and excessive fatigue . J Sleep Res . 1995;4:51–56
  40. Deary IJ , Tait R . Effects of sleep disruption on cognitive performance and mood in medical house officers . BMJ . 1987;295:1153–1156
  41. Firth-Cozens J . Emotional distress in junior house officers . BMJ . 1987;295:533–536
  42. Hurwitz TA , Beiser M , Nichol H , Patrick L , Kozak J . Impaired interns and residents . Can J Psych . 1987;32:165–169
  43. Lingenfesler T , Kaschel R , Weber A , Zaiser-Kaschel H , Jakober B , Kuper J . Young hospital doctors after night duty . Med Educ . 1994;28:566–572
  44. Engel W , Seime R , Powell V , D'Alessandri R . Clinical performance of interns after being on call . South Med J . 1987;80:761–763
  45. Heffner JE , Ellis R , Zeno B . Safety in training and learning in the intensive care unit . Crit Care Clin . 2005;21:129–148
  46. Schenarts P , Bowen J , Bard M , Sagraves S , Toschlog E , Goettler C , et al.   The effect of a rotating night-float coverage scheme on preventable and potentially preventable mortality at a level 1 trauma center . Am J Surg . 2005;190:147–152
  47. Naylor RA , Rege RV , Valentine RJ . Do resident duty hour restrictions reduce technical complications of emergency laparoscopic cholecystectomy? . J Am Coll Surg . 2005;201:724–731
  48. Commission on Accreditation of Medical Transport Systems . Accreditation Standards . 5th Ed.. Anderson, SC: CAMTS; 2002;
  49. 14 CFR 135.261 et seq. . Available at: http://www.airweb.faa.gov/Regulatory_and_Guidance_Library/rgFAR.nsf/0/e43bf3c7d02881ca8625694a00070224e Open Document. Accessed November 13, 2006.
  50. Blumen IJ . A safety review and risk assessment in air medical transport . Salt Lake City, UT: Air Medical Physicians Association; 2002;
  51. Akerstedt T . Consensus statement: Fatigue and accidents in transport operations . J Sleep Res . 2000;9:395
  52. Lathrop GM , Thomson DP . Should 24-hour shifts be allowed? . Airmed . 1997;3:8; 10-2.
  53. Manacci C , Rogers K , Martin G , Kovach B , et al.   Efficacy of 24 hour shifts . Air Med J . 1999;18:20–25
  54. Allen TL , Delbridge TR , Stevens MH , Nicholas D . Intubation success rates by air ambulance personnel during 12 versus 24-hour shifts . Prehosp Emerg Care . 2001;5:340–343
  55. Baker SP, Grabowski JG, Dodd RS, Shanahan DF, Lamb MW, Li GH. EMS helicopter crashes: What influences fatal outcome? Ann Emerg Med; 2006: (in press). Available at http://www.annemergmed.com/article/PIIS019606440501958X/abstract. Accessed February 5, 2006.
  56. Anonymous  . 2003 Directory of air medical programs . Air Med J . 2003;22:34–48
  57. Anonymous  . Random integer generator . Available at http://www.random.org/nform.html Accessed April 5, 2006.
  58. Poulton KT . Legal implications of on-the-job fatigue: can employers limit outside employment? . Air Med J . 2005;24:217–219
  59. O'Brien RG , Muller KE . Applied analysis of variance in behavioral science . New York: Dekker; 1993;
  60. Babbie E . The Practice of Social Research . Belmont, CA: Wadsworth Publishing Company; 1989;
  61. Brehm J . The phantom respondents . Ann Arbor, MI: University of Michigan Press; 1993;
  62. Fowler FJ . Survey research methods . Thousand Oaks, CA: Sage; 1984;
  63. Bourque LB , Fiedler EP . How to conduct self-administered and mail surveys . Thousand Oaks, CA: Sage; 1995;
  64. Lystrup A , Treadwell D . Position paper: flight nurse safety in the air medical environment . Available at http://www.astna.org/Position-papers/Safety1.pdf Accessed April 18, 2006.

PII: S1067-991X(06)00157-X

doi: 10.1016/j.amj.2006.05.003

Air Medical Journal
Volume 26, Issue 1 , Pages 45-49 , January 2007

Article Tools