Home Emergency Management News Combating Fatigue among First Responders in Emergency Medical Services

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 Passionate about the issues affecting ambulances and disaster management, Allison focuses on Emergency Management and Emergency Medical Services policy. Allison has taught at the undergraduate level since 2010. Prior to teaching, she worked in a level-one trauma center emergency department and for a member of Congress in Washington, D.C. She holds four master’s degrees in Emergency Management, National Security Studies, International Relations, and History; a Graduate Certificate in Homeland Security; and a Bachelor of Arts in Political Science. Allison is an Emergency Medical Technician, Lifeguard, and Lifeguard Instructor, and is trained in Technical Large Animal Emergency Rescue. She serves on the Board of Trustees for Pi Gamma Mu International Honor Society as Chancellor of the Southeast Region, Vice Chair of the Tactical Emergency Medical Support Committee with the International Public Safety Association, and serves as the Advocacy Coordinator of Virginia with the National Association of Emergency Medical Technicians. She is also a member of several committees including the Editorial Committee with APCO, the Rescue Task Force Committee with the International Public Safety Association, and the Advocacy Committee with the National Association of Emergency Medical Technicians. She also serves as Chair of the Leadership Development Program for the 2020 Pi Gamma Mu Triennial Convention. Allison has published several book reviews and continues to write about issues affecting ambulances, emergency management, and homeland security.