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Fatigue in EMS

Evidence-Based Resources for Safer EMS Operations

Fatigue can affect EMS personnel performance, safety, and well-being. Understanding sleep health and managing fatigue-related risks are important components of safer EMS operations.

Through a five-year project funded by the National Highway Traffic Safety Administration (NHTSA), NASEMSO partnered with the University of Pittsburgh School of Medicine and the Institutes for Behavior Resources, Inc. to develop evidence-based guidelines and practical resources for fatigue risk management in EMS.

Explore the tools, implementation guidance, research, and educational materials below.

Developing Evidence-Based Fatigue Risk Management Guidelines for Emergency Medical Services

Tools & Implementation Resources

Practical resources to support fatigue risk management in EMS organizations.

Scheduling Tool

Shift Schedule Fatigue Risk Analyzer

Evaluate fatigue-related risks associated with simple, repeating EMS shift schedules using this web-based analysis tool.

Access Analyzer →

Implementation Resource

Implementation Guidebook

Explore condensed summaries of the evidence-based recommendations and sample policy statements that can be adapted to local EMS agency needs.

Download Guidebook →

Project Overview Webinar

Learn about the Fatigue in EMS project, its findings, and the tools available to support fatigue risk management.

Watch on YouTube →

Evidence-Based Guidelines & Research

Explore the scientific evidence, recommendations, and published research supporting fatigue risk management in EMS.

Primary Guidelines & Performance Measures

Methodology & Systematic Reviews

Systematic Review Methodology for the Fatigue in EMS Project (2018)

Reliability and Validity of Survey Instruments to Measure Work-Related Fatigue in the EMS Setting: A Systematic Review (2017)

Shorter Versus Longer Shift Durations to Mitigate Fatigue and Fatigue-Related Risks in EMS: A Systematic Review (2018)

Systematic Review and Meta-Analysis of the Effects of Caffeine in Fatigued Shift Workers: Implications for EMS Personnel (2018)

Effects of Napping During Shift Work on Sleepiness and Performance in EMS Personnel and Other Shift Workers: A Systematic Review and Meta-Analysis (2018)

Does Implementation of Biomathematical Models Mitigate Fatigue and Fatigue-related Risks in EMS Operations? A Systematic Review (2018)

Effect of Task Load Interventions on Fatigue in EMS Personnel and Other Shift Workers: A Systematic Review (2018)

Articles & Editorials

Looking for the complete publication list? View All Articles & Publications →

Education & Training Resources

Access presentations, educational materials, and recorded webinars to support awareness and understanding of fatigue risk management in EMS.

Educational Materials

Presentation | January 2018

Project Overview ↗

Comprehensive presentation introducing the Fatigue in EMS project, its scientific foundation, and key findings.

Infographic | Updated December 2024

Fatigue in EMS Infographic ↗

Visual educational resource highlighting fatigue risk management concepts and recommendations.

Recorded Webinars

NHTSA Office of EMS | September 2017

Evidence-Based Guidelines for Fatigue Risk Management in EMS ↗

Dr. Daniel Patterson discusses the evidence supporting fatigue risk management recommendations and how EMS organizations can incorporate these findings into policies and training.

National Association of EMS Educators | April 2020

Fatigue Risk Management in EMS ↗

Dr. Daniel Patterson reviews sleep physiology, fatigue, project findings, and practical ways EMS educators can incorporate fatigue awareness and sleep health into education.

Technical Reports & Additional Resources

Explore federal technical reports and additional sleep health resources supporting fatigue risk management in EMS.

NHTSA Technical Reports

Sleep Health Resources

Questions about the Fatigue in EMS project or its resources? Contact info@nasemso.org .

For more information: info@nasemso.org

Last revised: October 12, 2026