Shift length and on-duty rest patterns in rotor-wing air medical programs

Area of Science:

• Aviation Safety
• Occupational Health
• Emergency Medicine

Background:

• Air medical teams operate 24/7, increasing risks of fatigue due to circadian disruption and sleep deprivation.
• Safety in air medical services is paramount, yet data on shift length and rest practices are limited.
• This study investigates current duty and rest practices within US rotor-wing air medical programs.

Purpose of the Study:

• To survey air medical programs regarding shift length and on-duty rest practices.
• To analyze how these practices correlate with program model, base location, flight volume, and job requirements.
• To identify factors influencing work and rest patterns in air medical crews.

Main Methods:

• Anonymous surveys were mailed to 182 US rotor-wing air medical programs conducting scene flights with nurses.
• 129 programs (70.9%) returned usable surveys for data analysis.
• Descriptive and nonparametric statistical methods were employed for analysis.

Main Results:

• Medical team members frequently work shifts over 12 hours (45% work 17-24 hours), unlike pilots (10-14 hours).
• Longer shifts (>12 hours) correlate with lower flight volume, non-hospital operation models, and non-hospital bases.
• Medical team members have less access to on-duty rest (67.4% permitted) compared to pilots (100% permitted).

Conclusions:

• Significant disparities exist in work and rest patterns between pilots and medical team members in air medical services.
• Medical teams commonly experience longer shifts and reduced rest opportunities, with variations based on program type.
• Divergent practices in shift length and rest availability may influence fatigue mitigation strategies and overall safety.