An investigation of pilot fatigue in helicopter emergency medical services

Pilot error has caused the majority of helicopter emergency medical services (HEMS) accidents in the United States for almost 2 decades. Pilot fatigue may have contributed to some of these accidents. This nonexperimental quantitative study investigated the relationships between fatigue reported by on-duty HEMS pilots (the criterion variable) and consecutive HEMS pilot day shifts, consecutive HEMS pilot night shifts, age, and experience as an HEMS pilot (the predictor variables). Surveys completed by 395 on-duty HEMS pilots in the US were examined to quantify respondent fatigue with the Brief Fatigue Inventory (BFI). This study found some evidence of a statistically significant positive relationship between HEMS pilot night shift respondent BFI scores and experience as an HEMS pilot, while controlling for consecutive HEMS pilot night shifts and age. A 1-way analysis of variance suggested that the effect of experience as an HEMS pilot on HEMS pilot night shift respondent BFI scores was statistically significant. Multivariate regression analysis suggested that experience as an HEMS pilot predicted HEMS pilot night shift respondent BFI scores. Additional quantitative research is recommended to confirm the results of this study and to investigate relationships between fatigue experienced by HEMS pilots and other variables that were not considered in this investigation. Qualitative research to identify and document fatigue management strategies that are used by experience HEMS pilots is also recommended.