Investigators at the University of Pittsburgh Department of Emergency Medicine lead numerous projects that address the impact of shift work on the health and safety of emergency care workers. The purpose of this webpage is to provide a summary of these projects and links to additional information. To learn more about the various projects, please contact Daniel Patterson, PhD, NRP at firstname.lastname@example.org.
Napping During Shift Work:
- There is much controversy surrounding napping (sleeping) during shift work. Some EMS organizations allow it, whereas others do not. We offer a discussion on the pros and cons of this unique strategy for fatigue mitigation. See this DOI LINK for an open access article on the topic.
- If you are in EMS and unsure about how long to nap during the night shift, or if you are in administration and unsure about how long to allow your EMS crews to nap during the night shift, take a look at this Systematic Review of experimental studies that test different duration naps on simulated night shifts. This paper provides a systematic review of the best available evidence. The findings may help guide decision making.
Strategies for EMS to address Sleep Health, Fatigue, and Alertness during the COVID-19 Pandemic:
- This brief video is intended to highlight a few evidence-based strategies for improving sleep health and alertness during shift work. This information is intended for EMS clinicians and other first responders who must work extended shifts, extra shifts, or overtime during the COVID-19 pandemic.
The EMS Sleep Health Research Study:
- The purpose of this experimental research study is to determine the impact of sleep health education and training on EMS clinician sleep quality and fatigue. Support for this research study comes from the National Highway Traffic Safety Administration (NHTSA) and the National Association of State EMS Officials (NASEMSO). See the study specific website: www.emssleephealth.pitt.edu for more information.
The Sleep and Teamwork in EMS Study:
- This research study uses a cluster-randomized study design of EMS agencies and is focused on sleep and teamwork behaviors in EMS. Investigators will use novel data collection tools such as a mobile app and text messages. Support for this research study comes from the National Institute for Occupational Safety and Health (NIOSH). See the study specific website: www.saftie.pitt.edu for more information.
Impact of Intra-Shift Naps on Indicators of Cardiovascular Health among EMS Clinicians:
- This research study is a lab-based experimental cross-over study that aims to test the impact of brief naps during simulated night shifts on key indicators of cardiovascular health (i.e., blood pressure and heart rate variability). Support for this research study comes from the ZOLL Foundation. For more information, please contact the study’s co-investigator (Daniel Patterson, PhD, NRP at email@example.com).
The Ambulatory Blood Pressure Monitoring (ABPM) and Heart Rate Variability (HRV) Feasibility Study:
- This research study uses a prospective 7-day observational study design. Investigators use serial monitoring to assess the impact of shift work on blood pressure (BP) and heart rate variability (HRV) in a small convenience sample of EMS clinician and small convenience sample of traditional day workers. For more information, please contact the study’s principal investigator (Daniel Patterson, PhD, NRP at firstname.lastname@example.org).
The Ambulatory Blood Pressure in EMS Study:
- This research study used a prospective study design of two 24-hour periods of observation. The focus was on EMS clinicians who worked night shift and the impact of napping on blood pressure (BP). The study aimed to:  Determine the feasibility of serial ambulatory blood pressure monitoring (ABPM) during one workday and one non-workday in a convenience sample of EMS clinician shift workers; and  To characterize patterns of blood pressure (BP) by wake vs. sleep and work vs. non-work periods. Our findings are published in the Occupational Environmental Medicine journal of BMJ. Click HERE for the peer-reviewed publication of study findings.
Impact of shift work on blood pressure among Emergency Medical Services clinicians and related shift workers: A systematic review and meta-analysis:
- The purpose of this research study was to identify the available evidence that examined the acute impact of shift work on blood pressure (BP) among EMS clinicians and related shift workers. This project is one of several that involve the University of Pittsburgh Department of Emergency Medicine’s EMS Evidence-Based Practice Center (EMS-EPC). Findings from this study are published in the journal SLEEP HEALTH.
Does evidence support banking sleep by shift workers? A systematic review:
- The purpose of this research study was to examine the published evidence germane to banking sleep prior to shift work and examine the impacts of this intervention on outcomes. This study has concluded and the results are published in the Sleep Health Journal (Volume 5, Issue 4, PMID-31031179). (https://doi.org/10.1016/j.sleh.2019.03.001).
Evidence-Based Guidelines for Fatigue Risk Management in EMS:
- This research project was funded by the National Highway Traffic Safety Administration (NHTSA) in collaboration with the National Association of State EMS Officials (NASEMSO). Phase 1 of this project was completed in 2018 and included seven systematic reviews and multiple meta-analyses. These studies informed an evidence-based guideline process led by Daniel Patterson, PhD, NRP, multiple co-investigators, and the University of Pittsburgh. The results of this project are freely available at www.emsfatigue.org, at https://www.ems.gov/projects/evidence-based-guidelines.html, and at https://www.tandfonline.com/doi/full/10.1080/10903127.2017.1376137