EMS Shift Work Project

Pitt EMS faculty lead numerous projects that address the impact of shift work on the health and safety of emergency care workers.

Ongoing Studies

CODE 3: First Responder Sleep Health 

Poor sleep health and fatigue are common among EMS clinicians and other first responders. Chiefs, Directors, Deputy Chiefs, Supervisors, and other Administrators of EMS operations face numerous challenges when it comes to addressing the sleep health and fatigue of frontline personnel. The purpose of this research study is to identify the barriers EMS Administrators experience so a NEW program can be created to help administrators. We are seeking the feedback and opinions of EMS Administrators (and frontline personnel). We want to hear from YOU! We want to know about your experiences and hear your opinions. We want to hear from Urban and Rural EMS Administrators and frontline personnel. We want to hear from Administrators and frontline personnel from all four U.S. Census Regions (Midwest, Northeast, South, and West). Participants are remunerated for their time. Participation is completely voluntary. This research study is supported by the American Academy of Sleep Medicine Foundation.  

Principal Investigator: Daniel Patterson, PhD, MS, MPH, NRP

Study Coordinator: David Roach, MPH, NREMT

Observational Study of Shift Work and Arterial Stiffness

Investigators at the University of Pittsburgh's Department of Emergency Medicine are conducting a research study to improve our understanding of the association between shift work and cardiovascular health. Our ultimate goal is to enroll up to 100 total EMS and other healthcare shift workers. Each participant will be asked to visit our lab on the University of Pittsburgh Main Campus (Iroquois Building) and spend about 1-hour answering survey questions and having their arterial stiffness assessed with a non-invasive short test. In a cohort sub-study, we will approach up to 50 EMS shift workers to determine if they would agree to coming back to our lab and doing additional assessments in the future (every 6 months). We are recruiting public safety EMS shift workers and different types of healthcare clinician shift workers residing in and/or working in Western Pennsylvania. All participants will receive $50 dollars of remuneration and a parking voucher.

Principal Investigator: Daniel Patterson, PhD, MS, MPH, NRP

Study Coordinator: David Roach, MPH, NREMT

Ambulatory Blood Pressure Monitoring and Heart Rate Variability 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.

Principal Investigator: Daniel Patterson, PhD, MS, MPH, NRP

Select Completed Studies

Should public safety shift workers be allowed to nap while on duty?

Shift workers nap study logo

Daniel Patterson, Matthew Weaver, Francis Guyette, Christian Martin-Gill | American Journal of Industrial Medicine (2020)

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.

 

 

 

Does the evidence support brief (≤30-mins), moderate (31-60-mins), or long duration naps (61+ mins) on the night shift? A systematic review

Nap length systematic review study logo

Daniel Patterson, Mary Liszka, Quentin Mcilvanie, Lily Nong, Matthew Weaver, Rose Turner, Thomas Platt, Samantha Opitz, Francis Guyette, Christian Martin-Gill, Leonard Weiss, Daniel Buysse, Clifton Callaway | Sleep Medicine Review (2021)

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, 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.

 

 

 

The Emergency Medical Services Sleep Health Study: A cluster-randomized trial

EMS Sleep trial logo

Daniel Patterson, Sarah Martin, Bridget Brassil, Wei-Hsin Hsiao, Matthew Weaver, Tiffany Okerman, Staci Seitz, Charity Patterson, Kathy Robinson | Sleep Health (2023)

The purpose of this experimental research study was to determine the impact of sleep health education and training on EMS clinician sleep quality and fatigue. This research study was supported by the National Highway Traffic Safety Administration (NHTSA) and the National Association of State EMS Officials (NASEMSO).

 

 

 

Effect of Short versus Long Duration Naps on Blood Pressure during Simulated Night Shift Work: A Randomized Crossover Trial

Effect of night shift study logo

Daniel Patterson, Tiffany Okerman, David Roach, Matthew Weaver, Charity Patterson, Sarah Martin, Nicholas Okwiya, Lily Nong, Chinemeh Eyiba, Jordan Huff, Anna Ruzicka, Julia Ruggieri, Quentin McIlvanie, Leonard Weiss | Prehospital Emergency Care (2023)

In this lab-based experimental cross-over study we tested the impact of a 30-min opportunity, 2-hr nap opportunity, and no-nap during simulated night shifts on key indicators of cardiovascular health (i.e., blood pressure). Support for this research study comes from the ZOLL Foundation. The study protocol can be accessed here: PMID: 33726840.

 

 

 

The effect of a night shift nap on post-night shift performance, sleepiness, mood, and first recovery sleep: A randomized crossover trial

Effect of night shift study logo

Daniel Patterson, Cassie Hilditch, Matthew Weaver, David Roach, Tiffany Okerman, Sarah Martin, Charity Patterson, Leonard Weiss | Scandinavian Journal of Work, Environment & Health (2023)

In this lab-based experimental cross-over study we tested the impact of a 30-min opportunity, 2-hr nap opportunity, and no-nap during simulated night shifts on key indicators of cardiovascular health (i.e., blood pressure). Support for this research study comes from the ZOLL Foundation. The study protocol can be accessed here: PMID: 33726840.

 

 

 

Ambulatory blood pressure monitoring among emergency medical services night shift workers

Ambulatory BP study logo

Daniel Patterson, Kristina Mountz, Michael Agostinelli, Matthew Weaver, Yi-Chuan Yu, Brandon Herbert, Mark Markosyan, David Hopkins, Alana Alameida, John Maloney, Sarah Martin, Bridget Brassil, Christian Martin-Gill, Francis Guyette, Clifton Callaway, Daniel Buysse | Occupational & Environmental Medicine (2023)

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: [1] 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 [2] To characterize patterns of blood pressure (BP) by wake vs. sleep and work vs. non-work periods. 

 

 

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

EBG project logo

Daniel Patterson, Stephen Higgins, Hans Van Dongen, Daniel Buysse, Ronald Thackery, Douglas Kupas, David Becker, Bradley Dean, George Lindbeck, Francis Guyette, Josef Penner, John Violanti, Eddy Lang, Christian Martin-Gill | Prehospital Emergency Care (2018)

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. The results of this project are freely available at www.emsfatigue.org and from ems.gov.