**8.4 Formal guidelines about fatigue in EMS**

In response to numerous research projects demonstrating the negative impacts of fatigue on patient safety, the National Association of State EMS Officials, in conjunction with the National Highway Traffic Safety Administration (NHTSA), published a set of five evidence-based guidelines in 2017 [37]. Though each guideline may not be universally applicable given the individual needs of a community or EMS organization, it does set the framework for agencies to establish their own system of fatigue hazard mitigation (**Table 3**).

These recommendations serve as a tool but not a comprehensive list of innovative strategies to decrease risks to patient safety due to EMS clinician fatigue. It remains the responsibility of an agency to conduct its own internal assessment of practitioner


#### **Table 3.**

*Evidence-based fatigue management recommendations.*

fatigue, develop mitigation techniques unique to its service, and reassess the practicality and effectiveness of these policies [38]. Ultimately, regardless of shift length or agency guidelines, an EMS professional should develop their own personal health and sleep regimen to prevent fatigue to avoid making critical mistakes or the news headlines for an adverse event.
