Impacts of Alcohol / Fatigue on Paramedic Skills

Becker, Les

Abstract

(Verbatim from application) A.
Specific Aims Among employees in safety sensitive occupations, the two most prevalent forms of performance deficits are fatigue and alcohol related impairments, whether intoxication or hangover. The proposed research seeks to determine whether routine levels of fatigue and alcohol hangover among certified practicing Emergency Medical Technician-Paramedics (EMT-Ps) can be found to impair judgment and/or performance in such a way that patients who are reliant on the medical resuscitation and stabilization skills of EMT-Ps can be placed at unacceptable risk as a consequence of these impairments. There are currently no national standards for regulating these types of impairments for EMT-Ps, nor have the consequences of such impairments ever been systematically studied. The proposed study is important because EMT-Ps are society's front-line prehospital providers of emergency medical care, bringing Advanced Cardiac Life Support (ACLS) into America's homes and businesses. We will seek to validate a methodology and provide pilot information about specific areas of performance deficit among EMT-Ps. We will assess whether an instrumented manikin-simulator integrated with personal computer-based ACLS software can serve as a sensitive indicator, of performance impairment among licensed EMT- Ps. Depending on the findings, the results could serve to: temper concerns that typical levels of fatigue and alcohol hangover raise patient risk, warrant mounting a more comprehensive evaluation of these relationships, and/or initiate policy action that will lower risks if risks are identified. Specifically, this project aims to: o Assess EMT-P performance deficits on standard cognitive and psychomotor tasks known to be sensitive to fatigue from partial sleep deprivation as well as low blood alcohol concentration (BAC), or alcohol hangover. o Validate the sensitivity of a rescue skill-specific programmable instrumented manikin-simulator with assessment protocols known to be sensitive to fatigue and hangover, and determine the extent to which the simulation can detect areas of task-relevant impairment among EMT-Ps when they are fatigued toward the end of typically long work shifts of 24 hours, and when they are coming onto a shift following moderate alcohol use that produces hangover symptoms 6 or more hours later. o Communicate preliminary findings to the emergency medical research community and to the state and national licensing boards authorized to set policy for EMT-Ps, emergency nurses, and emergency physicians.