In order to ensure that we are operating as safely as possible, WDMEMS/IA EMS Alliance developed a "fatigue matrix" to measure fatigue in our full-time 24 hour personnel that are on shift. This fatigue matrix was developed after reviewing how other companies, mostly air ambulance services but also some ground ambulance services, measured fatigue within their employees. Each one of our 24 hour full-time employees on shift or part-time employees that are working a 24 hour shift are expected to fill out this fatigue matrix and send it to the lieutenant on duty at 1900. Employees receive a point for each hour of "windshield time." "Windshield time" is time spent on a trip. Extra points are also assigned for adverse weather conditions, missed meals, and ride-alongs. The lieutenant reviews the fatigue matrix at 1900 and again at 2300 if necessary. If that employee is nearing the 20 point mark on the matrix, another lead paramedic is notified and given the option to move then or when the crew member reaches 21+ points, if before 2300. The fact that the employee is at 21+ points does not mean that the employee is too tired to safely perform patient care, but that the employee is placed on a different truck to ensure they don't have to go on any long-distance transfers during the night. At any time, an employee who doesn't feel safe to work can call a "time out," in which the lieutenant is able to switch out the employee with a more rested employee and/or give them ensured down time for rest.

    You can view a copy of the fatigue matrix here.

    Assistant Chief Edgar and PS Trede developed this matrix over several weeks. AC Edgar and PS Trede went to the EMS Today EMS Conference in Washington DC to receive an Innovation award for their work.

    This fatigue matrix is so unique and cutting-edge that it was featured in an article in JEMS. It was published in the EMS 10: Innovators of EMS 2013 Issue. The article was written by Cynthia Kincaid and the original publishing date was March 2014. It can be viewed at: