Effects of a modified ambulance night shift system on fatigue and physiological function among ambulance paramedics.

OBJECTIVES In the present study, we modified a night shift system for an ambulance service so that ambulance paramedics were assured of taking a nap, and examined the effects of this new system on the fatigue and physiological function of ambulance paramedics. METHODS Ten ambulance paramedics at a fire station in the center of a large city in Japan voluntarily enrolled as subjects in this field study. They worked a 24-h shift system. There were two teams of 5 ambulance paramedics in the fire station. Three ambulance paramedics per shift usually provided the emergency services. In the traditional system, the ambulance paramedics had to deal with all emergency calls throughout a 24-h shift (T-shift). In the modified system, 2 ambulance paramedics were allotted time for naps in the 21:00-3:00 (C-shift) or 3:00-8:30 (B-shift) shift by the addition of another a firefighter (D-shift). RESULTS There were fewer emergency dispatches and nap time was longer in the B- and C-shifts than in the T-shift. Parasympathetic nerve activities during naps in B- and C-shifts were higher than in the T-shift. The results of critical flicker fusion frequency and 3-choice reaction time in the B-shift at 7:30 tended to be higher and shorter than that in T-shift. CONCLUSIONS The results of this study suggest that the modified night shift which ensured time for ambulance paramedics to take long, restful power naps alleviated subjective fatigue, and improved physiological functions which are often adversely affected by night workload.