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Fatigue: have we learned from the past to ensure our safety today and into the future?


Judi Shields
Retrieval Services Queensland / Lady Cilento Childrens Hospital, Emergency Department


Judi Shields is a Registered Nurse and Midwife with qualifications in Emergency, Aviation Nursing and Primary Health Care. She has worked as a Flight nurse for the NTAMS and RFDS. She is a Churchill Fellow and she studied fatigue countermeasures and alertness management in flight operations at NASA and the USAirforce. She has been active in both ASA and FNA. A past committee member in ASA and coordinated the Darwin 2003 ISASFNA Conference. She was on the inaugural FNA committee and has held the positions of President, Secretary and Committee Member. In 2015 she was honoured to receive lifetime membership of FNA.


Fatigue is recognised around the world as a serious safety implication for twenty-four hour operations. Operational requirements of an aviation medical transport service dictate service provision twenty-four hours a day.

Scientific research into fatigue and fatigue countermeasures in the past has taught us that in any twenty-four hour operation fatigue is a critical concern which can lead to catastrophic events, serious operational safety implications, significant decrements in alertness and performance, chronic sleep loss and disruption to circadian rhythms. Australian research into fatigue formed the basis for a parliamentary inquiry into managing fatigue in transport and compared the impairment on performance by fatigue as similar to the effects of moderate alcohol intoxication. Work periods longer than 10 to 12 hours are likely to impair wakefulness and performance and the impact of sleep inertia on safety.

This paper will investigate if we have learnt from our past in relation to fatigue research and will explore new innovations in fatigue management and fatigue countermeasures in the air medical environment.



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