An Investigation of Pilot Fatigue in Helicopter Emergency Medical Services

Pilot error has caused the majority of Helicopter Emergency Medical Services (HEMS) accidents in the United States for almost two decades. Pilot fatigue may have contributed to some of these accidents. The problem investigated by this nonexperimental quantitative study is that although research has shown that many HEMS pilots experience fatigue while on duty, the relationships between fatigue (the criterion variable) and (a) consecutive HEMS pilot day shifts, (b) consecutive HEMS pilot night shifts, (c) age, and (d) experience as an HEMS pilot (the predictor variables) has not been studied. This study surveyed 395 HEMS pilots from the estimated 3,340 HEMS pilots in the United States to assess fatigue with the Brief Fatigue Inventory (BFI). A statistically significant correlation between HEMS pilot night shift respondent BFI scores and experience as an HEMS pilot (r = .149, p = .037) suggested a weak relationship between these research variables. The correlation weakened but remained statistically significant (r = .131, p = .070) when analysis controlled for consecutive HEMS pilot night shifts and age. A one-way analysis of variance suggested that the effect of experience as a HEMS pilot on HEMS pilot night shift respondent BFI scores was statistically significant, F(1,193) = 4.390, p = .037. Multivariate regression analysis suggested that experience as an HEMS pilot significantly predicted HEMS pilot night shift respondent BFI scores while controlling for consecutive HEMS pilot night shifts and age, b = .038, t(193) = 2.095, p = .037. The following regression equation states the regression model from this analysis: Y = 4.053 + .038X, where Y represents the HEMS pilot night shift respondent BFI score and X represents experience as an HEMS pilot. This study suggested that additional research is needed to clarify the relationship between fatigue and experience as an HEMS pilot and to investigate relationships between fatigue experienced by HEMS and other variables that were not considered in this investigation. Development of fatigue-management strategies in HEMS that emphasize the unique challenges of working at times that are biologically matched with the need for sleep is also recommended.