# Tricks of staying alert and awake?



## Chall09 (Sep 24, 2009)

Anybody know of any tricks of the trade to stay alert and awake while on the job? 

Caffeine and ample rest should be obvious. 

Any secrets out there would be appreciated! 

-Chall09


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## guardian528 (Sep 24, 2009)

stay busy. play little games. make sure to get up and move around every once in a while.


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## MRE (Sep 24, 2009)

I'm a volley, so whenever I am in the ambulance we are either training or on a call, so there really isn't any time that I would have to worry about falling asleep.

At my real job I sometimes have to sit through fairly boring meetings, most of which I am not doing anything but sitting there.  If I find myself in danger of falling asleep, I sometimes put my tongue between my teeth, and if I start to nod off, I end up biting down just hard enough to get my attention.


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## Shishkabob (Sep 24, 2009)

Tabasco sauce in the eyes.


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## surname_levi (Sep 24, 2009)

try some mild cardio, like jumping jacks while not on a run?  anything that involves movement or speeding up the heart keeps me going. 

or even little snacks

turn the music up loud and dance


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## Dominion (Sep 24, 2009)

A nap does me wonders.  To prevent myself from seeming like I'm being sarcastic.  I'm talking power naps. If I can pass out for about 10-20 minutes, I usually wake myself up abruptly andwhen I do I get a 'second wind' kind of thing going.


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## DV_EMT (Sep 24, 2009)

this topic was disscussed in an earlier thread... search anyone???


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## medic417 (Sep 24, 2009)

Proper sleep is the key to being alert and awake.


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## mycrofft (Sep 24, 2009)

*Eat properly too.*

See what eating pattern drowses you out and avoid it. Also, you might find a substancial snack may help. Finally, often when we are "tired" we are also bored, change up your routine, get a little mental stimulation (in a departmentally approved fashion, of course). 
Finally, last resort, STAND UP.


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## cm4short (Sep 24, 2009)

How bouscare yourself awake after running a RED LIGHT while driving with one eye open and the other one resting. It works for me...:blush:


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## firecoins (Sep 24, 2009)

a kick to the balls usually does it.


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## ViniG (Sep 24, 2009)

I go to the bathroom and splash some water from the sink on my face. That usually does the trick.


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## cm4short (Sep 24, 2009)

Or... the safer alternative... LET YOUR PARTNER DRIVE WHILE YOU GET SOME REST.


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## bunkie (Sep 25, 2009)

guardian528 said:


> stay busy. play little games. make sure to get up and move around every once in a while.



This is what we do. We play the celebrity name game. Its a great way to keep the mind going.



Linuss said:


> Tabasco sauce in the eyes.



I do this every skills night.


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## Medic One (Sep 26, 2009)

I usually just take cat naps anytime I can coffee etc does not do it for me...so cat naps power naps etc...


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## exodus (Sep 26, 2009)

5 laps around the rig :]


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## EMSLaw (Sep 26, 2009)

I've heard that an old trucker trick is to drink a cup of coffee, then take a nap.  The caffine takes 30 mins to begin working, so by napping during that time, you get the best of both.

As you can tell by the "I've heard....", I have no evidence to support this, so take it for what it's worth.


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## Sasha (Sep 26, 2009)

medic417 said:


> Proper sleep is the key to being alert and awake.



Plus 1. If you are having trouble staying awake, go out of service and go home. Don't risk people's lives because you're tired and next time come to work better prepared for your shift.

It is dangerous to drive tired like some are describing (running redlights because you're basically sleeping at the wheel??? Are you freaking kidding!?)


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## EMSLaw (Sep 26, 2009)

Sasha said:


> Plus 1. If you are having trouble staying awake, go out of service and go home. Don't risk people's lives because you're tired and next time come to work better prepared for your shift.
> 
> It is dangerous to drive tired like some are describing (running redlights because you're basically sleeping at the wheel??? Are you freaking kidding!?)



+1 from me as well.  Though there's a difference between "*Yawn*  Wow, it's been a long shift..." and "Wow!  Look at the pretty pink elephants in the road!"


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## MrBrown (Sep 26, 2009)

I personally believe coffee is an evil and toxic brew that should be avoided at all costs so I ... 

1.  Get lots of sleep
2.  Drink plenty of water
3.  A good balanced diet
4.  Do some mild cardio; work Mini-Anne for a couple minutes


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## Flight-LP (Sep 26, 2009)

Speed..............


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## 46Young (Sep 26, 2009)

medic417 said:


> Proper sleep is the key to being alert and awake.



Not that simple. A large part of the country works 24's.
It's been proven in several studies that working in excess of 16 consecutive work hours leads to cognitive impairment not unlike being ETOH. 

It's also difficult to always be properly rested when you're working several jobs, going to school, need to spend time with the family, child care, or dealing with forced OT.


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## Akulahawk (Sep 26, 2009)

Flight-LP said:


> Speed..............


Not Mother, Juggs, and...


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## 46Young (Sep 26, 2009)

Sasha said:


> Plus 1. If you are having trouble staying awake, go out of service and go home. Don't risk people's lives because you're tired and next time come to work better prepared for your shift.
> 
> It is dangerous to drive tired like some are describing (running redlights because you're basically sleeping at the wheel??? Are you freaking kidding!?)



How many times will an employer tolerate you placing yourself out of service citing fatigue before they get rid of you? Agencies with high call volume have no business running shifts in excess of 16 hours. There should be a law regarding a unit's ratio of active time, or time out of station running calls, relocating for coverage, etc. that force the agency to reduce the shift from 24 to a 16/8 or 12/12 split if a certain threshold is reached.


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## Akulahawk (Sep 26, 2009)

I've found that staying busy helps tremendously. Physically and mentally busy. Caffeine helps to keep you from falling asleep, but it really doesn't do much for being _tired_. I've found that on those slow days where all you do is about one or two calls for the whole day, I'm actually MORE tired than if I'd run, say, 12 or 14... or more. Some of my partners didn't like that I liked being pretty busy, as they'd thought they'd had a tough day after running 8 calls on a 24... Once they got used to the tempo, they did find that staying busy helped keep them fresh. Now I'm not advocating running back-to-back calls for an entire 24 hour shift... If you're at that tempo, 12 hours should be the max...

That being said, I do nap, when I can, and I do try to sleep during the night-time, but it's always a light, barely restorative sleep. Also, sometimes it just takes time to acclimate yourself to doing 24's.


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## CPG (Sep 27, 2009)

I chew gum


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## Flight-LP (Sep 27, 2009)

46Young said:


> How many times will an employer tolerate you placing yourself out of service citing fatigue before they get rid of you?



As many times as we need to actually, its in our operational SOP's. Believe it or not, they are actually termed safety naps. 

If you are constantly fatigued on a 24 and are running ragged into the ground, then you need to be on 12 hour shifts as many agencies are starting to do.


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## Akulahawk (Sep 27, 2009)

Flight-LP said:


> As many times as we need to actually, its in our operational SOP's. Believe it or not, they are actually termed safety naps.
> 
> If you are constantly fatigued on a 24 and are running ragged into the ground, then you need to be on 12 hour shifts as many agencies are starting to do.


As I was saying above, if your operational tempo is such that you're constantly fatigued on a 24 because you've got no time for rest, you need to be doing 12's. 24's are great, as long as you're not going all-out for the full 24. That leads to unsafe conditions for you, your partner, your patient, and everyone else around you while you're driving.


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## MSDeltaFlt (Sep 27, 2009)

Chall09 said:


> Anybody know of any tricks of the trade to stay alert and awake while on the job?
> 
> Caffeine and ample rest should be obvious.
> 
> ...


 
The secret to staying awake is there's no secret.  Stay awake.  If you need caffeine, you've got a problem.  Me?  I love coffee; high octane, decaf, so long as it's coffee.  I love the flavor.  I'm kinda like Agent Gibbs.  Just having it with me is pretty much all I need.  That being said I can only come up with two reasons why you'd have a hard time staying awake.  Either you're behind on your sleep, or you're bored.  

If you're behind on your sleep, then get more sleep.  Simple enough.  It ain't rocket science.  

If you're bored, then you need to un-bore yourself.  Do whatever it takes to keep your mind occupied.  It tends to speak volumes when you have a student in the corner doing the "noodle-neck head-bob" while they're trying to learn to do what we all love to do.

Good luck.


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## VentMedic (Sep 27, 2009)

In busy EMS areas, the employers may have to look at doing 12 hour shifts. We no longer allow any of our doctors, including residents, to do 24s. We also now have hospitalists (house doctors) in nonteaching hospitals to cover for a private attending for most situations as there have been many issues with a phone order from a doctor who is barely awake at home and away from his notes. 

Errors can be costly. There have been more EMTs killed on duty by one of them falling asleep while driving than there have been by firearms. Yet some want to rush out and buy a gun rather than addressing other safety issues. Even the wrongful death pronounciation in San Antonio had the Paramedics stating it was their 23 hour on the job. Who knows if they were searching for an excuse or stating fact that they were over tired. 

Now, if you do use some type of chemical substance to stay awake such as NoDoz, it can backfire if you do have an accident as it has for many truck drivers who have been drug tested. Some of the other "PEP" pills ir even Speed can also show up as questionable substances as well as having consequences to one's health. Cocaine used to also be used especially in the 80s and that also is not advised even if you believe your agency will not drug test.

There have been too many in EMS that have started using substances to stay awake and have ruined their health and careers.


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## MrBrown (Sep 27, 2009)

We have strict limits on our driving hours (part union contract and part legislative); if you are worried you can't say awake you need to talk to somebody about that.

If you are out all night partying and pissing it up then rolling up to work with a couple cups of coffee and some Lynx spray to cover up the odour of vomit and bar fights then you should also be looking at your lifestyle.

Do you eat breakfast? Like PROPER breakfast with fruit and cereal n' stuff
What is your sleep pattern like? Is it regular?
What is your diet like?


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## Sasha (Sep 27, 2009)

46Young said:


> How many times will an employer tolerate you placing yourself out of service citing fatigue before they get rid of you?



I don't care how many times your agency will tolerate that. If you can't show up to work well rested, then don't show up. By driving tired even with a ton of caffeine or other stimulants in your system you are putting your partner and your patients in danger as well as everyone else on the road. What job is worth that risk? If your shifts are too busy for you to handle, find another job.

I have called a supervisor and gotten my partner taken off my truck because they showed up too tired or too hung over or whatever to work. I've got no shame in it. I would hope if I ever showed up to work like that, my partners would do the same. To me, in a roundabout way that is part of scene safety.


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## WolfmanHarris (Sep 27, 2009)

Step one starts at home. I have made it very clear to my fiance that when I'm on nights, 11am to me, is like 3am to her. She wouldn't like me waking her up at 3am, even if I prefaced it with a "I'm really sorry but..." and neither do I. So she leaves me be until my alarm goes off.

Good sleep hygiene is key. Some pointers I learned in Psych:
1) Darken your sleep space.
2) Don't work, eat, watch tv, etc. in bed. Try to devote this space to sleep as much as possible. If reading helps you sleep, you may actually be better doing it in another room and then going to bed when drowsy.
3) Watch your pre-bed activities to ensure you're not overstimulated before sleep.
4) Get a GOOD bed. I dropped over a thousand on one three years back. Best purchase I've made in years.

Even when I'm working out of a quiet base where I can usually expect a full night sleep (thank-you North District), I get a minimum 4 hours before work. I'd rather be sitting up all night at the base reading or posting on these forums, then non-functional at a call.

You may have tonnes of responsibilities at home, but your first responsibility is to come home safe in the morning. Filter your choices through that first.


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## EMS49393 (Sep 27, 2009)

There is an agency, that shall remain nameless in the southern part of the country that has employees working anywhere from 12 to 72 hours at a time without a break.  My first year with them, I had to work all the holidays.  It was already hard enough on me at 30 years old to stay awake for 24 hours at a time however with the holiday schedule, I was given a 48 hour shift Thanksgiving, Christmas, and New Years.  Thanks to my husband for help, and a kidney stone, I never actually worked a full 48 any of the time.  I went PRN with them shortly after and went to work in a hospital.

My point is, that there are agencies that could care less how tired you are.  If you want a job, you better work, stay awake, and shut up.  They want bodies, not safety.  

I fear driving when I'm tired, but I really fear killing a patient because I'm too tired to treat them appropriately.  I can't focus on an assessment, and formulate a treatment modality when I'm dead on my feet.  It's not fair to my patient, and it's not fair to myself.

So my tips are sleep, work no more than 16 hours and preferably no more than 12 hour shifts, eat well, drink water, stay away from stimulants, and take care of yourself because you're irreplaceable.


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## 46Young (Sep 27, 2009)

Flight-LP said:


> As many times as we need to actually, its in our operational SOP's. Believe it or not, they are actually termed safety naps.
> 
> If you are constantly fatigued on a 24 and are running ragged into the ground, then you need to be on 12 hour shifts as many agencies are starting to do.



It must be a flight thing (not bashing it, that's a great provision). Most agencies have no such provisions, and have plenty of warm bodies with a pulse and a patch ready to step in when someone gives resistance. 

Charleston County EMS runs a few busy 24 hour rigs, and regularly screws their crew chiefs with an extra 12-24 hours added on. Those working on 12 hour rigs (their busiest) are subject to being mandated to work up to 36 consecutive hours. that place is a ticking time bomb, IMO. 

I'd love to blow the whistle on that place if I could, but the "lifers" there are real suck up backstabbing company people. Let things stay the way they are, and let them be miserable.


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## 46Young (Sep 27, 2009)

Sasha said:


> I don't care how many times your agency will tolerate that. If you can't show up to work well rested, then don't show up. By driving tired even with a ton of caffeine or other stimulants in your system you are putting your partner and your patients in danger as well as everyone else on the road. What job is worth that risk? If your shifts are too busy for you to handle, find another job.
> 
> I have called a supervisor and gotten my partner taken off my truck because they showed up too tired or too hung over or whatever to work. I've got no shame in it. I would hope if I ever showed up to work like that, my partners would do the same. To me, in a roundabout way that is part of scene safety.



Most places won't take too kindly to you taking yourself out of service for fatigue, they will brand you a problem child and will look to start a paper trail to facilitate your resignation/dismissal. They can also cite you for "refusing a call". Your strategy for getting your partner off of the rig who isn't fit for duty is commendable.

At our station naps are encouraged provided all of our chores and drills are completed. One night our Tower driver was crispy and said that he was too tired to drive, we put him in the bucket, and the Lt drove the call. No big deal. We're good like that. We can always go home "sick", and no one will argue with it. We jokingly call it soft leave.


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## Seaglass (Sep 27, 2009)

My station is great for sleep. They frown on 24's because they're worried about patient care errors. So most of us are on 12's. However, certain employees are allowed 24's because they commute from pretty far away. It means that our crew roster can get a bit confusing, but it seems to work well enough. Meanwhile, we usually establish who's up to doing what kind of work at the beginning of the shift. It's also OK to occasionally trade shifts at short notice if you're tired and can find someone to cover. Sleeping between calls is encouraged, and there's always coffee and leftovers around. 

I also chew gum and keep candy in a pocket. I don't do well on caffeine, so no coffee for me. Powernaps and physical exercise are also helpful.


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## medicstudent101 (Mar 10, 2011)

Linuss said:


> Tabasco sauce in the eyes.



Win.


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## samiam (Mar 10, 2011)

Give yourself an Fast1 sternal IO and toss in a little epi for good measure h34r:


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## EMSDude54343 (Mar 10, 2011)

i try to walk around for at least 5-10 min at a time, seems to help some. try to find something you like to do that takes time and concentration, like reading, or if you have computer access, surfing forums like this


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## FrostbiteMedic (Mar 11, 2011)

Now, from personal experience (having worked a company that liked to send us on long IFT's) if you have a long IFT/transport/whatever is making you tired, and neither you nor your partner is particularly chipper....cold water poured from a sport bottle down the back of the shirt is a sure fire way to stay awake....but make sure it is COLD...talking about 35 degree water here...


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## calebsheltonmed23 (Mar 11, 2011)

I take power naps like a few others have said.  If I can fall asleep for 10-40 minutes, I can be awake for another 4 hours.  And for some reason, when I'm tired and I keep at it by not going to sleep, I won't be sleepy until I lay down.  I stayed up for 42 hours about a month ago.  I was still wanting to work, but the sup. said GO HOME!  Caffeine just does not work for me.  I hate coffee anyways.  And you can always let your partner drive to the scene!


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## emt seeking first job (Mar 11, 2011)

EMSLaw said:


> I've heard that an old trucker trick is to drink a cup of coffee, then take a nap.  The caffine takes 30 mins to begin working, so by napping during that time, you get the best of both.
> 
> As you can tell by the "I've heard....", I have no evidence to support this, so take it for what it's worth.



I will second that. I have done it.

Your body needs to sleep.


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## emt seeking first job (Mar 11, 2011)

Sit still or upright in a chair, let your mind drift, you can get used to sleeping sitting up.


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## TransportJockey (Mar 11, 2011)

medicstudent101 said:


> Win.



Seriously? You bumped an almost 2 year old thread just to post that?


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## EMSrush (Mar 11, 2011)

Stabbing yourself in the leg works wonders.


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## rescue_356 (Mar 11, 2011)

*re:*

Ok so I really don't have a lot of problems staying awake on the ambulance but at my regualar job I sit in a chair for 12 hours and watch cardiac rhythms . At times I get extremely tired and have found that isometrics help keep me alive as well as eating an apple or some other fruit . Caffiene helps but only for alittle bit and I usual feel worse when it wears off so I hope this helps


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## Rubles (Mar 17, 2011)

In a documentary I saw, they showed that if you've had a few sleepless nights, you are more prone to making errors while driving if you're also high on caffeine.


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## Chief Complaint (Mar 17, 2011)

I am prescribed Nuvigil for my ADD.  Its also used to treat narcolepsy, and is given to Air Force pilots who fly long missions, so one of the side effects is increased alertness (read: difficulty sleeping).  

Relying on medications to stay awake isnt usually something id vouch for, but its gotten me through quite a few long shifts.


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## exodus (Mar 17, 2011)

medicstudent101 said:


> Win.


Really man?


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## lightsandsirens5 (Mar 17, 2011)

Rubles said:


> In a documentary I saw, they showed that if you've had a few sleepless nights, you are more prone to making errors while driving if you're also high on caffeine.


Yea....caffeine will keep you awake, but not alert. Your body is still just as tired, it just cant fall asleep cause it is loaded with drugs. (So to speak)


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## Bullets (Mar 17, 2011)

Epipen to the leg WOWZAS youll be flying high

also, windows open in the cab, the cold air hitting your face will keep you up a bit.


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## MEDIC802 (Mar 18, 2011)

hot sauce on the ball sack works wonders, I think I have done it to much though I can now pee after eating 50 hot wings (without washing may hands first) with no problem.


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