A tactical physician writes on the risks posed by officer fatigue

From the Calibre Press Street Survival Newsline

Capt. George Stasko with the San Fransisco Police Department was killed when his car left the road and struck a tree. When the crash occurred, Stasko was on his way home in the early morning hours of Jan. 16 after working a full shift, then assisting at the scene of a bank robbery during which two officers and one civilian were shot.

The drive home for Stasko was a long one -- about 60 miles. After working a long, stress-filled day, it was a drive that may have proven to be too much for his tired body to handle. Although the exact reason Stasko's car left the road has not yet been determined, it is safe to assume fatigue may have played a role in the crash.

After hearing of Stasko's death, Dr. Kevin Gerold, the assistant medical director and tactical physician for the Maryland State Police, believed it was time to bring to light a little-recognized enemy that could threaten the safety of any officer, particularly officers who have just been involved in a long-term, high-stress tactical operation. That enemy is fatigue.

Street Survival Newsline member Sgt. Mark Gibbons with the Maryland State Police asked that we share an article Dr. Gerold wrote after he was notified of Stasko's death with other Newsline members. Mark hopes, as does Calibre Press, that the doctor's article may help prevent fatigue-related injuries or deaths.

Here is what Dr. Gerold wrote:

Fatigue is an ever present danger during law enforcement tactical operations. Call-outs occur with little or no warning and continue for unpredictable periods of time. Officers responding to tactical situations do so in varying states of rest. It is well established that increased numbers of accidents occur when people are tired or sleepy. High-vigilance tasks such as driving a motor vehicle or performing a dynamic entry are the types highly associated with fatigue-related injury.

The death of Capt. Stasko, a member of the San Fransisco Police Department SWAT team, exemplifies what may be the most dangerous time for fatigue related accidents -- the drive home. Following the successful completion of a mission, there is a sense of achievement. Officers are pumped up, and there is an adrenaline rush. This, coupled with interactions with team members and the often constant stimulus of the event, help keep tactical officers alert.

Once the team demobilizes and officers begin their journey home, that environment changes. Officers may, for the first time, become aware of the wear and tear exacted by the operation. The patrol or personal vehicle is quiet and comfortable, far different from the surroundings of the recent tactical operation. It is here that an officer may first recognize that he is fatigued. Judgment of fatigued officers may be clouded by a strong desire to get home for needed rest. Depending on the degree of fatigue and the duration of the drive, fatigue may prevent an officer from arriving at his destination.

Preventing fatigue

Humans require 7.5 to 8.5 hours of sleep per night. Maintaining performance levels during extended operations can be achieved by most individuals if they obtain 4.5 to 5.5 hours of sleep per night. Maintaining performance levels during extended operations lasting several days requires operators to obtain at least 3 to 4 hours of undisturbed sleep per day coupled with occasional naps as time permits.

Naps are the most effective method of maintaining operator performance during continuous operations. The longer the nap, the better; but effective naps should last about 20 minutes. Incident commanders should recognize the importance of napping and encourage teams (including the commander) to take 20-minute naps when the tempo of an operation permits. During sustained operations, napping is equal in importance to other critical aspects of a mission.

Recognizing sleepiness

Though officers will become aware of when they are sleepy and in danger of falling asleep, it is not possible for them to predict when sleep will actually occur. Drivers fighting the desire to sleep who experience falling asleep for 1 to 2 seconds (called microsleep) often fall asleep again within 30 minutes of the microsleep episode. Stopping the car to get out and exercise does not help. Signs of sleepiness include tunnel or fixed vision, eyes straining, eyes wanting to close, an inability to focus, head nodding and persistent yawning. Additional signs that signal a loss of vigilance and the possibility that falling asleep is imminent include wandering or dreamlike thoughts, microsleeps and visually fixating on the taillights of the car ahead.

Preventing fatigue-related injury

Tactical medical officers should incorporate a sleep plan as part of the operation's medical threat assessment. This plan should include the expected duration of the incident and the state of rest of individual operators, and it should project when naps and sleep might occur during the operation. If manpower and the operational tempo permit, tactical operators should have the opportunity to rest when they become sleepy or sense a loss of the ability to remain vigilant. Rotation of officers assigned to critical tasks will also help maintain vigilance, reduce fatigue and contribute to overall mission success. Well-rested and alert operators are the ones who will perform at their best when the needs of the mission require them to do so.

Following the conclusion of an operation, operators who experience sleepiness while driving should let someone else drive or pull off the road and take a nap. If a microsleep episode occurs while driving, the driver must recognize that they are at high risk to fall asleep behind the wheel and must pull over and nap a soon as possible. Rolling down the window, lowering the temperature in the car or turning up the radio will not help. Such fatigue can only be overcome by napping.

Sleep researchers have shown that tired people placed in a quiet place for 7 minutes will usually fall asleep, even when resisting the urge to sleep. Commanders or medical personnel can use this finding during demobilization to objectively identify operators who are too tired to safely drive and who may be unaware of their own fatigue. Implementing this tool requires only that operators lie down somewhere relatively quiet for 10 minutes prior to departing an operation. If the operator falls asleep, he is allowed to sleep for at least 30 minutes. If he remains awake at the end of 10 minutes, he is free to depart. A call-back/accountability system will further ensure that tactical operators arrive at their destinations safely.

We do not propose that fatigue contributed to the death of Capt. Stasko, but circumstances suggest this may have been a factor. Fatigue is an ever-present danger inherent in all emergency operations and may have contributed to this tragic accident. We believe that this event provides an opportunity to review the significance of fatigue in tactical operations and provide guides to minimize its effects on operator safety and performance.

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