Amann Ulrike, Holmes Alex, Caldwell John, Hilditch Cassie
Rega/Swiss-Air Ambulance, Rega Center, Zurich Airport, Zurich, Switzerland.
Aviat Space Environ Med. 2014 Sep;85(9):954-9. doi: 10.3357/ASEM.3986.2014.
Airplane emergency medical services (AEMS) operators use fixed-wing airplanes to undertake rapid response, round-the-clock medical transport missions. This paper explores the structure of long-range, multileg AEMS missions and the sleep and sleepiness of the pilots who work them.
During nine long-range AEMS missions, pilots kept a sleep and sleepiness logbook and wore a wrist activity monitor to evaluate the timing of sleep/wake.
Missions had a mean duration of 20 h 00 min ± 2 h 39 min, involved two to four flight legs, and were crewed by three or four pilots who rotated between operating and sleeping in curtained-off bunks. The pilots obtained a mean of 15 h 26 min ± 4 h 51 min and 7 h 54 min ± 1 h 33 min of sleep in the 48 h and 24 h prior to checking in for duty, respectively. During missions, a mean of 3 h 33 min ± 1 h 46 min of sleep was taken, usually across two in-flight sleep periods. Karolinska Sleepiness Scores (KSS) at top of climb and top of descent were typically less than 5 ('neither alert nor sleepy'). A small number of individual higher KSS scores were recorded on the longest missions and on flights between 02:00 and 06:00.
These findings suggest that despite the long duration, timing, and multileg nature of AEMS missions, it is possible via careful design and management to operate these missions with appropriate levels of pilot alertness.
飞机紧急医疗服务（AEMS）运营商使用固定翼飞机执行快速响应、全天候的医疗运输任务。本文探讨了远程、多航段AEMS任务的结构以及执行这些任务的飞行员的睡眠和困倦情况。
在九次远程AEMS任务中，飞行员记录睡眠和困倦日志，并佩戴手腕活动监测器以评估睡眠/觉醒时间。
任务平均持续时间为20小时00分钟±2小时39分钟，涉及两到四个航段，由三或四名飞行员组成机组，他们在操作和在带帘子的床铺睡觉之间轮流。在报到值班前的48小时和24小时内，飞行员平均睡眠时间分别为15小时26分钟±4小时51分钟和7小时54分钟±1小时33分钟。在任务期间，平均睡眠时间为3小时33分钟±1小时46分钟，通常是在两个飞行中的睡眠时段。在爬升至最高点和下降至最低点时的卡罗林斯卡嗜睡评分（KSS）通常小于5（“既不警觉也不困倦”）。在最长的任务以及02:00至06:00之间的航班上记录到少数个体的KSS评分较高。
这些发现表明，尽管AEMS任务持续时间长、时间安排特殊且具有多航段性质，但通过精心设计和管理，有可能在飞行员保持适当警觉水平的情况下执行这些任务。
