We have and continue to fail those with mental health and social issues. The emergency response system as it is designed was never designed to deal with the complexities of the underlying psychological trauma and pain that leads to the varied behaviours which result in the application of force or instigating a revolving door in the emergency department or criminal justice system. It’s no wonder these problems are escalating. We are making every issue a nail and approaching it with a hammer.

Fatigue is a complex phenomenon that has effects on physical characteristics, cognition, behaviours, and physical and mental health. Paramedicine crosses the boundaries of many high-risk industries, namely medicine, transport and aviation. The effects of fatigue on paramedics thus need to be explored and considered in order to begin to identify appropriate interventions and management strategies.