Fatigue Assessment Tool

Select Name:

Have I had less than 5 hours sleep in the past 24 hours?

Have I had less than 12 hours sleep in the past 48 hours?

Was the quality of my sleep less than adequate?

- Did you have a problem falling or staying asleep?
- Did you wake up feeling unrefreshed or groggy?

By the time my shift ends today, will I have been awake for 17 consecutive hours or more?

Start calculating how long you've been awake based on when you woke up. If you had a nap of at least 2 hours or more, calculate from after the nap.

Have I exhibited 3 or more of these symptoms in the past 15 minutes?

- Yawning and lack of energy
- Heavy limbs
- Slowed movements or reactions
- Poor hand-eye coordination
- Difficulty concentrating
- Difficulty remembering tasks
- Forgetting procedures
- Quieter or withdrawn than usual
- Rubbing eyes or blurred vision
- Slurred or garbled speech
- Failing to communicate important information
- Failing to anticipate events or notice hazards
- Increased stress, anxiety, or irritability
- Impatience or decreased tolerance

Have I exhibited 1 or more of these symptoms?

- Heavy or drooping eyelids
- Head dropping or bobbing
- Drifting off or microsleeps
- Poor decision making
- Increase in risk taking behaviour
- Making errors
- Impaired judgment or problem-solving ability
- Ignoring procedures
- Uncontrolled temper or aggression
- Feeling overwhelmed