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Study: Lack of sleep could cause errors among surgical students

Imagine going to the hospital for an operation and learning just before the procedure that your surgeon is legally drunk. That would certainly be grounds for a medical malpractice lawsuit, not to mention the surgeon's dismissal from his job. But a new study has found that many surgical students are operating under an equivalent impairment: sleep deprivation.

The study followed orthopedic surgical residents at two East Coast hospitals. The researchers found that the residents were averaging 5½ hours of sleep per night, and that they were so fatigued during their waking hours that one-fourth of the time, they suffered impairment on the same level of being legally drunk.

One of the researchers' goals was also to determine exactly when surgical residents were most fatigued. By doing so, hospitals could set up interventions or schedules that would prevent medical errors. The study first interviewed residents about their sleep and exercise habits, as well as whether they used alcohol, sedatives or stimulants. Participating residents also wore "actigraphy" wristwatches that recorded their movements, thereby gauging their levels of activity.

The results were somewhat frightening: The amount of sleep residents got ranged from 2.8 hours to 7.8 hours a day. Based on their activity levels, the surgical students were functioning at about 70 percent of their mental effectiveness during 27 percent of the time they were awake --the rough equivalent to having a .08 blood alcohol level. The researchers also determined the residents had a 22 percent greater risk of causing a medical error than doctors who were alert and well-rested.

Night-shift doctors, who slept an average of 5.1 hours a day and functioned at less than 70 percent of their mental effectiveness 32 percent of the time, fared worse than day-shift workers. Those residents got an average of 5.7 hours of shuteye and functioned at or below 70 percent effectiveness only 17 percent of the time. They had a projected 19 percent increase in their risk of a surgical error, compared to the night-shifters, who had a 24 percent increased risk.

The lead author on the study is quick to point out that its findings are somewhat limited, and that more research should be done so hospitals can develop ways to prevent dangerous medical errors. But the research should open patients' and doctors' eyes to the dangers of sleep deprivation and the potential costs to health and safety.

Source: Fox News, "Tired surgical residents may up error risk, study suggests," Reuters, May 22, 2012

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