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Surgeons May Still Be Too Fatigued, Despite New Regulations

A study of orthopedic surgical residents in two Boston hospitals analyzed the impact fatigue had on performance, as well as the frequency with which new surgeons worked while tired. The study participants averaged 5.3 hours of sleep per day. When the results of the residents were compared to a group of well-rested residents, it was shown that the sleep-deprived group was operating at 70 percent mental effectiveness. The researchers calculated that 70 percent effectiveness equated to a 22 percent greater chance of committing a medical error than an alert and properly rested physician.

During the course of the study, which gathered data from 2010 and a large portion of 2011, the graduate medical education body passed rules that limited the work hours of new surgeons. Those rules impacted the hours that the study participants were allowed to be on duty. The rule changes did not have the effect of eliminating fatigue among the residents. The lead author of the research and his colleagues focused on trying to determine at what point during a resident's waking hours he or she was most affected by fatigue.

The researchers compared the 70 percent mental effectiveness figure to a blood alcohol level of 0.08. They concluded that a fatigued resident was as impaired as a person who was legally drunk. The frequency of fatigue was worse among night shift workers.

The lead author of the study pointed out that no data was gathered regarding actual medical errors made by the residents. The percentage increases in medical error were predictions based on prior evidence of the effect of fatigue.

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

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