SACRAMENTO MEDICAL MALPRACTICE LAWYER | CALIFORNIA MEDICAL MALPRACTICE ATTORNEY

2006-01-11
Naps may not Help Sleep-Deprived Doctors

A new sleep study shows that doctors and medical students who are woken up from their naps or sleep may be in a worse state shortly after waking up than if they hadn’t slept at all. The time between waking up and fully waking up has been termed “sleep inertia” and this time period may impair people even more than significant sleep deprivation.

The study is significant because people have often thought that even taking short naps could help ease the grogginess and incoordination of professionals and students working in high stress environments, such as the medical or even firefighter or law enforcement fields. The periods of sleep inertia may last several minutes or even longer, says the study’s director, Kenneth P. Wright Jr. Ph.D., of the Sleep and Chronobiology Lab at the University of Colorado.

The study’s findings suggest that sleep inertia could lead to more accidents and potentially problematic medical mistakes, especially among doctors and residents who are woken up and must perform important functions immediately. The study was reported on in a research letter in the January 11, 2006 issue of The Journal of the American Medical Association.

The study followed eight men and one woman, all free of any medications or drugs, including caffeine, nicotine, and alcohol. The first six nights the subjects were allowed about eight hours of uninterrupted sleep. On the sixth night the subjects were wakened and given a series of cognitive tests over the following 26 hours.

The study found that the scores of the subjects were uniformly awful upon awakening and showed some significant improvement after twenty minutes.

The study’s findings shed more light on the problems in high stress and sleep-deprived occupations, and on naps and rhythms of sleep patterns. The findings are likely to create new studies and spawn further research into the area.

2005-11-18
2004 C-Sections the Highest Ever Recorded in US

Both the number of premature births and the number of Caesarean deliveries are the highest they have ever been in the US, according to government figures revealed this past Tuesday.

The rate of C-sections rose to 29.1 percent of all US births in 2004, an increase of over 40 percent more since 1996. Over 500,000 babies were born prematurely last year as well, the highest ever recorded. At the same time maternal and infant health rates are not improving, prompting many to proclaim a state of emergency.

The results of the data are staggering to many in the government. Doctors and medical officials point to the concern among medical practitioners over the possibilities of medical malpractice lawsuits causing the increased C-section deliveries. They report that although most of the C-sections were unnecessary, they were done to prevent any problems stemming from natural birth methods.

C-sections are also widely performed because pregnant women typically see them as less problematic and less painful than natural births.

Low birth weights and premature births have also been on the rise. Since 1990 low birth weights have risen by 16 percent. Reasons for the premature and low birth weight deliveries are not that clear but many doctors suggest that the recent increase of obesity in the US may have a part to play. Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine suggests that the timely delivery of prenatal care was a result of racial discrimination. Many hospitals that have the increased rate are in areas with larger ethnic minority populations.

Dr. Katz also points to the increase of C-section surgery, which he finds troubling, because there hasn’t been a parallel increase in women’s and infant’s health that corresponds to the number of C-sections.

2005-09-07
Study shows long medical shifts could be as dangerous as drinking

A study appearing in The Journal of the American Medical Association reports long hours and frequent overnight work shifts may have the same effect on new doctors as a few cocktails.

Articles continue to question whether rigorous training involving long work shifts prepare new doctors should an extreme emergency occur or if the practice itself puts patients at risk.

The small study of 34 pediatrics residents around the ages of 28 years old were given tests after a 44-hour work week, or a “light call,” and after a 90-hour work week with frequent overnight shifts, or a “heavy call.” The test involving driving simulation and reaction time was given four times.

Some doctors were also given a few alcoholic drinks after finishing a light call schedule as well as some on the heavy call schedule. Other doctors received no drinks and some of the heavy call schedule was given drinks with no alcohol, though they were not aware the drinks were nonalcoholic.

The last component of the test involved sleep time. Doctors on the heavy call schedule got just three hours of sleep, and doctors on the lighter schedule got more than twice as much sleep, about 6.5 hours. Devices checked sleep and activity around the clock.

The main finding revealed test performance was as bad after a heavy work schedule as after drinking alcohol on a shorter shift. Reaction times in light call with alcohol, heavy call and heavy call with placebo were 7% to 10%. There was no difference between light call with alcohol and heavy call with placebo.

The driving simulation tests showed speed variability was 29% greater during heavy call with placebo than light call with alcohol. Speed variability was also 34% to 75% higher in light call with alcohol, heavy call with placebo and heavy call when compared with light call.

Although researchers did not directly test medical skills, the study's findings, according to the researchers, support limiting extreme hours for new doctors. However, the researchers' conclusions were not supported by all experts believing restricting working hours could have overall greater risks in other aspects, such as limited health care access.