Tewari Anurag, Soliz Jose, Billota Federico, Garg Shuchita, Singh Harsimran
Department of Anesthesiology, Dayanand Medical College & Hospital, Ludhiana, India.
Indian J Anaesth. 2011 Jan;55(1):12-7. doi: 10.4103/0019-5049.76572.
The provision of anaesthesia requires a high level of knowledge, sound judgement, fast and accurate responses to clinical situations, and the capacity for extended periods of vigilance. With changing expectations and arising medico-legal issues, anaesthesiologists are working round the clock to provide efficient and timely health care services, but little is thought whether the "sleep provider" is having adequate sleep. Decreased performance of motor and cognitive functions in a fatigued anaesthesiologist may result in impaired judgement, late and inadequate responses to clinical changes, poor communication and inadequate record keeping, all of which affect the patient safety, showing without doubt the association of sleep debt to the adverse events and critical incidents. Perhaps it is time that these issues be promptly addressed to prevent the silent perpetuation of a problem that is pertinent to our health and our profession. We endeavour to focus on the evidence that links patient safety to fatigue and sleepiness of health care workers and specifically on anaesthesiologists. The implications of sleep debt are deep on patient safety and strategies to prevent this are the need of the hour.
麻醉的实施需要高水平的知识、合理的判断力、对临床情况快速准确的反应以及长时间保持警惕的能力。随着期望的变化和医疗法律问题的出现,麻醉医生夜以继日地工作以提供高效及时的医疗服务,但却很少有人思考“睡眠提供者”自身是否有足够的睡眠。疲劳的麻醉医生运动和认知功能下降可能导致判断力受损、对临床变化反应迟缓且不充分、沟通不良以及记录不完整,所有这些都会影响患者安全,这无疑表明睡眠债与不良事件和严重事故之间存在关联。或许是时候迅速解决这些问题,以防止这个与我们的健康和职业相关的问题悄然持续存在。我们致力于关注将患者安全与医护人员疲劳和困倦联系起来的证据,特别是麻醉医生的相关证据。睡眠债对患者安全的影响深远,当下需要采取预防这种情况的策略。