Monday, July 26, 2010

Work Hour Reform Ctd.

More from the work hour reform beat (via Health Science Blog):
The researchers reviewed 2,908 laparoscopic cholecystectomies, in which the gall bladder is surgically removed through a small incision in the abdomen, and 1,726 appendectomies to remove patients’ appendixes that were performed at Harbor-UCLA Medical Center from July 2003 to March 2009. These are the two most common operations performed by residents, and the two surgical procedures are often performed at night when residents are more likely to have worked a long shift.

The researchers compared outcomes in these two operations when they were performed during the day by surgical residents who had worked less than 16 hours and at night by surgical residents who had worked 16 or more hours. The researchers concluded that “appendectomy and cholecystectomy operations performed at night by less rested and possibly sleep-deprived residents have similar good outcomes compared with those performed during the regular work day.”

So are you telling me that surgeons do not, in fact, require nappy time if they have been awake for 16 hours prior to performing a cholecystectomy? Really? Who knew? I can't believe it. What about the cookies and milk? Has anyone done a RCT studying the effects of a bellyful of cookies and ice cold milk on a surgeon's competence? Why hasn't the Institute of Medicine investigated this? And don't be trying to pass off a Nilla Wafer as a cookie.


Anonymous said...

Surgical outcomes are not what people are worried about with sleep deprivation. All that muscle memory stuff is the last to go. It's making sure that heparin order got written, making sure Mr. Jones got his morphine, making sure someone checked Ms. Johnson's pulses with a doppler

Anonymous said...

thats what the PA is for.

Anonymous said...

I share your amazement that there is no difference between surgery at night and in the daytime. I recently posted something about the proposed ACGME work hour rules on my blog if yoou ar interested.