At what point do the brain farts set in?

[MMiz]

My usual schedule in EMS would include the weekend midnight shifts. I think we all realize that after a certain time, or hours without sleep, our brains don't function as well as they do on a good nights sleep.

One of my favorite TV series, Hopkins 24/7, profiled a young doctor who left the field partly because of the crazy 36 hour shift requirements. She argued that after 12 she was good, 24 and it was getting pretty bad, and she didn't remember the last six. JEMS even did an article on this a few issues back.

At what point does your brain just not work as well as you'd like to? Do you think this leads to mistakes and conflicts with a high standard of patient care?

I don't believe my lack of sleep ever impacted my patient care, but I wasn't clearly as sharp as I would have been early in the morning after good sleep.

 

[gradygirl]

I've read, though of course I can't remember for the life of me where, that a person who has been awake for 24 hours or more has the competence level of a legally drunk person. Kinda makes me wonder about the abilities of all of those residents on call during long shifts in hospitals...

 

[Wingnut]

I've read, though of course I can't remember for the life of me where, that a person who has been awake for 24 hours or more has the competence level of a legally drunk person. Kinda makes me wonder about the abilities of all of those residents on call during long shifts in hospitals...

I've read that too..and wondered the same.

I can't answer your question Mmiz because my brain farts are a constant problem. But I can tell you that if I work a busy station around 18 hrs I get a "fuzzy" feeling in my head and know maybe I should let my partner drive for a while.

 

[MedicPrincess]

For me, on my truck, either myself or my partner are in a state of brain fart most of the time. Its a good thing theres 2 of us, using both of our minds we are able to accomplish most things.

Seriously though, its hard to say at what point. For me it really depends on whats gone on. Its not really a number of hours, but at about call number 13 or 14 for the day I can begin to drag.

Or if we have been up all day and finally get caught up on reports and get to lay down at 0100 only to have to get back up at 0120, thats when I am a bit sluggish (for me anyway).

 

[aline]

I'm usually done after 12-14 hours of constant running, 18 hours on a slow day. My last shift (24/hrs) I got a 45 minute nap at 05:15. End of shift is 0600. We were back to back all day...with the last two Pt's being serious head injuries. I was bagged. I prayed we didn't get a late call. I don't think I would have been competent on anything more than a hangnail. (BTW, this is not uncommon for my district.)
I know most people would have stayed awake but I had to take a nap so I would be safe to drive home.

There are many studies out about how lack of sleep causes physical, emotional, reactions, and memory.

Take care and stay safe.

 

[DT4EMS]

There has been recent news coverage of a similar topic. I also received an email regarding the driving while tired study being conducted by a national DWI detection group.

Here is an interesting read on the subject.

http://everything2.com/index.pl?node_id=1451053

 

[Jon]

For me, it isn't always hours on shift... it is often hours awake (on/off shift), and even that is relative to my sleep status..... When I worked 3 on/ 4 off overnights, I went in short of sleep, then had 5 hours sleep 2 days in a row, then stayed up "late" to be on a "normal" schedule for my days off. I often fell asleep on the train home on my last day and missed my stop.


On a related note - I know that when I sleep at the station, on the "second call" crew... If "first call" had a couple of runs and we didn't go anywhere - I often don't remeber hearing any tones overnight... I assume that I wake up, listen, and go right back to sleep.

 

[gradygirl]

It truly amazes me how important sleep is to one's health/performance. During this past semester, my sleep schedule got really badly thrown off, especially with some 40+ hour days. Most of my medic friends work nights, so they would call me in the middle of the night, regardless of whether or not I was awake, though I usually was. After a few months of no more than about 4 hours of sleep a night, I started forgetting things, being utterly exhausted ALL the time, barely able to do my school work, much less anything else. I actually started to get sick, one night having over a 103 degree fever and being really susceptible to anyone else's germs when I'm usually not. The worst was when I had to get up at 8:30 to get ready for a 10:00 class, and was literally paralyzed by the lack of sleep; I ended up sleeping until rugby practice at 4:00. The moral of this story: please get sleep, our bodies do it for a reason!